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Prestwick3_000334
Also known as: Sulfafurazole, 127-69-5, Sulphafurazole, Sulfisoxazol, Sulfafurazol, Sulfaisoxazole
Molecular Formula
C11H13N3O3S
Molecular Weight
267.31  g/mol
InChI Key
NHUHCSRWZMLRLA-UHFFFAOYSA-N
FDA UNII
740T4C525W

A short-acting sulfonamide antibacterial with activity against a wide range of gram- negative and gram-positive organisms.
Sulfisoxazole is a Sulfonamide Antimicrobial.
1 2D Structure

Prestwick3_000334

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
4-amino-N-(3,4-dimethyl-1,2-oxazol-5-yl)benzenesulfonamide
2.1.2 InChI
InChI=1S/C11H13N3O3S/c1-7-8(2)13-17-11(7)14-18(15,16)10-5-3-9(12)4-6-10/h3-6,14H,12H2,1-2H3
2.1.3 InChI Key
NHUHCSRWZMLRLA-UHFFFAOYSA-N
2.1.4 Canonical SMILES
CC1=C(ON=C1C)NS(=O)(=O)C2=CC=C(C=C2)N
2.2 Other Identifiers
2.2.1 UNII
740T4C525W
2.3 Synonyms
2.3.1 MeSH Synonyms

