Classes
DEA Class; Rx
Common Brand Names; Daraprim
- Antimalarials;
- Antiparasitic Agents
Description
Synthetic antiparasitic agent with slow schizonticidal activity
Used for the treatment of toxoplasmosis in combination with sulfadoxine
Only available through the DARAPRIM Direct Program
Indications
Indicated for
- Toxoplasmosis
- P jiroveci Pneumonia (Off-label)
- Prophylaxis p P jiroveci pneumonia (formerly Pneumocystis pneumonia); administer with dapsone
- Treatment of GM-2 gangliosidoses (Tay-Sachs disease and Sandhoff disease)
Contraindications
Hypersensitivity
Megaloblastic or folate-deficiency anemia
Adverse Effects
- Abdominal cramps
- Abnormal skin pigmentation
- Anaphylaxis
- Anorexia
- Arrhythmias (large doses)
- Atrophic glossitis
- Depression
- Fever
- Insomnia
- Lightheadedness
- Malaise
- Seizures
- Dermatitis
- Erythema multiforme
- Rash
- Stevens-Johnson syndrome
- Vomiting
- Diarrhea
- Xerostomia
- Megaloblastic anemia
- Leukopenia
- Pancytopenia
- Thrombocytopenia
- Pulmonary eosinophilia
- Neutropenia
Warnings
Use with caution in patients with G6PD deficiency
Use with caution in hepatic/renal impairment and history of seizure disorders
Dosage of pyrimethamine required for treatment of toxoplasmosis. has a narrow therapeutic window; if signs of folate deficiency develop, reduce dosage or discontinue drug according to response of patient; folinic acid (leucovorin) should be administered in a dosage of 5 to 15 mg daily (orally, IV, or IM) until normal hematopoiesis restored
Megaloblastic anemia, leukopenia, thrombocytopenia, neutropenia, and pancytopenia reported with high doses; monitor CBC and platelets twice weekly in patients receiving high dose therapy
Use caution in patients with possible folate deficiency, including pregnancy, malabsorption syndrome, and alcoholism
Administer with leucovorin, especially at high doses, to prevent hematologic complications, due to pyrimethamine-induced folic acid deficiency; continue leucovorin during therapy and for 1 week after discontinuing therapy
Pregnancy and Lactation
Pregnancy Category: C
Lactation: enters breast milk, do not nurse
Maximum Dosage
75 mg/day PO.
75 mg/day PO.
75 mg/day PO.
1 mg/kg/day is FDA-approved maximum dosage; however, doses up to 2 mg/kg/day (Max: 50 mg/day) are used off-label.
1 mg/kg/day is FDA-approved maximum dosage; however, doses up to 2 mg/kg/day are used off-label.
1 mg/kg/day is FDA-approved maximum dosage; however, doses up to 2 mg/kg/day are used off-label.
How supplied
Pyrimethamine
tablet
- 25mg
