Maladrin

Description:

This medicine is a fixed-dose combination of Pyrimethamine and Sulfadoxine, both of which interfere with folic acid metabolism in parasites. Pyrimethamine blocks the enzyme dihydrofolate reductase, while Sulfadoxine blocks dihydropteroate synthase. Together, they stop the parasite from making folic acid, an essential nutrient for survival. Because of this dual action, the combination is effective against Plasmodium species (malaria parasites) and certain other infections.

How to Use

• Take the tablet by mouth with a full glass of water.

• Usually taken with food to reduce stomach upset.

• Dosage and frequency depend on the infection being treated and your doctor’s advice.

• Always complete the full course, even if symptoms improve early.

• Do not self-medicate or adjust doses without consulting your physician.

Possible Side Effects

Most people tolerate this medicine, but side effects may include:

• Nausea, vomiting, diarrhea

• Loss of appetite

• Mouth sores

• Skin rash or itching

• Headache, fever, or fatigue

Serious but rare side effects:

• Bone marrow suppression (low blood cells)

• Severe allergic skin reactions (Stevens–Johnson syndrome, TEN)

• Liver or kidney problems

Seek medical help immediately if you develop rash, persistent fever, sore throat, unusual bleeding, or jaundice (yellowing of skin/eyes).

Warnings & Precautions

• Pregnancy: Not recommended, especially in the first trimester, unless clearly advised by a doctor.

• Breastfeeding: Avoid use; drug can pass into breast milk.

• Kidney/Liver disease: Use with caution; dose adjustment may be required.

• Blood disorders: Not suitable for patients with folate deficiency or megaloblastic anemia.

• Allergies: Do not use if allergic to sulfonamides or pyrimethamine.

• Not recommended for infants under 2 months due to risk of kernicterus.

Regular blood counts and liver function tests may be required during prolonged therapy.

Contraindications

Do not use if you:

• Have a known allergy to sulfa drugs, Pyrimethamine, or Sulfadoxine

• Have severe liver or kidney impairment

• Suffer from megaloblastic anemia due to folate deficiency

• Have a history of serious skin reactions to sulfonamides

• Are pregnant (first trimester) unless no safer alternative exists

Drug Interactions

This medicine may interact with:

• Methotrexate or other folate antagonists

• Phenytoin, phenobarbital (may lower effectiveness)

• Cyclosporine (risk of increased levels)

• Oral contraceptives (reduced effectiveness; use backup birth control)

• Theophylline (risk of toxicity)

• Iron or dairy products may reduce absorption

Always inform your doctor about all other medicines and supplements you are taking.

Storage

• Store at room temperature, away from heat, moisture, and sunlight.

• Keep in the original packaging.

• Keep out of reach of children.

• Do not use expired tablets. Dispose of safely with pharmacist guidance.

Quick Tips

• Take with food to reduce stomach upset.

• Drink plenty of fluids while on this medicine.

• Do not skip doses; missing treatment may reduce effectiveness.

• If you develop a rash or persistent fever, stop and consult a doctor immediately.

• Avoid alcohol as it may increase side effects.

Doctor’s Review

Dr. Imran Shah (MBBS, FCPS – Infectious Diseases)

This pyrimethamine–sulfadoxine combination is a long-standing option for resistant malaria and toxoplasmosis. It is very effective when used correctly, but patients need regular monitoring for side effects, especially with prolonged therapy. Self-medication is unsafe — it should always be taken under medical supervision.

Disclaimer

This information is provided for educational purposes only and is not a substitute for medical advice. Pyrimethamine + Sulfadoxine tablets must be used only under the supervision of a qualified doctor.