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©2013 UpToDate ® Print Email Sulfonamide antimicrobials (sulfonylarylamines) G6PD risk* Description Systemic agents Sulfadiazine Low As single agent or in combination with pyrimethamine. Sulfadoxine As single agent• or in combination with pyrimethamine. Long actingΔ. Sulfaguanidine• Low Gastrointestinal antimicrobial. Sulfamerazine• Low In combination with other sulfonamides or trimethoprim. Sulfamethizole• Urinary tract antimicrobial. Sulfamethazine (sulfadimidine)• High As single agent or in combination with other sulfonamides. Sulfamethoxazole Variable In combination with trimethoprim or as single agent. Sulfametopyrazine• In combination with pyrimethamine. Long actingΔ. Sulfamoxole• In combination with trimethoprim. Sulfapyridine• Rarely used due to crystalluria risk. Sulfasalazine (salazosulfapyridine, salazopyrin) High Rheumatologic/GI agent (NON antimicrobial) releases sulfapyridine in contact with gut flora. Sulfisoxazole (sulfafurazole) High As single agent or in combination with erythromycin. Topical and ophthalmic agents Mafenide Topical solution or cream. Silver sulfadiazine Low Topical cream or ointment. Sulfacetamide High As single agent ophthalmic solution, ointment, various topicals, vaginal or in combination with sulfabenzamide, sulfathiazole or prednisolone. Sulfanilamide High As single agent vaginal or in combination with other antimicrobials. * Risk in G6PD deficiency may vary by type. See: file://www.g6pd.org/favism/english/index.mvc?pgid=avoid. • Not available commercially in United States. Δ Long acting sulfonamides may be more frequently implicated in allergic reactions and are cleared slowly upon discontinuation.