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Pronunciation |
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(sul
fi SOKS a zole & fen az oh
PEER i deen) |
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Generic
Available |
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Yes |
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Synonyms |
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Phenazopyridine and Sulfisoxazole |
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Pharmacological Index |
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Antibiotic, Sulfonamide Derivative; Local Anesthetic |
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Use |
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Treatment of urinary tract infections and nocardiosis |
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Pregnancy Risk
Factor |
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B/D (at term) |
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Contraindications |
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Porphyria; hypersensitivity to any sulfa drug or any component; pregnancy at
term; children <2 months of age unless indicated for the treatment of
congenital toxoplasmosis; sunscreens containing PABA |
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Adverse
Reactions |
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>10%:
Central nervous system: Fever, dizziness, headache
Dermatologic: Itching, rash, photosensitivity
Gastrointestinal: Anorexia, nausea, vomiting, diarrhea
1% to 10%:
Dermatologic: Lyell's syndrome, Stevens-Johnson syndrome
Hematologic: Granulocytopenia, leukopenia, thrombocytopenia, aplastic anemia,
hemolytic anemia
Hepatic: Hepatitis |
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Drug
Interactions |
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Decreased effect with PABA or PABA metabolites of drugs (ie, procaine,
proparacaine, tetracaine); cyclosporine levels may be decreased
Increased effect/toxicity of oral anticoagulants, oral hypoglycemic agents,
hydantoins, uricosuric agents, methotrexate when administered with sulfonamides
Increased toxicity of sulfonamides with diuretics, indomethacin, methenamine,
probenecid, and salicylates |
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Mechanism of
Action |
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Interferes with bacterial growth by inhibiting bacterial folic acid synthesis
through competitive antagonism of PABA; phenazopyridine exerts local anesthetic
or analgesic action on urinary tract mucosa through an unknown
mechanism |
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Pharmacodynamics/Kinetics |
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Absorption: Sulfisoxazole acetyl is hydrolyzed in the GI tract to
sulfisoxazole which is readily absorbed
Serum half-life: 4-7 hours, prolonged with renal impairment
Time to peak serum concentration: Within 2-3 hours |
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Usual Dosage |
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Adults: Oral: 4-6 tablets to start, then 2 tablets 4 times/day for 2 days,
then continue with sulfisoxazole only |
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Dietary
Considerations |
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Should be administered 1 hour before or 2 hours after a meal on an empty
stomach |
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Administration |
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Administer around-the-clock rather than 4 times/day to promote less variation
in peak and trough serum levels |
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Mental Health: Effects
on Mental Status |
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Dizziness is common; sulfonamides reported to cause restlessness,
irritability, depression, euphoria, disorientation, panic, hallucinations, and
delusions |
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Mental Health:
Effects on Psychiatric
Treatment |
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Photosensitivity is common; use caution with concurrent psychotropics; may
cause leukopenia; caution with clozapine and carbamazepine |
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Dental Health: Local
Anesthetic/Vasoconstrictor
Precautions |
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No information available to require special precautions |
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Dental Health:
Effects on Dental Treatment |
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No effects or complications reported |
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Patient
Information |
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See individual agents. Pregnancy/breast-feeding precautions: Inform
prescriber if you are or intend to get pregnant. Consult prescriber if
breast-feeding. |
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Nursing
Implications |
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May cause reddish-orange discoloration of urine; staining of contact lenses
has also been reported; drink plenty of fluids; administer on an empty stomach;
avoid prolonged exposure to sunlight or wear protective clothing and sunscreen;
notify physician if rash, difficulty breathing, severe or persistent fever, or
sore throat occurs |
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Dosage Forms |
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Tablet: Sulfisoxazole 500 mg and phenazopyridine 50
mg |
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