Tannerella forsythia

Sulfalene is a long-acting sulfonamide often used in combination with pyrimethamine to treat or prevent malaria. It is also known by the brand name Fansidar.

Mechanism of Action

Sulfalene, like other sulfonamides, inhibits the enzyme dihydropteroate synthase, which is involved in the synthesis of folic acid in plasmodium species. This inhibition results in a decrease in the production of nucleic acids and proteins necessary for the growth and survival of the parasite.

Indications

Sulfalene is indicated for the treatment and prevention of malaria, particularly in areas where the parasite has developed resistance to other antimalarial drugs. It is often used in combination with pyrimethamine, a dihydrofolate reductase inhibitor, to enhance its antimalarial effect.

Side Effects

The most common side effects of sulfalene include nausea, vomiting, and rash. In rare cases, it can cause serious skin reactions, hemolytic anemia, and Stevens-Johnson syndrome.

Contraindications

Sulfalene is contraindicated in individuals with a known hypersensitivity to sulfonamides or pyrimethamine. It should also be avoided in patients with severe renal or hepatic impairment, and in those with a history of blood disorders.

Drug Interactions

Sulfalene may interact with other drugs, including warfarin, phenytoin, and methotrexate, potentially increasing their effects and the risk of side effects.

References

• World Health Organization. Guidelines for the treatment of malaria. 3rd edition. Geneva: World Health Organization; 2015.
• British National Formulary. BNF 76. London: Pharmaceutical Press; 2018.

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