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What are the dosages of Daraprim and Sulfadiazine in treating Toxoplasma? Side effects?

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I read that daraprim and sulfadiazine are used to treat toxoplasma. What is the typical dosage? Are there negative side effects?
Posted Tue, 1 May 2012 in Infections
Answered by Dr. Sujeet N Charugulla 12 hours later
Hello and thanks for your query.

I shall make an effort to provide you with good professional recommendations specific to your questions.

As per present treatment guidelines, in cases of Toxoplasmic encephalitis, the initial dose of Pyrimethamine is 200 mg orally once.Then, maintenance dose for <60 kg patient - Sulfadiazine 1 g orally every 6 hours plus pyrimethamine 50 mg orally once a day. For >= 60 kg patient - Sulfadiazine 1500 mg orally every 6 hours plus pyrimethamine 75 mg orally once a day.

In addition, leucovorin 10 to 20 mg/day orally (may increase up to 50 mg/day). Corticosteroids and anticonvulsants may also be given if indicated.

Total duration is at least 6 weeks, followed by chronic suppressive therapy in required cases which may be really long.

Most common side effects of sulfadiazine are headache, nausea, skin sensitivity. But allergic reactions, haematuria dysuria, yellow eyes, dyspnea, rashes, fatigue, diarrhea etc warrant reporting to physician. While, pyrimethamine may often cause allergy, nausea, anorexia, vomiting, megaloblastic anemia.

Leucovorin is administered till the blood counts come normal.

Let me know if I have missed out any other concern in your question.

Yet again, I duly appreciate your query to me, I do hope that you have found something useful to help you and I shall be glad to answer any further apprehensions.


Dr Sujeet N Charugulla,
Consultant Physician.
Above answer was peer-reviewed by
Follow-up: What are the dosages of Daraprim and Sulfadiazine in treating Toxoplasma? Side effects? 12 hours later
Hello Dr Charugulla,
I was given the protocol you mentioned though with out the leucovorin.
By the third day my hands were shaking, eyes felt dialated, dizzy, and severe nausea and vomiting, couldnt eat or drink. I do acupuncture, and I had to cancel my whole day of work and it took me about 24 hrs to get over the nausea. This was yesterday. Im feeling better this morning but still dont feel normal yet.
It scared me how sick it made me and now what my options might be. Ive heard of some natural remedies that take longer but claim effectiveness.
Can you help?
Thank you, XXXXXXX
Answered by Dr. Sujeet N Charugulla 9 minutes later

Thanks for the reply.

I am afraid; you would need to consult your doctor about taking Leucovorin. I believe you have to be prescribed by him, as I elaborated already.

I am sorry, am not an expert in natural remedies. But, I can tell you there are no substantial studies available to prove the many natural remedies even if available. So, accountability will be an issue with those medicines.

For now, I advice you to report the above symptoms back to your prescribing physician - perhaps he will see the need of leucovorin and you should do fine once the efficacy of the drugs against the parasite starts.

Hope this helps. Let me know if you have any more concerns. If I have answered all your queries, please close this discussion.

Dr Charugulla
Above answer was peer-reviewed by
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