Drug | Dose | Major adverse reactions |
Preferred regimen | ||
TMP-SMX | TMP-SMX (15 to 20 mg/kg/day of the trimethoprim component) orally or IV given in three or four divided doses*¶ | Rash (rarely SJS/TEN), fever, neutropenia, hyperkalemia, transaminase elevations, photosensitivity, increased serum creatinine |
Alternative regimens | ||
TMP plus dapsoneΔ | TMP: 5 mg/kg orally three times daily¶ | Trimethoprim: Rash, gastrointestinal distress, transaminase elevation, neutropenia, hyperkalemia |
Dapsone: 100 mg orally once per day | Dapsone: Rash, fever, lymphadenopathy, transaminase elevations (sulfone hypersensitivity syndrome), gastrointestinal upset, methemoglobinemia, hemolytic anemia | |
PrimaquineΔ plus clindamycin* | Primaquine: 30 mg (base) orally once per day | Primaquine: Rash, fever, gastrointestinal distress, methemoglobinemia, hemolytic anemia, leukopenia, neutropenia |
Clindamycin: 900 mg IV every eight hours OR 600 mg IV every six hours OR 600 mg orally three times daily OR 450 mg orally four times daily | Clindamycin: Rash, diarrhea, Clostridioides difficile colitis, abdominal pain | |
Atovaquone suspension | 750 mg orally twice daily (must be taken with food) | Gastrointestinal distress, fever, transaminase elevation, rash (less frequently than with other regimens) |
Pentamidine◊ | 4 mg/kg IV once daily¶ | Nephrotoxicity, infusion reactions, hyperkalemia, hyperglycemia, pancreatitis, cardiac arrhythmias (including TdP), transaminase elevations, hypotension, hypoglycemia, hypokalemia, hypocalcemia Certain adverse effects can be life threatening (eg, hypoglycemia and hypotension)§ |
Adjunctive glucocorticoids§ | ||
Prednisone | 40 mg orally twice daily for five days, followed by 40 mg orally once daily for five days, followed by 20 mg orally once daily for 11 days |
Do you want to add Medilib to your home screen?