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Medical Author:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Medical Editor:

Mary Nettleman, MD, MS, MACP

Mary Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

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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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