{"id":4699,"date":"2025-03-31T18:12:17","date_gmt":"2025-03-31T18:12:17","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/sulfadiazine-txt\/"},"modified":"2025-03-31T18:12:17","modified_gmt":"2025-03-31T18:12:17","slug":"sulfadiazine-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/sulfadiazine-txt\/","title":{"rendered":"sulfadiazine.txt"},"content":{"rendered":"<p><H3>  CLINICAL USE <\/H3><br \/>\nAntimicrobial agent:Toxoplasmosis in AIDS patients  (unlicensed indication)Prevention of rheumatic fever <H3> DOSE IN NORMAL RENAL FUNCTION  <\/H3>Loading dose: 2\u20134 gMaintenance dose: 2\u20136 g daily in divided doses<H3>  PHARMACOKINETICS    <\/H3><LI> Molecular weight &amp;nbsp  &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp  &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp :250.3; 272.3 (as sodium salt)<\/li>\n<li>  %Protein binding  &amp;nbsp &amp;nbsp &amp;nbsp  &amp;nbsp  &amp;nbsp  &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp :20\u201355<\/li>\n<li>  %Excreted unchanged in urine &amp;nbsp &amp;nbsp : 80 \u2013 <\/li>\n<p><LI> Volume of distribution (L\/kg) &amp;nbsp &amp;nbsp &amp;nbsp :0.29<\/li>\n<p><LI>half-life \u2013 normal\/ESRD (hrs)&amp;nbsp &amp;nbsp &amp;nbsp :17\/Prolonged<H3>  DOSE IN RENAL IMPAIRMENT <\/H3> <H4>GFR (mL\/MIN)<\/H4><LI> 20 to 50  &amp;nbsp &amp;nbsp : Dose as in normal renal function<LI> 10 to 20  &amp;nbsp &amp;nbsp : Use 50% of dose and monitor levels<LI> &lt;10 &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp : Use 25% of dose and monitor levels<H3> DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES  <\/H3><LI> CAPD  &amp;nbsp &amp;nbsp &amp;nbsp  &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp:Unknown dialysability. Dose as in GFR &lt;10 mL\/min<\/p>\n<li> HD &amp;nbsp  &amp;nbsp &amp;nbsp  &amp;nbsp &amp;nbsp  &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp :Dialysed. Dose as in GFR<LI> &lt;10 &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp : mL\/min<LI>HDF\/high flux  &amp;nbsp :Dialysed. Dose as in GFR<LI> &lt;10 &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp : mL\/min<LI>CAV\/VVHD  &amp;nbsp &amp;nbsp &amp;nbsp:Dialysed. Dose as in GFR=10\u201320 mL\/min<H3> IMPORTANT DRUG INTERACTIONS  <\/H3>Potentially hazardous interactions with other drugs\n<li>Antibacterials: increased risk of  crystalluria with methenamine\n<li>Anticoagulants: effect of coumarins  enhanced\n<li>Anti-epileptics: antifolate effect and  concentration of phenytoin increased\n<li>Antimalarials: increased risk of antifolate  effect with pyrimethamine\n<li>Antipsychotics: avoid concomitant  use with clozapine (increased risk of agranulocytosis)\n<li>Ciclosporin: reduced levels of ciclosporin;  increased risk of nephrotoxicityCytotoxics: increase risk of methotrexate  toxicity<H3> ADMINISTRATION  <\/H3><H4> Reconstition<\/H4>\u2013<H4>  Route  <\/H4>Oral  <H4>  Rate of Administration  <\/H4>\u2013<H4>Comments<\/H4>\u2013<H4>  OTHER INFORMATION  <\/H4>Penetrates into the CSF within 4 hours of  oral administration to produce therapeutic concentrations which may be more than half those in the bloodMetabolised in the liver to the acetylated  form, with elimination predominantly via the kidneysUrinary excretion of sulfadiazine and  its acetyl derivative is dependent on pH; when the urine is acidic about 30% is excreted unchanged in both fast and slow acetylators, whereas when the urine is alkaline about 75% is excreted unchanged by slow acetylatorsCrystalluria may be avoided by adequate  hydration and alkalinising the urine to a pH &gt;7.15Blood concentrations of 100\u2013150  micrograms\/mL are desirableFor treatment of toxoplasmosis, use  sulfadiazine in conjunction with pyrimethamine 25\u2013100 mg daily.<br \/>\n","protected":false},"excerpt":{"rendered":"<p>CLINICAL USE Antimicrobial agent:Toxoplasmosis in AIDS patients (unlicensed indication)Prevention of<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4699","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4699","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=4699"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4699\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4699"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4699"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4699"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}