$Unique_ID{BRK02142}
$Pretitle{}
$Title{SULFISOXAZOLE AND PHENAZOPYRIDINE COMBINATION}
$Subject{Azo Gantrisin (Roche)
Azo-Sulfisoxazole (various manufacturers)}
$Volume{}
$Log{}

Copyright (C) 1991 Publications International, Ltd.


SULFISOXAZOLE AND PHENAZOPYRIDINE COMBINATION
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BRAND NAMES (Manufacturers):
     Azo Gantrisin (Roche)
     Azo-Sulfisoxazole (various manufacturers)
TYPE OF DRUG:
     Antibiotic and urinary tract analgesic
INGREDIENTS:
     sulfisoxazole and phenazopyridine
DOSAGE FORM:
     Tablets (500 mg sulfisoxazole and 50 mg phenazopyridine)
STORAGE:
     Sulfisoxazole and phenazopyridine combination tablets should be stored at
       room temperature in a tightly closed, light-resistant container.

USES

     Sulfisoxazole and phenazopyridine combination is used to treat painful
infections of the urinary tract.  Sulfisoxazole is a sulfonamide antibiotic,
which acts by preventing production of nutrients that are required for growth
of infecting bacteria.  Phenazopyridine is excreted in the urine, where it
exerts a topical analgesic (pain-relieving) effect on the urinary tract.  This
medication is not useful for any pain other than that of a urinary tract
infection.

TREATMENT

     It is best to take this medication with a full glass of water on an empty
stomach, either one hour before or two hours after a meal.  However, if it
causes stomach upset, check with your doctor to see if you can take it with
food or milk.
     This medication works best when the level of medication in your blood and
urine is kept constant.  It is best, therefore, to take the doses at evenly
spaced intervals day and night.  For example, if you are to take two doses a
day, the doses should be spaced 12 hours apart.
     If you miss a dose of this medication, take the missed dose immediately.
However, if you do not remember to take the missed dose until it is almost
time for your next dose, take the missed dose immediately; space the following
dose about halfway through the regular interval between doses; and then return
to your regular dosing schedule.  Try not to skip any doses.
     It is important to continue to take this medication for the entire time
prescribed by your doctor (usually seven to 14 days), even if your symptoms
disappear before the end of that period.  If you stop taking the drug too
soon, resistant bacteria are given a chance to continue growing, and the
infection could recur.

SIDE EFFECTS

     Minor.

     Abdominal pain, diarrhea, dizziness, dry mouth, headache, indigestion,
insomnia, loss of appetite, nausea, or vomiting.  These side effects should
disappear as your body adjusts to the medication.
     Sulfisoxazole can cause increased sensitivity to sunlight.  It is,
therefore, important to avoid prolonged exposure to sunlight and sunlamps.
Wear protective clothing and sunglasses, and use an effective sunscreen.
However, a sunscreen containing para-aminobenzoic acid (PABA) interferes with
the antibacterial activity of this medication and should NOT be used.
     Phenazopyridine causes your urine to become orange-red in color.  This is
not harmful; however, it may stain your clothing.  The urine will return to
its normal color soon after the drug is discontinued.
     If you feel dizzy, sit or lie down for a while; get up slowly from a
sitting or reclining position, and be careful on stairs.
     Sucking on ice chips or a piece of hard candy or chewing sugarless gum
helps to relieve mouth dryness.

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
aching joints and muscles, back pain, bloating, blood in the urine, chest
pain, chills, confusion, convulsions, depression, difficulty in breathing,
difficulty in swallowing, difficult or painful urination, fever,
hallucinations, hives, itching, loss of coordination, pale skin, rash or
peeling skin, ringing in the ears, sore throat, swelling of the front part of
the neck, swollen ankles, unusual bleeding or bruising, unusual tiredness, or
yellowing of the eyes or skin.  Also, if your symptoms of infection seem to be
getting worse rather than improving, you should contact your doctor.

INTERACTIONS

     This drug interacts with several types of drugs:
     1. Sulfisoxazole can increase the blood levels of oral anticoagulants
(blood thinners, such as warfarin), oral antidiabetic agents, methotrexate,
aspirin, thiopental, and phenytoin, which can lead to serious side effects.
     2. Methenamine can increase the side effects to the kidneys caused by
sulfisoxazole.
     3. Probenecid, oxyphenbutazone, phenylbutazone, and sulfinpyrazone can
increase the blood levels of sulfisoxazole, which can lead to an increase in
side effects.
     Before starting to take this medication, BE SURE TO TELL YOUR DOCTOR
about any medications you are currently taking, especially any of those listed
above.

WARNINGS

     * Tell your doctor about any reactions you have had to drugs, especially
to phenazopyridine, sulfisoxazole, or any other sulfa drug (other sulfonamide
antibiotics, diuretics, dapsone, sulfoxone, oral antidiabetic medications,
oral antiglaucoma medications, acetazolamide).
     * Tell your doctor if you now have or if you have ever had
glucose-6-phosphate dehydrogenase (G6PD) deficiency, kidney disease, liver
disease, or porphyria.
     * This medication has been prescribed for your current infection only.
Another infection later on, or one that someone else has, may require a
different medicine.  You should not give your medicine to other people or use
it for other infections, unless your doctor specifically directs you to do so.
     * This medication should be taken with plenty of water, orange juice, or
cranberry juice in order to prevent kidney stone formation.
     * If this drug makes you dizzy, do not take part in any activity that
requires alertness, such as driving a car or operating potentially dangerous
machinery.
     * Diabetic patients using this medication, which contains phenazopyridine
may get delayed reactions or false-positive readings for sugar or ketones with
urine tests.  Clinitest is not affected by this medication, but the other
urine sugar tests may be.  Discuss this with your doctor.
     * If there is no improvement in your condition several days after
starting to take this medication, check with your doctor.  This medication may
not be effective against the bacteria causing your infection.
     * Before having surgery or any other medical or dental treatment, be sure
to tell your doctor or dentist that you are taking this medication.
     * Be sure to tell your doctor if you are pregnant.  Small amounts of
sulfisoxazole cross the placenta.  Although this medication appears to be safe
during pregnancy, extensive studies in humans have not been conducted.  Also,
tell your doctor if you are breast-feeding an infant.  Small amounts of this
medication pass into breast milk and may temporarily alter the bacterial
balance in the intestinal tract of a nursing infant, resulting in diarrhea.
This medication should not be used in an infant less than two months of age
(in order to avoid side effects involving the liver).

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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
