Sulfapyridine (Oral)

Sulfapyridine is a sulfa medicine. It is used to help control dermatitis herpetiformis (Duhring's disease), which is a skin condition. It may also be used for other conditions as your doctor decides. However, this medicine will not work for any type of infection like other sulfa medicines do.

This medicine may cause some serious side effects. Before using this medicine, make sure to talk to your doctor about these issues, as well as the benefits this medicine may provide.

Sulfapyridine was available only with your doctor's prescription.

In December 1990, the manufacturer stopped selling sulfapyridine.

It is very important that your doctor checks your progress at regular visits. This medicine may cause blood problems, especially if it is taken for a long time.

If your symptoms do not improve within a few days, or if they become worse, check with your doctor.

Sulfapyridine may cause blood problems. These problems may lead to a greater chance of certain infections, slow healing, and bleeding of the gums. Therefore, you should be careful when using regular toothbrushes, dental floss, and toothpicks. Dental work should be delayed until your blood counts have returned to normal. Check with your medical doctor or dentist if you have any questions about proper oral hygiene (mouth care) during treatment.

Sulfapyridine may make your skin more sensitive to sunlight than it usually is. Exposure to sunlight, even for a short time, may cause a skin rash, itching, redness or other discoloration of the skin, or a severe sunburn. When you begin taking this medicine:

• Stay out of direct sunlight, especially between the hours of 10:00 A.M. and 3:00 P.M., if possible.
• Wear protective clothing, including a hat. Also, wear sunglasses.
• Apply a sunblock product that has a skin protection factor (SPF) of at least 15. Some patients may need a product with a higher SPF number, especially if they have a fair complexion. If you have any questions about this, check with your health care professional.
• Apply a sunblock lipstick that has an SPF of at least 15 to protect your lips.
• Do not use a sunlamp or tanning bed or booth.

You may still be more sensitive to sunlight or sunlamps for many months after stopping this medicine. If you have a severe reaction from the sun, check with your doctor.

Tell the doctor in charge that you are taking this medicine before you have any medical tests. The results of the bentiromide (e.g., Chymex) test for pancreas function are affected by this medicine.

In deciding to use a medicine, you and your doctor need to think about the risks of taking it compared to the benefits it may provide. Here are some important points to consider for this medicine:

Allergies

Inform your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also let your healthcare professional know if you have any other allergies, such as to foods, dyes, preservatives, or animals. For over-the-counter products, carefully read the label or package ingredients.

Pediatric

This medicine is not recommended for children since dermatitis herpetiformis usually does not occur in this age group.

Geriatric

Many medicines have not been specifically studied in older adults. Therefore, it may not be clear if they work the same way as they do in younger adults or if they cause different side effects or issues in older people. There is no specific information comparing the use of sulfapyridine in older people with use in other age groups.

Breast Feeding

Research in women suggests that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while in other cases, two different medicines might be used together even if an interaction could happen. In these situations, your doctor may adjust the dose or take other precautions. It is especially important for your healthcare professional to know if you are taking any of the medicines listed below while you are using this medicine. The following interactions are based on their potential significance and are not an exhaustive list.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to prescribe this medication or may change some of the other medicines you take.

• Methenamine

Using this medicine with any of the following medicines is usually not recommended, but may be necessary in some situations. If both medicines are prescribed together, your doctor may adjust the dose or how often you use one or both of the medicines.

• Methotrexate
• Porfimer

Using this medicine with any of the following medicines may increase the risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Aminolevulinic Acid

Interactions with Food/Tobacco/Alcohol

Some medicines should not be taken around the time of eating or with certain foods since interactions may occur. Using alcohol or tobacco with certain medicines may also lead to interactions. Talk with your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical problems may affect your use of this medicine. Be sure to inform your doctor if you have any other medical conditions, especially:

• Blood problems or
• Glucose-6-phosphate dehydrogenase deficiency (lack of G6PD enzyme)—Patients with these conditions may experience more side effects that affect the blood.

• Kidney disease or
• Liver disease—Patients with kidney disease or liver disease may have a higher chance of side effects.

• Porphyria—Using sulfapyridine may trigger an attack of porphyria.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

• Fever
• headache (continuing)
• itching
• skin rash

Less common

• Aching of joints and muscles
• difficulty in swallowing
• pale skin
• redness, blistering, peeling, or loosening of skin
• sore throat
• unusual bleeding or bruising
• unusual tiredness or weakness
• yellow eyes or skin

Rare

• Blood in urine
• lower back pain
• pain or burning while urinating
• swelling of front part of neck

Check with your doctor as soon as possible if any of the following side effects occur:

More common

• Increased sensitivity of skin to sunlight

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Diarrhea
• loss of appetite
• nausea or vomiting

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Chemical Class: Sulfonamide

Each dose of sulfapyridine should be taken with a full glass (8 ounces) of water. Several additional glasses of water should be taken every day, unless otherwise directed by your doctor. Drinking extra water will help to prevent some unwanted effects (e.g., kidney stones) of the sulfa medicine.

For patients taking sulfapyridine for dermatitis herpetiformis:

• Your doctor may want you to follow a strict, gluten-free diet.
• You may have to use this medicine regularly for 6 months to a year before you can reduce the dose of sulfapyridine or stop it altogether. If you have any questions about this, check with your doctor.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For dermatitis herpetiformis: Adults and adolescents: 250 milligrams to 1 gram four times a day until improvement occurs. After improvement has occurred, the dose should then be reduced by 250 to 500 milligrams every three days until there are no symptoms; that dose should be taken once daily. Children: Use is not recommended, because children usually do not get this condition.

Missed Dose

If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If your symptoms do return or get worse, take the missed dose as soon as possible. Then go back to your regular dosing schedule.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.