1. Ammonium Salt Sulfisoxazole

2. Diolamine, Sulfisoxazole

3. Gantrisin

4. Gantrisin Pediatric

5. Monolithium Salt Sulfisoxazole

6. Monosodium Salt Sulfisoxazole

7. Neoxazoi

8. Pediatric, Gantrisin

9. Sulfadimethyloxazole

10. Sulfafurazol Fna

11. Sulfafurazole

12. Sulfasoxizole

13. Sulfisoxazole Diolamine

14. Sulfisoxazole, Ammonium Salt

15. Sulfisoxazole, Monolithium Salt

16. Sulfisoxazole, Monosodium Salt

17. Sulfisoxazole, Monosodium, Monomesylate Salt

18. Sulfisoxazole, Triammonium Salt

19. Tl Azole

20. Tl-azole

21. Triammonium Salt Sulfisoxazole

22. V Sul

23. V-sul

2.3.2 Depositor-Supplied Synonyms

1. Sulfafurazole

2. 127-69-5

3. Sulphafurazole

4. Sulfisoxazol

5. Sulfafurazol

6. Sulfaisoxazole

7. Sulfofurazole

8. Sulfisoxasole

9. Gantrisin

10. Sulphaisoxazole

11. Sulfadimethylisoxazole

12. Alphazole

13. Amidoxal

14. Sulfalar

15. Sulfoxol

16. Sulfisoxazole Dialamine

17. Sulphafurazolum

18. Renosulfan

19. Sulfasoxazole

20. Sulfisonazole

21. Accuzole

22. Soxomide

23. Sulfazin

24. Sulfizin

25. Sulsoxin

26. Sosol

27. Roxosul Tablets

28. Sulphafurazol

29. Sulphisoxazol

30. Sulphofurazole

31. Chemouag

32. Cosoxazole

33. Gantrisona

34. Gantrosan

35. Isoxamin

36. Neazolin

37. Neoxazol

38. Sulfagan

39. Sulfasol

40. Uritrisin

41. Entusil

42. Entusul

43. Pancid

44. Soxisol

45. Stansin

46. Sulbio

47. Thiasin

48. Unisulf

49. Sulphadimethylisoxazole

50. 4-amino-n-(3,4-dimethylisoxazol-5-yl)benzenesulfonamide

51. Norilgan-s

52. Tl-azole

53. V-sul

54. Sk-soxazole

55. Sulfafurazolum

56. Sulphisoxazole

57. Dorsulfan

58. Gantrisine

59. Novazolo

60. Novosaxazole

61. Saxosozine

62. Sodizole

63. Soxamide

64. Soxazole

65. Soxitabs

66. Sulfapolar

67. Sulfisin

68. Sulfizol

69. Sulfizole

70. Urisoxin

71. Roxosul

72. Urogan

73. Vagilia

74. Azo Gantrisin

75. Dorsulfan Warthausen

76. Koro-sulf

77. Soxo

78. J-sul

79. 3,4-dimethyl-5-sulfonamidoisoxazole

80. 3,4-dimethyl-5-sulfanilamidoisoxazole

81. 5-sulfanilamido-3,4-dimethylisoxazole

82. Benzenesulfonamide, 4-amino-n-(3,4-dimethyl-5-isoxazolyl)-

83. 4-amino-n-(3,4-dimethyl-5-isoxazolyl)benzenesulfonamide

84. 3,4-dimethyl-5-sulphonamidoisoxazole

85. 3,4-dimethylisoxazole-5-sulfanilamide

86. G-sox

87. 3,4-dimethyl-5-sulphanilamidoisoxazole

88. 3,4-dimethylisoxazole-5-sulphanilamide

89. 5-sulphanilamido-3,4-dimethyl-isoxazole

90. 5-(4-aminophenylsulfonamido)-3,4-dimethylisoxazole

91. 5-(p-aminobenzenesulfonamido)-3,4-dimethylisoxazole

92. 5-(p-aminobenzenesulphonamido)-3,4-dimethylisoxazole

93. N1-(3,4-dimethyl-5-isoxazolyl)sulfanilamide

