Availability of Pyrimethamine: Statement from Adult & Adolescent OI Guideline Panel

Pyrimethamine is recommended for treatment and/or prophylaxis of Toxoplasma encephalitis, Pneumocystis pneumonia, and Isospora infection. As of June 2015, pyrimethamine is no longer available in retail pharmacies in the United States. It is only available through a special pharmacy program (http://www.daraprimdirect.com/how-to-prescribe). If there is a delay in procuring pyrimethamine for a patient in whom it is needed for one of the above indications, please refer to the specific pathogen section for alternative drug regimens for treatment or prophylaxis. For patients with suspected or documented toxoplasmosis who do not have a history of sulfa allergy, trimethoprim-sulfamethoxazole should be used to substitute for (pyrimethamine with sulfadiazine or clindamycin) until pyrimethamine is available.