Sulfadoxine + Pyrimethamine brands and prices in Pakistan

About Sulfadoxine-pyrimethamine

Sulfadoxine-pyrimethamine (often shortened to SP) is an antimalarial medicine that combines two drugs. Sulfadoxine is a sulfonamide ("sulfa") drug. It is used in public-health programmes to protect people from malaria, rather than as a medicine for everyday illness. It is given by health workers or on a clinic's advice, and the clinic decides when it is started.

Who should not take it, or should take care

• Do not take it if you are allergic to sulfadoxine, pyrimethamine or other sulfonamide (sulfa) medicines such as co-trimoxazole (sulfamethoxazole-trimethoprim).
• Do not use it if you have ever had a blood disorder caused by pyrimethamine or sulfadoxine.
• Premature babies and very young infants should not be given it.
• People living with HIV who take co-trimoxazole as a preventive medicine should not be given SP. WHO says this for pregnancy prevention and for seasonal prevention in children.
• Pregnancy: WHO says SP prevention should be avoided in the first trimester and started as early as possible in the second trimester, then continued until delivery in the programme set by the clinic.
• Do not take extra high-dose folic acid with SP in pregnancy. WHO says it can weaken the effect of SP. Your antenatal clinic will tell you what folic acid is suitable.
• Breastfeeding: the WHO-prequalified leaflet says it can be used while breastfeeding. Ask your clinic if unsure.
• Children who are acutely ill, have confirmed malaria or are too unwell to take medicine by mouth are left out of seasonal prevention programmes. So are children who recently had SP or amodiaquine.
• The tablets contain lactose, so tell the clinic if you cannot tolerate lactose.

Medicines and drinks that can interact

• Co-trimoxazole (sulfamethoxazole-trimethoprim): increases the risk of side effects and should not be combined with SP
• Other sulfonamide antibiotics
• Other medicines that contain pyrimethamine or sulfadoxine
• High-dose folic acid, which can stop SP working as well
• Tell the clinic or pharmacist about all other medicines, including over-the-counter and herbal products.

Always tell your doctor and pharmacist about every medicine, supplement and herbal product you take.

Using it safely

• Take it only as the clinic or health worker directs. They decide when each treatment is given, and missing a visit lowers your protection.
• If you miss a dose, follow the clinic's advice. The leaflet says to take the next dose as scheduled and not to double up.
• Stop and seek help straight away if a skin rash or itching appears.
• Tell the health worker if you have ever had a reaction to a sulfa medicine.
• Keep tablets in the original blister or container, away from children, and do not use them after the expiry date.
• Do not throw unused medicine in household waste or down the drain; ask a pharmacist how to dispose of it.
• Keep using bed nets and other mosquito protection. SP lowers the risk of malaria but does not replace them.

Common questions

Why is sulfadoxine-pyrimethamine given in pregnancy?
Malaria in pregnancy can harm both mother and baby. Studies summarised by researchers at the Liverpool School of Tropical Medicine found that SP preventive treatment lowers anaemia, malaria in the mother and placenta, miscarriage and low birth weight.

Is it safe in early pregnancy?
WHO advises that this preventive treatment should not be given in the first trimester. It should start as early as possible in the second trimester.

Can I take it if I am on co-trimoxazole for HIV?
No. WHO says women and children who take co-trimoxazole as a preventive medicine should not be given SP. Ask your HIV clinic what to use instead.

Does it still work if malaria is resistant to it?
Resistance shortens the protection, but studies in areas with high resistance still show better birth weight with SP in pregnancy. Health programmes keep reviewing this, and other options are being studied.

What should I do if I get a rash?
Stop the medicine and see a health worker straight away. A rash can be the first sign of a rare but serious skin reaction.

Prepared from the sources listed by the MedInfoBase team. General information, not medical advice: it gives no doses. Your doctor or pharmacist decides the medicine and dose for you.