Sulfadiazine Ice Yellow Tablets

Sulfadimethoxazole (SMZ) and trimethoprim (TMP) have synergistic antibacterial or bactericidal effects, because sulfa drugs act on dihydrofolate synthase, interfering with the first step of folic acid synthesis, while trimethoprim acts on the second step of folic acid anabolism, selectively inhibiting dihydrofolate reductase. Therefore, the combination of the two can double-block bacterial folate metabolism. The synergistic antibacterial effect of the two is enhanced compared to the use of a single drug, and drug-resistant strains are reduced.

This product is a compound preparation, and its components are: each tablet contains 300 mg of sulfamethoxazole, 60 mg of trimethoprim, 30 mg of artificial bezoar, and 5 mg of borneol.

This product is light orange-yellow tablets.

Used for tonsillitis, bronchitis, enteritis, dysentery, urinary tract infection, etc.

Oral administration: 1 to 2 tablets at a time, twice a day.

1. Adverse reactions of sulfamethoxazole (1) Allergic reactions are common and may manifest as drug eruptions. In severe cases, exudative erythema multiforme, exfoliative dermatitis and bullous epidermolysis atrophic dermatitis may occur. There are also serum sickness-like reactions such as photosensitivity, drug fever, joint and muscle pain, fever, etc. (2) Granulocytopenia or deficiency, thrombocytopenia and aplastic anemia. Patients may experience sore throat, fever, pallor and bleeding tendency. Therefore, when sulfonamides are used systemically, peripheral blood counts should be checked regularly and the drug should be discontinued immediately if abnormalities are found. (3) Hemolytic anemia and hemoglobinuria. Patients who lack glucose-6-phosphate dehydrogenase are more likely to develop hemolytic anemia after using sulfonamides. It is more common in newborns and children than in adults. (4) Hyperbilirubinemia and neonatal kernicterus. Sulfonamides compete with bilirubin for protein binding sites, which can cause an increase in free bilirubin. Neonates have imperfect liver function and poor bilirubin processing, so they are more likely to develop hyperbilirubinemia and neonatal jaundice, and occasionally kernicterus. (5) Liver damage. Jaundice and liver dysfunction may occur, and in severe cases, acute liver necrosis may occur. Therefore, patients with liver dysfunction should avoid systemic use of sulfonamides. (6) Kidney damage. Crystalluria, hematuria, and tubular urine may occur. If this product is used for a long course of treatment and in large doses, it is advisable to take sodium bicarbonate and drink plenty of water to prevent this adverse reaction. During treatment, urine routine tests should be performed at least 2 to 3 times a week. If crystalluria or hematuria is found, sodium bicarbonate should be given and plenty of water should be drunk until the crystalluria and hematuria disappear. This product is prone to renal damage in patients with dehydration, shock, and the elderly, so it should be used with caution or avoided. This product should not be used in patients with renal dysfunction. Occasionally, patients may experience serious adverse reactions such as interstitial nephritis or tubular necrosis. (7) Nausea, vomiting, decreased appetite, diarrhea, headache, fatigue, etc., generally mild symptoms, do not affect continued medication. Occasionally, patients develop Clostridium difficile enteritis, in which case the drug should be discontinued. (8) Occasionally, thyroid enlargement and hypofunction occur. (9) Central nervous system toxicity may occasionally occur, manifested as mental confusion, disorientation, hallucinations, euphoria or depression. Once it occurs, the drug should be discontinued immediately. Although serious adverse reactions caused by sulfonamides are rare, they can be fatal, such as exudative erythema multiforme, exfoliative dermatitis, epidermolysis bullosa atrophic dermatitis, fulminant liver necrosis, agranulocytosis, aplastic anemia and other blood system abnormalities. Close observation should be made during treatment, and the drug should be discontinued immediately when rash or other early signs of reaction appear. The above adverse reactions are more common in AIDS patients than in non-AIDS patients. 2. Adverse reactions of trimethoprim (1) Due to the interference of this product with folic acid metabolism, adverse reactions of the blood system may occur, such as leukopenia, thrombocytopenia or methemoglobin anemia. Generally, leukopenia and thrombocytopenia are mild and can be recovered if the drug is discontinued in time. Folic acid preparations can also be added. (2) Allergic reactions, such as itching and rash, may occur, and occasionally severe exudative erythema multiforme may occur. (3) Gastrointestinal reactions such as nausea, vomiting, and diarrhea, generally with mild symptoms. (4) Aseptic meningitis may occasionally occur, with headache, stiff neck, nausea, etc. (5) Co-sulfamethoxazole may occasionally cause anaphylactic shock. Elderly people are more likely to suffer from severe skin allergic reactions and blood system abnormalities when using this product, and those who use diuretics at the same time are more likely to suffer from it.

