Sulfonamides

Creator: Brian J. Werth
Published: 2022-06-14

Brian J. Werth

, PharmD, University of Washington School of Pharmacy

Reviewed/Revised Jun 2022 | Modified Sep 2022

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Use of Sulfonamides During Pregnancy and Breastfeeding

Topic Resources

Sulfonamides are a class of antibiotics Overview of Antibiotics Antibiotics are drugs used to treat bacterial infections. They are not effective against viral infections and most other infections. Antibiotics either kill bacteria or stop them from reproducing... read more that are effective against many gram-positive bacteria and gram-negative bacteria. Some sulfonamides are applied directly to the skin (topically) to treat burns and skin, vaginal, and eye infections.

Sulfonamides include the following:

Mafenide
Sulfacetamide
Sulfadiazine
Sulfadoxine
Sulfamethizole
Sulfamethoxazole (in combination with trimethoprim) Trimethoprim and Sulfamethoxazole Trimethoprim is an antibiotic and is available as a single drug or in combination with sulfamethoxazole (a sulfonamide antibiotic). Trimethoprim and the combination of trimethoprim and sulfamethoxazole... read more
Sulfanilamide
Sulfasalazine
Sulfisoxazole

Sulfamethoxazole (SMX) is commonly used in combination with trimethoprim Trimethoprim and Sulfamethoxazole Trimethoprim is an antibiotic and is available as a single drug or in combination with sulfamethoxazole (a sulfonamide antibiotic). Trimethoprim and the combination of trimethoprim and sulfamethoxazole... read more (TMP). The combination is called TMP/SMX.

Sulfonamides work by preventing bacteria from producing a form of folic acid they need to grow and multiply.

Sulfonamides

Drug

Common Uses

Some Potential Side Effects

Mafenide

Sulfacetamide

Sulfadiazine

Sulfadoxine

Sulfamethizole

Sulfanilamide

Sulfasalazine

Sulfisoxazole

Trimethoprim/sulfamethoxazole Trimethoprim and Sulfamethoxazole Trimethoprim is an antibiotic and is available as a single drug or in combination with sulfamethoxazole (a sulfonamide antibiotic). Trimethoprim and the combination of trimethoprim and sulfamethoxazole... read more

Urinary tract infections Overview of Urinary Tract Infections (UTIs) In healthy people, urine in the bladder is sterile—no bacteria or other infectious organisms are present. The tube that carries urine from the bladder out of the body (urethra) contains no bacteria... read more (except sulfasalazine, sulfacetamide, and mafenide)

For sulfanilamide: Inflammation of the vagina (vaginitis Vaginal Discharge A discharge from the vagina may occur normally or may result from inflammation of the vagina (vaginitis), often due to an infection. The genital area (vulva)—the area around the opening of the... read more )

For sulfasalazine: Inflammatory bowel disease Overview of Inflammatory Bowel Disease (IBD) In inflammatory bowel diseases, the intestine (bowel) becomes inflamed, often causing recurring abdominal pain and diarrhea. The 2 primary types of inflammatory bowel disease (IBD) are Crohn... read more

For sulfacetamide: Superficial eye infections

For mafenide and sulfadiazine: Only topically for burns

For trimethoprim/sulfamethoxazole: Skin infections caused by susceptible bacteria that are resistant to other antibiotics, including methicillin-resistant Staphylococcus aureus (MRSA Methicillin-resistant Staphylococcus aureus (MRSA) Staphylococcus aureus is the most dangerous of all of the many common staphylococcal bacteria. These gram-positive, sphere-shaped (coccal) bacteria (see figure ) often cause skin infections... read more )

Nausea, vomiting, and diarrhea

Allergic reactions Allergies to Drugs People sometimes mistake many adverse drug reactions for allergies. For example, people who experience stomach discomfort after taking aspirin (a common adverse reaction) often say they are... read more including rashes, anaphylaxis, and angioedema

Crystals in urine (rare)

A decrease in white blood cell and platelet counts

Sensitivity to sunlight

Possibly increased tendency to bleed if used with warfarin

In people with G6PD deficiency (see table More About Some Causes of Anemia More About Some Causes of Anemia ), the breakdown of red blood cells

G6PD = deficiency of glucose-6-phosphate dehydrogenase.

Sulfonamides should be used during pregnancy only when the benefits of treatment outweigh the risks. However, they should not be used when the due date is near because, taken at that time, they may cause jaundice Jaundice in the Newborn Jaundice is a yellow color to the skin and/or eyes caused by an increase in bilirubin in the bloodstream. Bilirubin is a yellow substance formed when hemoglobin (the part of red blood cells... read more in the newborn, which may be severe enough to cause brain damage (kernicterus Complications of jaundice Jaundice is a yellow color to the skin and/or eyes caused by an increase in bilirubin in the bloodstream. Bilirubin is a yellow substance formed when hemoglobin (the part of red blood cells... read more ) in the newborn. (See also Drug Use During Pregnancy Safety of Medications During Pregnancy During pregnancy, women may need to take medications to treat new or existing health conditions. Also, certain vitamins are recommended during pregnancy. Before taking any medication (including... read more .)

Sulfonamides should not be taken during breastfeeding. (See also Drug Use During Breastfeeding Medication and Substance Use During Breastfeeding When women who are breastfeeding have to take a medication, they wonder whether they should stop breastfeeding. The answer depends on the following: How much of the medication passes into the... read more .)

Generic Name	Select Brand Names
mafenide	Sulfamylon
sulfacetamide	AK-Sulf , Bleph-10, Carmol, Cetamide, Klaron, Mexar, Ocu-Sul , Ovace, Ovace Plus, RE-10 , Rosula NS, Seb-Prev, Sodium Sulamyd, Sulf-10
sulfadiazine	No brand name available
trimethoprim	Primsol, Proloprim, TRIMPEX
sulfanilamide	AVC
sulfasalazine	Azulfidine, Azulfidine En-Tabs, Sulfazine , Sulfazine EC
folic acid	Folacin , Folicet, Q-TABS

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