Treatment of Toxoplasmosis

Drugs

Dosage

Adverse Effects

Remarks

Pyrimethamine

Congenital Toxoplasma
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2 mg/kg/day on Day1 & 2
Continuation
1 mg/kg/day for 2-6 months and then 1mg/kg 3 times a week to complete 12 months
Acquired Toxoplasma
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2 mg/kg/day for 3 days
Continuation
1 mg/kg/day for 6 weeks

Rash (including Stevens-
Johnson syndrome)
nausea, bone marrow
suppression.

Folinic acid should be
administered with
pyrimethamine to prevent bone marrow suppression. It should be continued for 1 week after pyrimethamine has been discontinued

Sulphadiazine

Congenital Toxoplasma
50 mg/kg/dose BD for 12 months
Acquired Toxoplasma
25-50 mg/kg/dose
4 times daily

Rash (including Steven-Johnson syndrome),
fever, leukopenia,
hepatitis, GI symptoms
and crystalluria

Drugs

Dosage

Adverse Effects

Remarks

Clindamycin

5-7.5 mg/kg/do PO 4 times daily
(max 600 mg/dose)

Fever rash, GI symptoms, Pseudomembranous colitis, hepatotoxicity

In patients hypersensitive to sulfonamide. Is given along with Pyrimethamine

Azithromycin

-

-

Used in adults with
Pyrimethamine in sulfa-
allergic patients

Atovaquone

-

-

Used in adults with
Pyrimethamine or

Sulphadiazine or as a single agent

TMP/SMX

5 mg/kg TMP
+ 25 mg/kg SMX
IV/PO BD

-

Not used in children. Used as alternative to
Pyrimethamine-Sulfadiazine in adults.