Tetracyclines General Statement: Cautions

The most frequent adverse reactions to tetracyclines are dose-related GI effects including nausea, vomiting, diarrhea, bulky loose stools, anorexia, flatulence, abdominal discomfort, and epigastric burning and distress. Stomatitis, glossitis, dysphagia, sore throat, hoarseness, black hairy tongue, pancreatitis, and inflammatory lesions in the anogenital region with candidal overgrowth have also been reported occasionally.

Sulfisoxazole, Sulfisoxazole Acetyl

Sulfisoxazole and its derivatives share the actions and uses of the sulfonamides. The relative solubility of the drug in alkaline and slightly acidic urine makes the drug particularly useful for the treatment of urinary tract infections. A combination product containing sulfisoxazole acetyl and erythromycin ethylsuccinate is commercially available for the treatment of acute otitis media caused by susceptible strains of Haemophilus influenzae in children and is usually active against ampicillin-resistant strains of the organism.

Sulfasalazine: Cautions

Generally, the incidence of severe sulfasalazine-induced adverse effects is low, but minor adverse effects occur frequently. Onset of adverse effects generally occurs within a few days to 12 weeks following initiation of sulfasalazine therapy, especially when dosage exceeds 4 g daily. Clinical experience to date indicates that the incidence of sulfasalazine-induced adverse effects in patients with ulcerative colitis generally is similar to that reported in patients with rheumatoid arthritis, although there is a greater incidence of some reactions. The most frequent adverse effects associated with sulfasalazine therapy in patients with ulcerative colitis are anorexia, headache, nausea, vomiting, gastric distress, and reversible oligospermia.

Sulfasalazine: Dosage and Administration

Sulfasalazine conventional and delayed-release tablets are administered orally. The total daily dosage should be divided into equally divided doses, and, if possible, doses should be administered after meals. The delayed-release tablets should be swallowed whole. For the treatment of ulcerative colitis, the interval between doses of sulfasalazine given as conventional or delayed-release tablets should not exceed 8 hours.

Sulfamethizole

Sulfamethizole shares the actions and uses of the other antibacterial sulfonamides. Sulfamethizole is used principally in the treatment of urinary tract infections caused by sulfonamide-susceptible organisms.

Sulfadiazine

Sulfadiazine is administered orally. Patients should be instructed to drink one full glass (250 mL) of water with each dose of the drug and at frequent intervals throughout the day while they are receiving sulfadiazine. The usual adult dosage of sulfadiazine is 2-4 g initially, followed by 2-4 g daily administered in 3-6 equally divided doses.

Sulfonamides General Statement

Sulfonamides, synthetic derivatives of p-aminobenzenesulfonamide (sulfanilamide), are classified as anti-infectives if they possess antibacterial activity that is antagonized by p-aminobenzoic acid or p-aminobenzoyl glutamic acid.