Keeping the urine dilute by maintaining a high volume of fluid intake, is the key to preventing the risk of toxicity from sulfonamide medications.
Sulfonamides may be systemically absorbed when applied to the skin, eye, or mucosal membranes. The use of sulfonamides has been associated with hematologic toxicity, including methemoglobinemia, sulfhemoglobinemia, leukopenia, granulocytopenia, eosinophilia, hemolytic anaemia, aplastic anaemia, purpura, clotting disorder, thrombocytopenia, hypofibrinogenemia, and hypoprothrombinemia.
Therapy with topical sulfonamides should be administered cautiously in patients with preexisting blood dyscrasias or bone marrow suppression. Complete blood counts should be obtained regularly during prolonged therapy (>2 weeks), and patients should be instructed to immediately report any signs or symptoms suggestive of blood dyscrasia such as fever, sore throat, local infection, bleeding, pallor, dizziness, or jaundice.
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