Comparative Pharmacology
Head-to-head clinical analysis: SULFADIAZINE versus SULFAMETHOPRIM DS.
Peer-Reviewed Evidence
Head-to-head clinical analysis: SULFADIAZINE versus SULFAMETHOPRIM DS.
SULFADIAZINE vs SULFAMETHOPRIM-DS
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Competitive inhibitor of dihydropteroate synthase, blocking the synthesis of folic acid in bacteria.
Sulfamethoprim-DS is a combination of sulfamethoxazole, a dihydropteroate synthase inhibitor, and trimethoprim, a dihydrofolate reductase inhibitor. The sequential inhibition of folate synthesis leads to bactericidal activity.
Oral: 2-4 g initially, then 1 g every 4-6 hours for mild to moderate infections; for severe infections, 4 g initially followed by 1.5 g every 4 hours. IV: Not available in IV form in the US; if using oral suspension, adjust accordingly.
Sulfamethoprim-DS (trimethoprim 160 mg-sulfamethoxazole 800 mg) orally every 12 hours for 10-14 days for uncomplicated UTI; for Pneumocystis jirovecii pneumonia: 3-5 mg/kg/day (based on TMP) orally or IV divided every 6-8 hours for 21 days.
None Documented
None Documented
Clinical Note
moderateSulfadiazine + Gatifloxacin
"Sulfadiazine may increase the hypoglycemic activities of Gatifloxacin."
Clinical Note
moderateSulfadiazine + Rosoxacin
"Sulfadiazine may increase the hypoglycemic activities of Rosoxacin."
Clinical Note
moderateSulfadiazine + Levofloxacin
"Sulfadiazine may increase the hypoglycemic activities of Levofloxacin."
Clinical Note
moderateSulfadiazine + Trovafloxacin
"Sulfadiazine may increase the hypoglycemic activities of Trovafloxacin."
Terminal elimination half-life 10-20 hours (prolonged in renal impairment; may require dose adjustment)
Terminal elimination half-life of sulfamethoxazole is 9-11 hours (prolonged to 20-50 hours in severe renal impairment). Clinically, this supports twice-daily dosing in normal renal function; dose adjustment required for CrCl <30 mL/min.
Renal excretion of unchanged drug (50-70%) and acetylated metabolites; minor biliary/fecal (<5%)
Renal excretion of unchanged drug (50-70%) and metabolites (primarily N4-acetylated form, 15-30%); biliary/fecal excretion accounts for <5%.
Category D/X
Category C
Sulfonamide Antibiotic
Sulfonamide Antibiotic