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Keep this medicine out of the reach of children. Overdose is especially dangerous in children.

If this medicine upsets your stomach or causes vomiting, it may be taken with meals or a snack.

If you are taking this medicine to treat malaria, take the number of tablets your doctor told you to take (up to 3) once, as a single dose, along with other medicine your doctor gave you. If you develop a fever and are not near a medical facility, and are taking this medicine to treat what you think may possibly be malaria, take the number of tablets your doctor told you to take (up to 3) once, as a single dose.

This medicine works best when you take it on a regular schedule. If you are to take two doses a day, one dose may be taken with breakfast and the other one with the evening meal. Make sure that you do not miss any doses. If you have any questions about this, check with your health care professional.

Dosing

The dose of pyrimethamine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of pyrimethamine. If your dose is different, do not change it unless your doctor tells you to do so.

The number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking pyrimethamine.

• For the treatment of malaria:
  • Adults and adolescents: 25 milligrams of pyrimethamine daily together with a sulfonamide for 2 days. These two medicines may also be taken with other medicine. This will be determined by your doctor.
  • Children: Dose is based on body weight and will be determined by the doctor. Pyrimethamine may be taken together with other medicines.
• For the treatment of toxoplasmosis:
  • Adults and adolescents: Starting dose if 50 to 75 milligrams of pyrimethamine daily taken together with other medicines for several weeks. After one to three weeks, your doctor may lower your dose. The proper dose for you must be determined by the doctor.
  • Children: Dose is based on body weight and must be determined by the doctor.
• For the prevention of malaria:
  • Adults and adolescents: 25 milligrams taken once a week.
  • Children: Dose is based on age and must be determined by the doctor.

Missed dose

If you do miss a dose of this medicine, take it as soon as possible. This will help you to keep taking your medicine on a regular schedule. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

To store this medicine:

• Keep out of the reach of children. Overdose is very dangerous.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For pyrimethamine, the following should be considered:

Allergies Tell your doctor if you have ever had any unusual or allergic reaction to pyrimethamine. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy Pyrimethamine has not been studied in pregnant women. However, studies in animals have shown that pyrimethamine causes birth defects such as cleft palate, brachygnathia (abnormal shortness of the jaw bone), oligodactyly (fewer than 5 digits on a hand or foot), microphthalmia (abnormal smallness of the eye). Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding Pyrimethamine passes into breast milk. However, problems in nursing babies have not been reported. Mothers who are taking this medicine and who wish to breast-feed should discuss this with their doctor.

Children Pyrimethamine has been used in children and, in effective doses, has not been shown to cause different side effects or problems in children than it does in adults.

Older adults Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of pyrimethamine in the elderly with use in other age groups.

Other medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking pyrimethamine, it is especially important that your health care professional know if you are taking any of the following:

• Amphotericin B by injection (e.g., Fungizone) or
• Antineoplastics (cancer medicine) or
• Antithyroid agents (medicine for overactive thyroid) or
• Azathioprine (e.g., Imuran) or
• Chloramphenicol (e.g., Chloromycetin) or
• Colchicine or
• Cyclophosphamide (e.g., Cytoxan) or
• Flucytosine (e.g., Ancobon) or
• Ganciclovir (e.g., Cytovene) or
• Interferon (e.g., Intron A, Roferon-A) or
• Mercaptopurine (e.g., Purinethol) or
• Methotrexate (e.g., Mexate) or
• Plicamycin (e.g., Mithracin) or
• Zidovudine (e.g., AZT, Retrovir) Use of these medicines together with pyrimethamine may increase the chance of side effects affecting the blood

• Bone marrow suppressants (methotrexate [e.g., Rheumatrex], proguanil [e.g., Malarone], sulfonamides [medicines used to treat infections], trimethoprim-sulfamethoxazole [e.g., Bactrim], zidovudine [e.g., Retrovir]) may increase risk of bone marrow problems

• Lorazepam (e.g., Ativan) Mild liver problems have been reported when using this medicine together with pyrimethamine

• Phenytoin (e.g., Dilantin) Use of this medicine together with pyrimethamine may affect folate (vitamin B) levels in the body

• Allergy to pyrimethamine or any ingredient in the medicine pyrimethamine should not be used

• Anemia or other blood problems High doses of pyrimethamine may make these conditions worse

• Kidney problems or
• Liver problems or
• Lack of vitamin B in the body caused by
  • Alcoholism (drinking too much alcohol) or
  • Malabsorption syndrome (when a person's body does not absorb enough nutrients from the food they eat)
  May make the condition worse

• Seizure disorders, such as epilepsy High doses of pyrimethamine may increase the chance of convulsions (seizures)