Sumadan (Sulfur and sulfacetamide) is available is creams, lotions, cleansing pads, gels, and suspensions for topical application.

Sumadan (Sulfur and sulfacetamide) Uses:

• Acne rosacea, acne vulgaris, and seborrheic dermatitis:

  • Treatment of seborrheic dermatitis, acne rosacea, and acne vulgaris.

Sumadan (Sulfur and sulfacetamide) dose in Adults

Acne vulgaris, acne rosacea, and seborrheic dermatitis therapy with sumadan (sulphur and sulfacetamide) dosage:

• Cream, gel, lotion, suspension, emollient cream:

  • One to three times each day, apply a thin coating to the afflicted region.

• Cleanser, cleansing cloth/pads:

  • Once or twice a day, wash the region that is broken.

• Emollient foam:

  • Apply 1–3 times per day to the afflicted region.
  • The foam may remain on the skin or maybe rinsed off after 1 to 10 minutes of application

Sumadan (Sulfur and sulfacetamide) dose in Children

• Refer to adult dosing.

Pregnancy Risk Factor C

• This combination has not yet been used in animal reproduction studies.
• For more information, refer to the sulfacetamide monograph

Use of sulfur or sulfacetamide during breastfeeding

• Breast milk excretes small amounts of sulfonamides taken orally; however, it is not known if they are also excreted as topically administered sulfur and sulfacetamide.
• The drug manufacturer suggests that breastfeeding mothers exercise caution when using sulfur or sulfacetamide.

Sumadan Dose in Kidney Disease:

• Use is contraindicated.

Sumadan Dose in Liver disease:

• There are no dosage adjustments mentioned in the drug manufacturer’s labeling.

Side effects of Sumadan (Sulfur and sulfacetamide):

• Local:

  • Local Irritation

• Central nervous system:

  • Drug fever

• Hematologic & Oncologic:

  • Agranulocytosis
  • Hemolytic Anemia (Acute)
  • Immune Thrombocytopenia

• Dermatologic:

  • Pruritus
  • Contact Dermatitis
  • Erythema
  • Exfoliative Dermatitis
  • Stevens-Johnson Syndrome
  • Xeroderma
•  

• Hepatic:

  • Jaundice

Contraindications to Sumadan (Sulfur and sulfacetamide):

• Hypersensitivity or hyperresponsiveness to any ingredient in the formulation, including sulphur or sulfonamides;
• Kidney disease

Notice:

Although the FDA-approved product labelling warns that this medication should not be taken in conjunction with other sulfonamide-containing medications, the validity of this claim has been questioned.

Cautions and Alerts

• Autoimmune diseases

  • Regardless of the method, sulfonamides have been associated with serious responses and even mortality.

• Blood dyscrasias:

  • Sulfonamides have been linked to severe reactions such as agranulocytosis and acute hemolytic anaemia.

• Dermatologic reactions

  • Sulfonamides have been linked to severe reactions such as Stevens-Johnson Syndrome, toxic epidermal necrolysis and drug fever.
  • Additionally, contact dermatitis and reddening of the skin can occur.

• Hepatic effects

  • Sulfonamides have been associated with serious side effects including fulminant liver necrosis and jaundice.

• Hypersensitivity reactions

  • Patients who have never had sulfonamide hypersensitivity before may experience skin rash or other reactions.
  • Stop using the medication immediately if you feel hypersensitive or rash.

• Allergy to sulfonamide ("sulfa")

  • Cross-reactivity concerns have been a concern for all compounds with the sulfonamide structural (SO-NH) in the past.
  • Less is known about type IV T-cell responses, such as maculopapular skin rash. Based on what is known at the moment, it is impossible to rule out this possibility.
  • It is improbable that non-antibiotic and antibiotic sulfonamides would react with one another, according to a fuller knowledge of allergic processes. It is quite unusual, at the very least.
  • When employing antibiotic sulfonamides or nonantibiotic sulfonamides, mechanisms of anaphylaxis (cross-reaction) caused by antibody formation are less likely to happen.
  • An antibiotic sulfonamide with the arylamine structure, sulfasalazine has the potential to interact with other antibiotic sulfonamides.
  • Some clinicians prefer to avoid these classes in cases of severe reactions (Stevens Johnson syndrome/TEN).

• Systemic effects

  • Application to infected, abraded or burnt skin can increase systemic absorption.

Sulfur and sulfacetamide: Drug Interaction

Monitoring parameters:

• signs of cutaneous sensitivity or irritation, particularly while receiving long-term treatment.

How to administer Sumadan (Sulfur and sulfacetamide)?

• For external use only.
• Wash hands prior to use.
• Avoid coming in touch with your lips, mucous membranes, eyes, or eyelids.

Cleanser:

• To generate a rich lather, apply to moist skin and gently massage for at least 10 to 20 seconds.
• Thoroughly cleanse the skin, then pat it dry.

Cleansing cloths/cleansing pads:

• Use water to wet the skin and the towel or pad, knead the water into a lather, and massage the foam into the skin for 10 to 20 seconds.
• Then, thoroughly rinse the skin and pat it dry.
• Dispose of trash
• do not flush.

Cream, lotion, gel, emollient cream:

• Apply to clean, dry skin;
• massage into the skin completely.

Emollient foam:

• Apply to clean, dry skin.
• Before using a can for the first time, prime it (for directions, see the labelling on medications).
• Before each use, shake the can violently and tap the bottom of the can three times or more into the palm of the other hand or a hard surface.
• The foam may remain on the skin or may be rinsed off after 1 to 10 minutes.

Suspension:

• Shake well prior to use.
• Apply to clean, dry skin;
• massage into the skin thoroughly.

Mechanism of action of Sumadan (Sulfur and sulfacetamide):

• Sulfacetamide inhibits bacteria growth through the inhibition of bacterial folic acid synthesis by competitive antagonism with PABA.
• Sulfur is keratolytic.
• A combination of these two products can be used to reduce the growth of acne-causing bacteria.
• For more information, refer to the Sulfacetamide monograph.

Absorption:

• Sulfur, topical: ~1%

International Brands of Sulfur and sulfacetamide:

• AVAR
• AVAR-e LS
• Rosanil
• Rosula Wash
• Rosula
• SSS 10-5
• BP 10-1
• BP Cleansing Wash
• Sumaxin
• Sumaxin TS
• AVAR-e
• Virti-sulf
• Zencia
• Clarifoam EF
• Clenia
• Plexion
• AVAR LS
• AVAR-e Green
• Prascion
• SulfaCleanse 8/4
• Sulfamez Wash
• Sumadan
• Sumadan XLT
• Sulfacet-R

Sulfur and sulfacetamide Brand Names in Pakistan:

No Brands Available in Pakistan.