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Treatments and drugs
By Mayo Clinic staffMost healthy people don't require toxoplasmosis treatment. But if you're otherwise healthy and have signs and symptoms of acute toxoplasmosis, your doctor may prescribe the following drugs:
- Pyrimethamine (Daraprim). This antimalarial medication is also used to treat toxoplasmosis. It's a folic acid antagonist, which means it may prevent your body from absorbing the important B vitamin folate (folic acid, vitamin B-9), especially when you take high doses over a long period of time. For that reason, your doctor may recommend taking additional folic acid. Other potential side effects of pyrimethamine include bone marrow suppression and liver toxicity.
- Sulfadiazine. This antibiotic is used in combination with pyrimethamine to treat toxoplasmosis.
Treating people with HIV/AIDS
If you are living with HIV/AIDS and have toxoplasmosis, the treatment of choice is also pyrimethamine and sulfadiazine, along with folic acid. An alternative is pyrimethamine in conjunction with clindamycin (Cleocin) — an antibiotic that can sometimes cause severe diarrhea.
Normally, you'll need to take these medications for life, although in some cases, your doctor may consider stopping toxoplasmosis therapy if your CD4 count remains very high for at least three to six months. Side effects of most drugs can be more severe in people with HIV/AIDS.
Treating pregnant women and babies
If you're pregnant and currently infected with toxoplasmosis but your baby isn't affected, you may be given the antibiotic spiramycin. Use of this drug can reduce the likelihood that your baby will become infected, without posing a risk to you or your child. Although routinely used to treat toxoplasmosis in Europe, spiramycin is still considered an experimental drug in the United States. Your doctor can obtain it from the Food and Drug Administration.
When tests indicate that your unborn child has toxoplasmosis, your doctor may suggest treatment with pyrimethamine and sulfadiazine. Because these drugs can have serious side effects for both women and babies, they're normally not used during pregnancy, but doctors sometimes prescribe them in extreme circumstances. Drug treatment can lessen the severity of congenital toxoplasmosis, but it won't undo any damage that's already been done.
- Toxoplasmosis fact sheet. Centers for Disease Control and Prevention. http://www.cdc.gov/toxoplasmosis/factsheet.html. Accessed May 5, 2009.
- Martin-Rabada P, et al. Blood and tissue protozoa. In: Cohen J, et al. Infectious Diseases. 2nd ed. New York, N.Y.: Mosby; 2004. http://www.mdconsult.com/das/book/body/135708454-2/0/1209/737.html?tocnode=49359306&fromURL=737.html#4-u1.0-B0-323-02407-6..50247-6--cesec17_8111. Accessed May 4, 2009.
- Kasper LH. Toxoplasma infections. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aid=2896423. Accessed May 4, 2009.
- McLeod R, et al. Toxoplasmosis (toxoplasma gondii). In: Kleigman RM, et al. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/135783748-2/0/1608/732.html?tocnode=54480801&fromURL=732.html#4-u1.0-B978-1-4160-2450-7..50289-9_6064. Accessed May 4, 2009.
- Toxoplasmosis. March of Dimes. http://www.marchofdimes.com/professionals/14332_1228.asp. Accessed May 6, 2009.
- Centers for Disease Control and Prevention, et al. Preventing congenital toxoplasmosis. MMWR Recommendations and Reports. 2000;49:57. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4902a5.htm. Accessed May 8, 2009.
- You can prevent toxo. Centers for Disease Control and Prevention. http://www.cdc.gov/hiv/resources/brochures/toxo.htm. Accessed May 5, 2009.
- Montoya JG, et al. Diagnosis and management of toxoplasmosis. Clinics in Perinatology. 2005;32:705.