94. N'-(3,4)dimethylisoxazol-5-yl-sulphanilamide

95. Nci-c50022

96. Eryzole

97. Nu 445

98. Pediazole

99. U.s.-67

100. 4-amino-n-(3,4-dimethyl-5-isoxazolyl)benzenesulphonamide

101. 4-amino-n-(3,4-dimethyl-1,2-oxazol-5-yl)benzenesulfonamide

102. Sulfafurazole (inn)

103. Sulfafurazole [inn]

104. N(sup1)-(3,4-dimethyl-5-isoxazolyl)sulfanilamide

105. Chebi:102484

106. Gantrisin (tn)

107. Sulfisoxazolum

108. Component Of Azo-sulfizin

109. Mfcd00003150

110. Nsc-13120

111. Component Of Azo Gantrisin

112. Chembl453

113. Nsc-683536

114. N(sup 1)-(3,4-dimethyl-5-isoxazolyl)sulfanilamide

115. N(sup 1)-(3,4-dimethyl-5-isoxazolyl)sulphanilamide

116. 4-amino-n-(dimethyl-1,2-oxazol-5-yl)benzene-1-sulfonamide

117. Nsc13120

118. 3,4-dimethylisoxale-5-sulfanilamide

119. Nsc683536

120. 740t4c525w

121. Sulfazin (van)

122. Ncgc00016384-03

123. Ncgc00016384-10

124. Azosulfizin

125. Solfafurazolo

126. Sulphafuraz

127. 4-amino-n-(3,4-dimethyl-isoxazol-5-yl)-benzenesulfonamide

128. Astrazolo

129. Bactesulf

130. Barazae

131. Cas-127-69-5

132. Resoxol

133. Roxoxol

134. Sulfagen

135. Suloxsol

136. Ganda

137. 4-amino-n-(3,4-dimethyl-1,2-oxazol-5-yl)benzene-1-sulfonamide

138. Solfafurazolo [dcit]

139. Dsstox_cid_1292

140. N(1)-(3,4-dimethyl-5-isoxazolyl)sulfanilamide

141. Dsstox_rid_76064

142. Dsstox_gsid_21292

143. N(1)-(3,4-dimethyl-5-isoxazolyl)sulphanilamide

144. 5-(p-aminobenzenesulfonamido)-3,4-dimethylisooxale

145. Sulfafurazolum [inn-latin]

146. Wln: T5noj Cmswr Dz& D1 E1

147. Sulfanilamide,4-dimethyl-5-isoxazolyl)-

148. Smr000037657

149. Ccris 568

150. Hsdb 797

151. Benzenesulfonamide,4-dimethyl-5-isoxazolyl)-

152. Sr-01000003085

153. Einecs 204-858-9

154. Nsc 13120

155. Sulfisoxazole [usp:jan]

156. Nsc 683536

157. Brn 0263871

158. Gantrizin

159. Ai3-24003

160. Unii-740t4c525w

161. Component Of Azo Gantrisin Accuzole

162. Prestwick_726

163. Spectrum_001024

164. Tocris-0731

165. Prestwick0_000334

166. Prestwick1_000334

167. Prestwick2_000334

168. Prestwick3_000334

169. Spectrum2_001325

170. Spectrum3_001728

171. Spectrum4_000349

172. Spectrum5_001222

173. Azo-sulfizin (salt/mix)

174. Sulfisoxazole [mi]

175. Azo Gantrisin (salt/mix)

176. Epitope Id:122240

177. Sulfisoxazole [jan]

178. Sulfafurazole [iarc]

179. Sulfisoxazole (jp17/usp)

180. Sulfisoxazole [hsdb]

181. Sulfisoxazole, >=99.0%

182. Oprea1_680668

183. Oprea1_828173

184. Schembl23467

185. Sulfanilamide, N1-(3,4-dimethyl-5-isoxazolyl)-

186. Bspbio_000367

187. Bspbio_003376

188. Kbiogr_000757

189. Kbioss_001504

190. Sulfisoxazole [vandf]

191. 4-27-00-04747 (beilstein Handbook Reference)

