Sulphadiazine + Sulphadimidine + Sulphapyridine

Sulphadiazine + Sulphadimidine + Sulphapyridine is a sulfonamide antibacterial combination medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

• Treatment of infections caused by sulfonamide-susceptible bacteria, when prescribed and appropriate for the licensed product.
• Use in veterinary bolus or powder products may be directed for susceptible bacterial infections in animals; follow the product label and the veterinarian’s instructions.
• Not useful for viral infections such as common cold or influenza.

No single standard adult dose can be safely stated for this combination because dosing depends on the exact product strength, indication, patient or animal weight, kidney and liver function, and local registration status. Use only the dose, route, frequency, and duration prescribed by a registered doctor or veterinarian. Drink adequate fluids during treatment unless a doctor advises otherwise, and complete the prescribed course.

• Nausea, vomiting, loss of appetite, or diarrhoea.
• Headache, dizziness, or tiredness.
• Skin rash, itching, photosensitivity, or fever.
• Crystalluria or kidney irritation, especially with dehydration.
• Rare but serious: severe allergic reactions, Stevens-Johnson syndrome/toxic epidermal necrolysis, blood disorders such as agranulocytosis or aplastic anaemia, hepatitis, and severe kidney injury.

Use with caution in people with kidney or liver disease, history of drug allergy, asthma, folate deficiency, G6PD deficiency, blood disorders, dehydration, or in elderly patients. Maintain adequate fluid intake unless restricted by a clinician. Stop the medicine and seek urgent medical help if rash, mouth ulcers, fever, jaundice, unusual bleeding, severe diarrhoea, or breathing difficulty occurs. Use Sulphadiazine + Sulphadimidine + Sulphapyridine under a registered doctor's or pharmacist's guidance; veterinary products should be used under a registered veterinarian’s guidance.

• Warfarin and other anticoagulants: increased bleeding risk may occur.
• Phenytoin: blood levels and toxicity may increase.
• Methotrexate: increased risk of bone-marrow suppression and toxicity.
• Sulfonylurea diabetes medicines: risk of low blood glucose may increase.
• Other medicines that can affect the kidneys or blood cells may increase toxicity risk.
• Methenamine and medicines that acidify urine may increase the risk of crystalluria.
• Adequate fluid intake is important unless a doctor has advised fluid restriction.

• Known allergy to sulfonamides or any component of the product.
• Previous severe skin reaction or serious blood disorder caused by sulfonamides.
• Severe liver disease or severe kidney impairment when safer alternatives or monitoring are not available.
• Infants under 2 months of age, except under specialist direction.
• Late pregnancy or breastfeeding of premature, jaundiced, ill, or G6PD-deficient infants unless a specialist decides the benefit outweighs the risk.

Sulfonamides should be used during pregnancy only if clearly needed and prescribed. They are generally avoided near delivery because of the theoretical risk of neonatal jaundice and kernicterus. Sulfonamides can pass into breast milk; breastfeeding mothers should seek medical advice, and use is usually avoided if the infant is premature, jaundiced, ill, or has G6PD deficiency.

Store in a cool, dry place away from direct sunlight, moisture, and heat. Keep the container tightly closed and out of reach of children. Do not use after the expiry date, and follow the product label for any specific storage instructions.