Prophylactic (repeated) use of Pyrimethamine + Sulphadoxine is contraindicated in patients with severe renal insufficiency, marked liver parenchymal damage or blood dyscrasias. Treatment must be immediately discontinued upon the appearance of any mucocutaneous signs or symptoms such as pruritus, erythema, rash, orogenital lesions or pharyngitis.
Sulphadoxine & Pyrimethamine at the recommended dose is well tolerated. Main side effects are given below
Skin reactions: Drug rash, pruritus and slight hair loss have been observed.
Gastro-intestinal reactions: Feeling of fullness, nausea, rarely vomiting, stomatitis.
Haematological reactions: In rare cases, leukopenia, thrombocytopenia, and megaloblastic anemia have been observed.
Other reactions: Fatigue, headache, fever, polyneuritis may occasionally occur.
Sulphadoxine & Pyrimethamine is contraindicated during pregnancy, premature and newborn infants during the first weeks of life and intolerance to sulfonamide. If pregnancy can not be excluded, possible risks should be balanced against therapeutic effect. Both Pyrimethamine and Sulphadoxine are excreted in maternal breast milk. Nursing mother should not take this preparation.
Impaired renal or hepatic function, folate deficiency, severe allergy or bronchial asthma, G6PD deficiency, pregnancy. Take with plenty of water to prevent crystalluria. Avoid excessive exposure to sun. Discontinue at the first sign of rash. Discontinue if signs of folic acid deficiency develops. Regular CBC monitoring, LFT, analysis of urine for crystalluria when admin for > 3 mth. Take with food to minimise Gi effects (e.g. anorexia and vomiting).
Anti-malarial drugs
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.