Comparative Pharmacology
Head-to-head clinical analysis: ILOSONE SULFA versus SULFAMETHOXAZOLE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ILOSONE SULFA versus SULFAMETHOXAZOLE.
ILOSONE SULFA vs SULFAMETHOXAZOLE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Ilosone (erythromycin) is a macrolide antibiotic that inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit. Sulfa (sulfisoxazole) is a sulfonamide that inhibits dihydropteroate synthase, blocking folate synthesis. The combination provides synergistic bacteriostatic activity.
Displaces dihydropteroate synthetase from its substrate para-aminobenzoic acid (PABA), inhibiting bacterial folate synthesis. Bacteriostatic against susceptible organisms.
Each 5 mL suspension contains 250 mg erythromycin base and 600 mg sulfisoxazole; typical adult dose is 10 mL (2 tsp) every 6 hours, not to exceed 40 mL/day.
800 mg sulfamethoxazole with 160 mg trimethoprim (DS tablet) orally every 12 hours.
None Documented
None Documented
Clinical Note
moderateSulfamethoxazole + Gatifloxacin
"Sulfamethoxazole may increase the hypoglycemic activities of Gatifloxacin."
Clinical Note
moderateSulfamethoxazole + Rosoxacin
"Sulfamethoxazole may increase the hypoglycemic activities of Rosoxacin."
Clinical Note
moderateSulfamethoxazole + Trovafloxacin
"Sulfamethoxazole may increase the hypoglycemic activities of Trovafloxacin."
Clinical Note
moderateSulfamethoxazole + Nalidixic acid
Erythromycin: 1.5-2 hours; Sulfisoxazole: 4-7 hours; clinical context: dose adjustment in renal impairment (CrCl <50 mL/min) needed for sulfisoxazole
9-11 hours in adults with normal renal function. Prolonged in renal impairment: up to 20-30 hours. In neonates, 6-12 hours.
Renal: 70-80% as unchanged drug and active metabolite (sulfisoxazole); Biliary: 10-15% as metabolites; Fecal: <5%
Primarily renal; ~80-90% excreted unchanged in urine, with 15-30% as acetylated metabolite. Biliary/fecal <5%.
Category C
Category D/X
Macrolide and Sulfonamide Antibiotic
Sulfonamide Antibiotic
"Sulfamethoxazole may increase the hypoglycemic activities of Nalidixic acid."