192. Mls000028495

193. Mls000037737

194. Mls000563718

195. Bidd:gt0322

196. Divk1c_000579

197. Spectrum1500555

198. Sulfafurazole [mart.]

199. Spbio_001449

200. Spbio_002288

201. Sulfafurazole [who-dd]

202. Sulfisoxazole [usp-rs]

203. Bpbio1_000405

204. Dtxsid6021292

205. Sulfanilamide, N(sup 1)-(3,4-dimethyl-5-isoxazolyl)-

206. Hms501m21

207. Kbio1_000579

208. Kbio2_001504

209. Kbio2_004072

210. Kbio2_006640

211. Kbio3_002596

212. [(4-aminophenyl)sulfonyl](3,4-dimethylisoxazol-5-yl)amine

213. 4-amino-n-(3,4-dimethylisoxazol-5-yl)-benzenesulfonamide

214. Ninds_000579

215. Hms1569c09

216. Hms2092k13

217. Hms2096c09

218. Hms2233g23

219. Hms3259c06

220. Hms3266n17

221. Hms3374k11

222. Hms3411f03

223. Hms3655b03

224. Hms3675f03

225. Hms3713c09

226. Nu445

227. Pharmakon1600-01500555

228. Sulfisoxazole [green Book]

229. Sulfisoxazole [orange Book]

230. Albb-014131

231. Hy-b0323

232. Nsc33807

233. Nsc38588

234. Str04988

235. Sulfafurazole [ep Monograph]

236. Tox21_110409

237. Tox21_112958

238. Tox21_202265

239. Tox21_302851

240. Bdbm50034452

241. Ccg-39263

242. Nsc-33807

243. Nsc-38588

244. Nsc757343

245. S1916

246. Stk400452

247. Sulfisoxazole [usp Monograph]

248. Zinc96006009

249. Akos000119074

250. Akos000310021

251. Tox21_110409_1

252. Ac-1941

253. Db00263

254. Nc00536

255. Nsc-757343

256. Idi1_000579

257. Ncgc00016384-01

258. Ncgc00016384-02

259. Ncgc00016384-04

260. Ncgc00016384-05

261. Ncgc00016384-06

262. Ncgc00016384-07

263. Ncgc00016384-08

264. Ncgc00016384-09

265. Ncgc00016384-11

266. Ncgc00016384-12

267. Ncgc00016384-14

268. Ncgc00016384-15

269. Ncgc00023116-02

270. Ncgc00023116-05

271. Ncgc00023116-06

272. Ncgc00023116-07

273. Ncgc00023116-08

274. Ncgc00256605-01

275. Ncgc00259814-01

276. Sulfisoxazole 100 Microg/ml In Methanol

277. Sbi-0051529.p003

278. Azo Gantrisin Component Sulfisoxazole

279. Db-041869

280. Upcmld00x127-69-5:001

281. Ab00052104

282. Bb 0259593

283. Ft-0631743

284. Sw196872-3

285. U0098

286. Sulfisoxazole 1000 Microg/ml In Acetonitrile

287. C07318

288. D00450

289. H10712

290. N1-(3,4-dimethyl-5-isoxazolyl)sulphanilamide

291. Sulfisoxazole Component Of Azo Gantrisin

292. Ab00052104-14

293. Ab00052104_15

294. Ab00052104_16

295. Q372598

296. Sulfisoxazole, Vetranal(tm), Analytical Standard

297. 5-(4-aminophenylsulphonamido)-3,4-dimethylisoxazole

298. J-005528

299. Sr-01000003085-2

300. Sr-01000003085-5

301. Sr-01000003085-6

302. 5-(p-aminobenzenesulphonamide)-3,4-dimethylisoxazole

303. Brd-k50859149-001-05-4

304. Brd-k50859149-001-10-4

305. Sulfanilamide, N(sup1)-(3,4-dimethyl-5-isoxazolyl)-

306. Sulfanilamide, N.sup1.-(3,4-dimethyl-5-isoxazolyl)-

307. 4-amino-n-(3,4-dimethyl-5-isoxazolyl)benzenesulfonamid

308. F0848-0391

309. 4-amino-n-(3,4-dimethyl-5-isoxazolyl)benzene-sulfonamide

310. 4-amino-n-(3,4-dimethyl-5-isoxazolyl)benzenesulfonamide #

311. Sulfafurazole, European Pharmacopoeia (ep) Reference Standard

312. Sulfisoxazole, United States Pharmacopeia (usp) Reference Standard

2.4 Create Date
2005-03-25
3 Chemical and Physical Properties
Molecular Weight 267.31 g/mol
Molecular Formula C11H13N3O3S
XLogP31
Hydrogen Bond Donor Count2
Hydrogen Bond Acceptor Count6
Rotatable Bond Count3
Exact Mass267.06776246 g/mol
Monoisotopic Mass267.06776246 g/mol
Topological Polar Surface Area107 Ų
Heavy Atom Count18
Formal Charge0
Complexity374
Isotope Atom Count0
Defined Atom Stereocenter Count0
Undefined Atom Stereocenter Count0
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Therapeutic Uses

Anti-Infective Agents /SRP: Antibacterial/

National Library of Medicine's Medical Subject Headings online file (MeSH, 1999)


Acute, recurrent or chronic urinary tract infections (primarily pyelonephritis, pyelitis and cystitis) due to susceptible organisms (usually Escherichia coli, Klebsiella-Enterobacter, staphylococcus, Proteus mirabilis and, less frequently, Proteus vulgaris) in the absence of obstructive uropathy or foreign bodies. /Included in US product label/

US Natl Inst Health; DailyMed. Current Medication Information for Sulfisoxazole (March 2007). Available from, as of June 30, 2008: https://dailymed.nlm.nih.gov/dailymed/about.cfm


Meningococcal meningitis where the organism has been demonstrated to be susceptible. Haemophilus influenzae meningitis as adjunctive therapy with parenteral streptomycin. /Included in US product label/

US Natl Inst Health; DailyMed. Current Medication Information for Sulfisoxazole (March 2007). Available from, as of June 30, 2008: https://dailymed.nlm.nih.gov/dailymed/about.cfm


Meningococcal meningitis prophylaxis when sulfonamide-sensitive group A strains are known to prevail in family groups or larger closed populations. (The prophylactic usefulness of sulfonamides when group B or C infections are prevalent has not been proven and in closed population groups may be harmful.) Important Note: In vitro sulfonamide susceptibility tests are not always reliable. The test must be carefully coordinated with bacteriologic and clinical response. When the patient is already taking sulfonamides, follow-up cultures should have aminobenzoic acid added to the culture media. /Included in US product label/

US Natl Inst Health; DailyMed. Current Medication Information for Sulfisoxazole (March 2007). Available from, as of June 30, 2008: https://dailymed.nlm.nih.gov/dailymed/about.cfm


For more Therapeutic Uses (Complete) data for SULFISOXAZOLE (26 total), please visit the HSDB record page.


4.2 Drug Warning

/Sulfisoxazole/ is contraindicated in the following patient populations: patients with a known hypersensitivity to sulfonamides; infants less than 2 months of age (except in the treatment of congenital toxoplasmosis as adjunctive therapy with pyrimethamine); pregnant women at term; and mothers nursing infants less than 2 months of age.

