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

Risk Factor C (Monitor therapy)
BCG Vaccine (Immunization)	The curative power of the BCG vaccination may be diminished by antibiotics (Immunization).
Risk Factor D (Consider therapy modification)
Sodium Picosulfate Hair Removing Hard Beans Wax Painless Beauty Wax Beans For All Skins Wax Beans For Face Body Legs	Antibiotics may reduce sodium picosulfate's therapeutic efficacy. Treatment: If a patient has ever taken or is currently using an antibiotic, consider using a different product to cleanse the bowels before a colonoscopy.
Risk Factor X (Avoid combination)
BCG (Intravesical)	Antibiotics may lessen BCG's therapeutic effects (Intravesical)

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.