1. It is contraindicated for patients with severe renal impairment; 2. It is contraindicated for patients who are allergic to sulfonamides; 3. It is contraindicated for patients with megaloblastic anemia; 4. It is contraindicated for infants under 2 months old; 5. It should be used with caution by pregnant women.

Precautions for children: Not for use in infants under 2 months old. Precautions for pregnancy and lactation: Use with caution in pregnant women. Precautions for the elderly: Not yet clear.

1. Sulfamethoxazole (1) The simultaneous use of urine alkalinizing drugs can enhance the solubility of sulfonamides in alkaline urine and increase excretion. (2) Para-aminobenzoic acid can replace sulfonamides and be taken up by bacteria, thus antagonizing the antibacterial effect of sulfonamides. The two should not be used together. (3) When the following drugs are used together with sulfonamides, the latter can replace the protein binding sites of these drugs or inhibit their metabolism, resulting in prolonged drug action or toxicity. Therefore, when these drugs are used after sulfonamides, their doses need to be adjusted. Such drugs include oral anticoagulants, oral hypoglycemic drugs, methotrexate, phenytoin sodium and thiopental sodium. (4) When bone marrow suppressive drugs are used together with sulfonamides, the adverse reactions of these drugs to the hematopoietic system may be enhanced. If there is an indication for the simultaneous use of the two types of drugs, the possible toxic reactions should be closely observed. (5) Contraceptives (oral estrogen-containing ones). The simultaneous long-term use of sulfonamides can reduce the reliability of contraception and increase the chance of extramenstrual bleeding. (6) When thrombolytic drugs are used together with sulfonamides, their potential toxic effects may be increased. (7) When hepatotoxic drugs are used together with sulfonamides, the incidence of hepatotoxicity may increase. Liver function should be monitored for such patients, especially those who have been taking the drugs for a long time and have a history of liver disease. (8) When photosensitizing drugs are used together with sulfonamides, additive photosensitivity may occur. (9) Patients receiving sulfonamide treatment have an increased need for vitamin K. 2. Trimethoprim (1) When this product is used together with bone marrow suppressants, the chances of leukopenia and thrombocytopenia increase. (2) When dapsone is used together with this product, the blood concentrations of both drugs may increase. The increase in dapsone concentrations may increase and aggravate adverse reactions, especially the occurrence of methemoglobinemia. (3) This product should not be used together with anti-tumor drugs or 2,4-diaminopyrimidine drugs, nor should it be used between courses of treatment with other folic acid antagonists, because it may cause bone marrow aplasia or megaloblastic anemia. (4) The simultaneous use of rifampicin and this product may significantly increase the latter's clearance and shorten its serum half-life. (5) The concurrent use with cyclosporine may increase renal toxicity. (6) This product may interfere with the hepatic metabolism of phenytoin, increase the half-life (t1/2) of phenytoin by 50%, and reduce its clearance by 30%. (7) Procainamide, when used together with trimethoprim, may reduce the renal clearance of the former, resulting in an increase in the blood concentration of the drug and its metabolite NAPA. (8) Warfarin and trimethoprim may inhibit the metabolism of the drug and enhance its anticoagulant effect.

Keep away from light and store in sealed container.

Compound

24 months