US Natl Inst Health; DailyMed. Current Medication Information for Sulfisoxazole (March 2007). Available from, as of June 30, 2008: https://dailymed.nlm.nih.gov/dailymed/about.cfm


Use in pregnant women at term, in infants less than 2 months of age and in mothers nursing infants less than 2 months of age is contraindicated because sulfonamides may promote kernicterus in the newborn by displacing bilirubin from plasma proteins.

US Natl Inst Health; DailyMed. Current Medication Information for Sulfisoxazole (March 2007). Available from, as of June 30, 2008: https://dailymed.nlm.nih.gov/dailymed/about.cfm


Fatalities associated with the administration of sulfonamides, although rare, have occurred due to severe reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, fulminant hepatic necrosis, agranulocytosis, aplastic anemia and other blood dyscrasias.

US Natl Inst Health; DailyMed. Current Medication Information for Sulfisoxazole (March 2007). Available from, as of June 30, 2008: https://dailymed.nlm.nih.gov/dailymed/about.cfm


Sulfonamides, including sulfisoxazole, should be discontinued at the first appearance of skin rash or any sign of an adverse reaction.

US Natl Inst Health; DailyMed. Current Medication Information for Sulfisoxazole (March 2007). Available from, as of June 30, 2008: https://dailymed.nlm.nih.gov/dailymed/about.cfm


For more Drug Warnings (Complete) data for SULFISOXAZOLE (34 total), please visit the HSDB record page.


4.3 Drug Indication

For the treatment of severe, repeated, or long-lasting urinary tract infections, meningococcal meningitis, acute otitis media, trachoma, inclusion conjunctivitis, nocardiosis, chancroid, toxoplasmosis, malaria and other bacterial infections.


5 Pharmacology and Biochemistry
5.1 Pharmacology

Sulfisoxazole is a sulfonamide antibiotic. The sulfonamides are synthetic bacteriostatic antibiotics with a wide spectrum against most gram-positive and many gram-negative organisms. However, many strains of an individual species may be resistant. Sulfonamides inhibit multiplication of bacteria by acting as competitive inhibitors of p-aminobenzoic acid in the folic acid metabolism cycle. Bacterial sensitivity is the same for the various sulfonamides, and resistance to one sulfonamide indicates resistance to all. Most sulfonamides are readily absorbed orally. However, parenteral administration is difficult, since the soluble sulfonamide salts are highly alkaline and irritating to the tissues. The sulfonamides are widely distributed throughout all tissues. High levels are achieved in pleural, peritoneal, synovial, and ocular fluids. Although these drugs are no longer used to treat meningitis, CSF levels are high in meningeal infections. Their antibacterial action is inhibited by pus.


5.2 MeSH Pharmacological Classification

Anti-Infective Agents

Substances that prevent infectious agents or organisms from spreading or kill infectious agents in order to prevent the spread of infection. (See all compounds classified as Anti-Infective Agents.)


5.3 FDA Pharmacological Classification
5.3.1 Active Moiety
SULFISOXAZOLE
5.3.2 FDA UNII
740T4C525W
5.3.3 Pharmacological Classes
Chemical Structure [CS] - Sulfonamides
5.4 ATC Code

J - Antiinfectives for systemic use

J01 - Antibacterials for systemic use

J01E - Sulfonamides and trimethoprim

J01EB - Short-acting sulfonamides

J01EB05 - Sulfafurazole


S - Sensory organs

S01 - Ophthalmologicals

S01A - Antiinfectives

S01AB - Sulfonamides

S01AB02 - Sulfafurazole


5.5 Absorption, Distribution and Excretion

Route of Elimination

The mean urinary excretion recovery following oral administration of sulfisoxazole is 97% within 48 hours, of which 52% is intact drug, with the remaining as the N4-acetylated metabolite. It is excreted in human milk.


Following oral administration, sulfisoxazole is rapidly and completely absorbed; the small intestine is the major site of absorption, but some of the drug is absorbed from the stomach. Sulfonamides are present in the blood as free, conjugated (acetylated and possibly other forms) and protein-bound forms. The amount present as "free" drug is considered to be the therapeutically active form. Approximately 85% of a dose of sulfisoxazole is bound to plasma proteins, primarily to albumin; 65% to 72% of the unbound portion is in the nonacetylated form.

