Comparative Pharmacology
Head-to-head clinical analysis: SULFISOXAZOLE versus SULMEPRIM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: SULFISOXAZOLE versus SULMEPRIM.
SULFISOXAZOLE vs SULMEPRIM
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Sulfisoxazole is a sulfonamide antibiotic that inhibits bacterial dihydropteroate synthase, blocking the synthesis of dihydrofolic acid and ultimately inhibiting bacterial folate synthesis and DNA replication.
Sulmeprim is a combination of sulfamethoxazole, a sulfonamide, and trimethoprim, a dihydrofolate reductase inhibitor. It inhibits sequential steps in bacterial folate synthesis, leading to bactericidal activity.
1-2 g orally once, then 500 mg-1 g orally every 4-6 hours; maximum 6 g/day.
Adults: 800 mg sulfamethoxazole/160 mg trimethoprim (one double-strength tablet) orally every 12 hours for 10-14 days. For severe infections or pneumonia, intravenous dose: 15-20 mg/kg/day (based on trimethoprim component) divided every 6-8 hours.
None Documented
None Documented
Clinical Note
moderateSulfisoxazole + Gatifloxacin
"Sulfisoxazole may increase the hypoglycemic activities of Gatifloxacin."
Clinical Note
moderateSulfisoxazole + Rosoxacin
"Sulfisoxazole may increase the hypoglycemic activities of Rosoxacin."
Clinical Note
moderateSulfisoxazole + Trovafloxacin
"Sulfisoxazole may increase the hypoglycemic activities of Trovafloxacin."
Clinical Note
moderateSulfisoxazole + Nalidixic acid
Terminal elimination half-life is 5-7 hours in adults with normal renal function; prolonged to 12-20 hours in renal impairment (CrCl <30 mL/min).
Terminal elimination half-life is 10-12 hours in patients with normal renal function, allowing twice-daily dosing. In severe renal impairment (CrCl <30 mL/min), half-life extends to >20 hours, requiring dose adjustment.
Renal excretion accounts for 70-85% of elimination, predominantly as unchanged drug (30-50%) and the N4-acetyl metabolite (15-30%). Biliary/fecal excretion is minimal (<5%).
Renal excretion of unchanged drug accounts for 70% of elimination; 20% is metabolized in the liver to inactive metabolites (glucuronide conjugates) and excreted in urine; 10% is eliminated in feces via biliary excretion.
Category C
Category C
Sulfonamide Antibiotic
Sulfonamide Antibiotic
"Sulfisoxazole may increase the hypoglycemic activities of Nalidixic acid."