SULFADOXINE + PYRIMETHAMINE (SP)

Antimalarial specifically used for prevention of malaria in pregnancy

Dosage Forms

▼

Tablet

Sulfadoxine 500 mg and pyrimethamine 25 mg

Uses

▼
  • Intermittent preventive treatment of malaria in pregnancy (IPTp)

Dose and Duration

▼
3 tablets taken at once, 2 times during pregnancy

First dose: Between weeks 16–24

Second dose: Between weeks 28–36

Contra-indications

▼
  • Allergy to Co-trimoxazole
  • Severe kidney disease
  • Severe liver disease
  • 1ˢᵗ trimester pregnancy
  • HIV patients on Co-trimoxazole prophylaxis

Side Effects

▼
  • Stomach upset
  • Blood disorders
  • Rash
  • Sore throat, mouth ulcers
  • Cough or shortness of breath
  • Fatigue, headache

Interactions

▼
  • Folic acid (cancelled effect)
  • Co-trimoxazole (increased risk of side effects)
  • Methotrexate (increased risk of methotrexate toxicity)

Patient Instructions

▼
  • Report to health worker immediately in case of shortness of breath.

Pregnancy

▼
  • Do not use in 1ˢᵗ trimester.

Breast-feeding

▼
  • Can be used.

⚠️ Caution

▼
  • Discontinue immediately if blood disorders occur.
  • SP is no longer recommended for use as treatment for P. falciparum malaria due to resistance of parasites.
  • When IPTp is given in pregnancy, withhold folic acid for one week after taking SP, then resume with folic acid.