US Natl Inst Health; DailyMed. Current Medication Information for Sulfisoxazole (March 2007). Available from, as of June 30, 2008: https://dailymed.nlm.nih.gov/dailymed/about.cfm


Maximum plasma concentrations of intact sulfisoxazole following a single 2-g oral dose of sulfisoxazole to healthy adult volunteers ranged from 127 to 211 ug/mL (mean, 169 ug/mL) and the time of peak plasma concentration ranged from 1 to 4 hours (mean, 2.5 hours). ... After multiple-dose oral administration of 500 mg /four times a day/ to healthy volunteers, the average steady-state plasma concentrations of intact sulfisoxazole ranged from 49.9 to 88.8 ug/mL (mean, 63.4 ug/mL).

US Natl Inst Health; DailyMed. Current Medication Information for Sulfisoxazole (March 2007). Available from, as of June 30, 2008: https://dailymed.nlm.nih.gov/dailymed/about.cfm


Following a single 4-g dose of acetyl sulfisoxazole to healthy volunteers, maximum plasma concentrations of sulfisoxazole ranged from 122 to 282 ug/mL (mean, 181 ug/mL) for the pediatric suspension and occurred between 2 and 6 hours postadministration. /Acetyl-sulfisoxazole/

US Natl Inst Health; DailyMed. Current Medication Information for Sulfisoxazole (March 2007). Available from, as of June 30, 2008: https://dailymed.nlm.nih.gov/dailymed/about.cfm


Wide variation in blood levels may result following identical doses of a sulfonamide. Blood levels should be measured in patients receiving sulfonamides at the higher recommended doses or being treated for serious infections. Free sulfonamide blood levels of 50 to 150 ug/mL may be considered therapeutically effective for most infections, with blood levels of 120 to 150 ug/mL being optimal for serious infections. The maximum sulfonamide level should not exceed 200 ug/mL, since adverse reactions occur more frequently above this concentration.

US Natl Inst Health; DailyMed. Current Medication Information for Sulfisoxazole (March 2007). Available from, as of June 30, 2008: https://dailymed.nlm.nih.gov/dailymed/about.cfm


For more Absorption, Distribution and Excretion (Complete) data for SULFISOXAZOLE (25 total), please visit the HSDB record page.


5.6 Metabolism/Metabolites

N1-acetyl sulfisoxazole is metabolized to sulfisoxazole by digestive enzymes in the gastrointestinal tract and is absorbed as sulfisoxazole. This enzymatic splitting is presumed to be responsible for slower absorption and lower peak blood concentrations than are attained following administration of an equal oral dose of sulfisoxazole. With continued administration of acetyl sulfisoxazole, blood concentrations approximate those of sulfisoxazole. /Acetyl-sulfisoxazole/

US Natl Inst Health; DailyMed. Current Medication Information for Sulfisoxazole (March 2007). Available from, as of June 30, 2008: https://dailymed.nlm.nih.gov/dailymed/about.cfm


Although the liver is the major site of metabolism, sulfonamides may also be metabolized in other body tissues. Most sulfonamides are metabolized mainly by N4-acetylation. The degree of acetylation, which is a function of time, varies from less than 5% for sulfamethizole to up to 40% for sulfadiazine. The N4-acetyl metabolites, which do not possess antibacterial activity, have greater affinity for plasma albumin than does the nonacetylated drug and are usually less soluble than the parent sulfonamide, particularly in acidic urine. Like acetyl derivatives, glucuronide derivatives do not possess antibacterial activity; however, glucuronide derivatives are water soluble, appear to resemble the nonacetylated sulfonamide in plasma binding capacity, and have not been associated with adverse effects. /Sulfonamides/

American Society of Health System Pharmacists. AHFS Drug Information 2008. Bethesda, Maryland 2008, p. 425


Identified urinary metabolites of sulfafurazole are acetylsulphisoxazole, sulphisoxazole-N-glucuronide, sulphisoxazole-N-sulphonate and sulphanilamide.

