Pyrimethamine (Daraprim)

Category:

• Antiparasitic

  Description:

• Folic acid antagonist

  Indications:

• Toxoplasmosis

• Malaria prophylaxis

  Contraindications:

• Documented megaloblastic anemia due to folate deficiency.

  Precautions:

• Pregnancy category C

• Perform semi-weekly blood counts, to include platelets.

• G-6-PD patients may precipitate the development of hemolytic anemia.

• May cause a rash to develop.

  Adverse Reactions (Side Effects):

• Cardiovascular changes, such as rhythm changes, may occur at large doses

• Gastrointestinal upset (vomiting and anorexia) may occur at large doses

Dosage:

Administered orally

Toxoplasmosis:

Adult:

• 50-75mg every day given with 1-4 grams of a sulfonamide antibiotic of the sulfapyrimidine class (sulfisoxazole or sulfmethoxazole) for 1-3 weeks

Pediatric:

• 1mg/kg/day in 2 equal does for 2-4 days, then decrease to 05mg/kg/day for 1 month 

Infused over 1 hour, every 8 hours for 7 days.

Malaria Prophylaxis:

• Adults and Children >10 years old: 25mg once every week

• Children 4-10 years old: 12.5mg once every week

• Children <4 years old: 6.25mg once every week