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Toxoplasmosis can be treated medically. There are several agents, usually used in combination, to treat infection by this parasite. The three drugs most often used in patients, including those with HIV, are pyrimethamine (Daraprim), sulfadiazine (Microsulfon), and folinic acid. However, pregnant patients are treated with spiramycin (Rovamycine) and leucovorin (Wellcovorin) in addition to the drugs listed above. Patients with HIV usually need lifelong treatment to keep the parasites suppressed. Other drugs occasionally used are clindamycin (Cleocin), azithromycin (Zithromax), or atovaquone (Mepron). These drugs are used mainly when the patient is allergic to pyrimethamine or sulfadiazine. Dosages vary; the best way to determine individual medical treatments, based on the patient health situation, is in consultation with an infectious diseases expert.
Unfortunately, pyrimethamine (Daraprim) and sulfadiazine (Microsulfon) can cause significant side effects, especially in the fetus of pregnant individuals. Two of the major side effects are bone marrow suppression (leucovorin treatment can reduce this suppression) and liver toxicity for pyrimethamine. For sulfadiazine, side effects can be nausea, vomiting, liver toxicity, seizures, and other symptoms. These drugs are used in pregnant women because the risks of infection by Toxoplasma are usually more severe than the drug side effects. The treating physician should be notified quickly if such side effects develop.
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