IARC. Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Humans. Geneva: World Health Organization, International Agency for Research on Cancer, 1972-PRESENT. (Multivolume work). Available at: https://monographs.iarc.fr/ENG/Classification/index.php, p. V24 280


In man it is excreted in urine as unchanged sulfisoxazole (56%), N(4)-acetyl derivative (18%), N(4)-glucuronide (3.4%), N(4)-sulfate (1.0%) & a second glucuronide which is probably N(2)-glucuronide of sulfisoxazole.

Parke, D. V. The Biochemistry of Foreign Compounds. Oxford: Pergamon Press, 1968., p. 181


Saturable metabolism of sulfisoxazole N1-acetyl in the rat during the initial pass of the drug from the intestinal lumen through the liver following oral administration of the drug (saturable first-pass metabolism) was investigated. The fraction of the total amount of drug recovered from the urine as the N4-conjugate fraction was apparent following the intravenous administration of sulfisoxazole acetyl or the oral administration of sulfisoxazole at the same dose levels.

PMID:1263077 Bloedow D, Hayton W; J Pharm Sci 65 (3): 334-8 (1976)


5.7 Biological Half-Life

The elimination half-life of sulfisoxazole ranged from 4.6 to 7.8 hours after oral administration. The elimination of sulfisoxazole has been shown to be slower in elderly subjects (63 to 75 years) with diminished renal function (creatinine clearance, 37 to 68 mL/min).

US Natl Inst Health; DailyMed. Current Medication Information for Sulfisoxazole (March 2007). Available from, as of June 30, 2008: https://dailymed.nlm.nih.gov/dailymed/about.cfm


The half-life of elimination from plasma ranged from 5.4 to 7.4 hr. /Acetyl-sulfisoxazole/

US Natl Inst Health; DailyMed. Current Medication Information for Sulfisoxazole (March 2007). Available from, as of June 30, 2008: https://dailymed.nlm.nih.gov/dailymed/about.cfm


The half-life of sulfafurazole is approximately 6 hours.

IARC. Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Humans. Geneva: World Health Organization, International Agency for Research on Cancer, 1972-PRESENT. (Multivolume work). Available at: https://monographs.iarc.fr/ENG/Classification/index.php, p. V24 280


5.8 Mechanism of Action

Sulfisoxazole is a competitive inhibitor of the enzyme dihydropteroate synthetase. It inhibits bacterial synthesis of dihydrofolic acid by preventing the condensation of the pteridine with para-aminobenzoic acid (PABA), a substrate of the enzyme dihydropteroate synthetase. The inhibited reaction is necessary in these organisms for the synthesis of folic acid.


The sulfonamides are bacteriostatic agents and the spectrum of activity is similar for all. Sulfonamides inhibit bacterial synthesis of dihydrofolic acid by preventing the condensation of the pteridine with aminobenzoic acid through competitive inhibition of the enzyme dihydropteroate synthetase. Resistant strains have altered dihydropteroate synthetase with reduced affinity for sulfonamides or produce increased quantities of aminobenzoic acid.

US Natl Inst Health; DailyMed. Current Medication Information for Sulfisoxazole (March 2007). Available from, as of June 30, 2008: https://dailymed.nlm.nih.gov/dailymed/about.cfm


Sulfonamides are usually bacteriostatic in action. Sulfonamides interfere with the utilization of p-aminobenzoic acid (PABA) in the biosynthesis of tetrahydrofolic acid (the reduced form of folic acid) cofactors in susceptible bacteria. Sulfonamides are structural analogs of PABA and appear to interfere with PABA utilization by competitively inhibiting the enzyme dihydropteroate synthase, which catalyzes the formation of dihydropteroic acid (a precursor of tetrahydrofolic acid) from PABA and pteridine; however, other mechanism(s) affecting the biosynthetic pathway also may be involved. Compounds such as pyrimethamine and trimethoprim, which block later stages in the synthesis of folic acid, act synergistically with sulfonamides. Only microorganisms that synthesize their own folic acid are inhibited by sulfonamides; animal cells and bacteria which are capable of utilizing folic acid precursors or preformed folic acid are not affected by these drugs. The antibacterial activity of the sulfonamides is reportedly decreased in the presence of blood or purulent body exudates. /Sulfonamides/

American Society of Health System Pharmacists. AHFS Drug Information 2008. Bethesda, Maryland 2008, p. 424


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