Products
Sulfadiazine is commercially available in combination with silver as silver sulfadiazine cream and gauze (Flammazine, Ialugen plus). This article refers to internal use. See also under silver sulfadiazine.
Structure and properties
Sulfadiazine (C10H10N4O2S, Mr =250.3 g/mol) exists as in the form of crystals or as a crystalline powder with white, yellowish or light pink color. It is practically insoluble in water.
Effects
Sulfadiazine (ATC J01EC02) is antiparasitic against and bacteriostatic against Nocardia. The effect is due to inhibition of folic acid synthesis.
Indications
For the treatment of toxoplasmosis in cases of impaired cell-mediated immunity in combination with pyrimethamine. Sulfadiazine may be used for nocardiosis. This is a bacterial infectious disease caused by Nocardia.
Dosage
According to the SmPC. Sulfadiazine is approved for the treatment of toxoplasmosis only in combination with pyrimethamine. Adequate fluid intake (2-3 L per day) should be maintained during therapy because the drug may crystallize in the kidney due to its poor water solubility.
Contraindications and interactions
For complete precautions, see the drug label.
Adverse effects
Occasionally, skin reactions may occur, including various rashes up to severe reactions such as Stevens-Johnson syndrome. Dizziness, headache, inflammation of peripheral nerves, gait disturbances, hallucinations, confusion, psychosis, and depression also occasionally occur. Rare side effects include blood count abnormalities up to agranulocytosis, cyanosis, hypoglycemia, folic acid deficiency, anemia, visual disturbances, nausea, vomiting, gastrointestinal distress, liver damage, renal damage and disease.
