Sulfadoxine (oral)

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Hypersensitivity to sulphonamides
• Term pregnancy
• Severe renal impairment
• Severe hepatic impairment
• Megaloblastic anaemia
• Premature infants
• Infants<2 months

Cautions

• Pregnancy
• Breastfeeding
• Mild to moderate renal impairment
• Mild to moderate hepatic impairment
• Elderly

Pregnancy

• Caution
• Risk cannot be ruled out

Breastfeeding

• Caution
• It is expected to be excreted in breast milk, however, at therapeutic dose; no adverse effect in the breastfed infant is anticipated
• There is limited data and therefore an alternate drug may be preferred

Renal Impairment

• Mild to moderate: Caution; no dose adjustment recommended
• Severe: Contraindicated

Hepatic Impairment

• Mild to moderate: Caution; no dose adjustment recommended
• Severe: Contraindicated 

Elderly

• Caution; no dose adjustment recommended

Central Nervous System Disorders

• Fatigue
• Headache
• Dizziness
• Polyneuritis

Gastrointestinal Disorders

• Nausea and vomiting
• Feeling of fullness
• Diarrhoea
• Stomatitis

Hepatobiliary Disorders

• Transient increase of hepatic enzymes
• Hepatitis

Genitourinary Disorders

• Interstitial nephritis
• Flank pain 
• Haematuria 
• Oliguria 

Skin and Subcutaneous Tissue Disorders

• Rash
• Pruritus
• Urticaria
• Photosensitisation
• Hair loss
• Erythema multiforme
• Stevens-Johnson syndrome
• Toxic epidermal necrolysis
• Fixed drug eruption
• Purpura

Immune, Blood and Lymphatic System Disorders

• Hypersensitivity reactions 
• Thrombocytopenia
• Megaloblastic anaemia
• Leucopenia
• Agranulocytosis
• Fever

• Cotrimoxazole
• Sulphonylureas
• Procaine
• Benzocaine
• Tetracaine
• Zidovudine
• Aminolevulinic acid
• Plasma protein binding agents

Sulfadoxine is a long acting sulphonamide which is an analogue para-aminobenzoic acid. Sulfadoxine activity is against the blood asexual form P. falciparum in uncomplicated malaria.