Pyrison

• Acute malaria (in combination with sulfonamide)
• Malaria prophylaxis
• Toxoplasmosis

Adult Dose (Oral):

• Acute malaria: 75 mg pyrimethamine + 1.5 g sulfadoxine (single dose)
• Malaria prophylaxis: 25 mg once weekly; start 1-2 days before arrival in endemic area, continue for 4-6 weeks after leaving
• Toxoplasmosis: 50-75 mg/day + 1-4 g sulfadiazine/day (1-3 weeks); then half dose for 4-5 weeks

Pediatric Dose (Oral):

• Acute malaria (7-13 years): 50 mg + 1 g sulfadoxine; (1-6 years): 25 mg + 500 mg sulfadoxine; (5-11 months): 12.5 mg + 250 mg sulfadoxine
• Malaria prophylaxis (<4 years): 6.25 mg/week; (4-10 years): 12.5 mg/week; (>10 years): 25 mg/week
• Congenital toxoplasmosis (>2 months): Loading 2 mg/kg/day for 2 days; Maintenance 1 mg/kg/day (2-6 months) then 1 mg/kg 3 times/week

Side Effects:

• Skin rash
• Macrocytic anemia (high dose)
• Leukopenia
• Thrombocytopenia
• Megaloblastic anemia
• Pancytopenia
• Abdominal pain
• Vomiting
• Atrophic glossitis
• Depression, fever, insomnia, lightheadedness
• Potentially fatal: Erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis (with sulfadoxine at large doses)

Use in Pregnancy: Unsafe during pregnancy; evidence of risk to the fetus; consult your doctor.

• Caution in renal or hepatic impairment
• Folate deficiency
• Monitor blood and platelet counts every 2 weeks with prolonged treatment and large doses
• Discontinue use if skin reactions, sore throat, or shortness of breath occurs
• Do not use during pregnancy
• Do not use during lactation