Adult Dosing
Treatment of toxoplasmosis
- Start 50-75 mg pyrimethamine PO qd with sulfadoxine 1-4 g/day PO x 1-3 wks; then reduce the dose to 25-37.5 mg pyrimethamine PO qd with sulfadoxine 0.5-2 g/day PO x 4-5 wks
Treatment of acute malaria
- 50 mg PO qd x 2 days when used alone in semi-immune individuals
Notes:- Not indicated alone in the treatment of acute malaria; used with fast-acting schizonticides such as chloroquine or quinine
- Pyrimethamine 25 mg PO qd x 2 days with a sulfonamide will initiate transmission control and suppression of susceptible strains of plasmodia
Chemoprophylaxis of malaria
Pediatric Dosing
Treatment of toxoplasmosis
- Start 1 mg/kg/day divided bid x 2-4 days; then reduce dose to 0.5 mg/kg/day divided bid x 1 month
Note:
- Use the usual pediatric sulfonamide dose in conjunction with this drug
Treatment of acute malaria
Chemoprophylaxis of malaria
[Outline]
See Supplemental Patient Information
- Effective dose of pyrimethamine indicated for toxoplasmosis is 10-20 times the recommended antimalaria dose and approaches the toxic level. If signs of folate deficiency occur, reduce the dose or discontinue the drug and initiate treatment with folinic acid (leucovorin) until normal hematopoiesis is restored
- As a precaution, concomitant administration of folinic acid is advised for all patients when pyrimethamine is used for the treatment of toxoplasmosis
- Carcinogenicity has been reported in a few cases with pyrimethamine at doses used to treat toxoplasmosis
- Overdose following accidental ingestion of pyrimethamine may be fatal in infants and children; hence, it should be kept out of their reach
- Starting dose should be low for patients with convulsive disorders to avoid the risk of CNS toxicity
Cautions: Use cautiously in
- Impaired renal function
- Impaired hepatic function
- Folate deficiency
- Malabsorption syndrome
- Myelosuppression
- Alcoholism
- Pregnancy
- Elderly patients
- Concomitant use of phenytoin
Supplemental Patient Information
- Instruct patients to discontinue the drug and promptly seek medical attention on development of a skin rash, sore throat, pallor, purpura, or glossitis
- Advise women of childbearing potential against becoming pregnant during pyrimethamine treatment
- Inform patients to take this medication with meals in order to prevent vomiting and anorexia that may occur during treatment
Pregnancy Category:C
Breastfeeding: Pyrimethamine is excreted in maternal milk. No adverse reactions have been reported in breastfed infants and it is acceptable in nursing mothers. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT). This drug is compatible and considered safe with breastfeeding based upon data from AAP Policy Guidelines (available at http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/3/776 last accessed 24 June 2011). According to manufacturer's data, a decision should be made whether to discontinue nursing or to discontinue the drug considering the importance of the drug to the mother.
Pricing data from www.DrugStore.com in U.S.A.
- Daraprim 25 MG TABS [Bottle] (AMEDRA PHARMACEUTICALS)
30 mg = $269.99
90 mg = $760
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
Drug Name: Daraprim 25 MG Oral Tablet
Ingredient(s): Pyrimethamine
Imprint: DARAPRIM;A3A
Color(s): White
Shape: Round
Size (mm): 7.00
Score: 2
Inactive Ingredient(s): starch, corn / starch, potato / lactose / magnesium stearate
Drug Label Author:
GlaxoSmithKline LLC
DEA Schedule:
Non-Scheduled
