This parasite is sensitive to clindamycin (Dalacin C, 4 x 600 mg per day) and to pyrimethamine (Daraprim®, 100 mg day 1, thereafter 50 mg per day) + sulphadiazine (4-6 g per day). It is best with this latter combination to add 15-30 mg folinic acid (Ledervorin®) per day to reduce bone marrow toxicity. Do not confuse folinic acid and folic acid: folic acid counteracts the therapeutic action of pyrimethamine. Pyrimethamine 50 mg together with dapsone 100 mg can also be used for toxoplasmosis. Atovaquone is moderately active against this organism. Corticosteroids are indicated when there are signs of intracranial hypertension. Phenytoin (Diphantoine®) can be used in epilepsy. Prevention of relapse with cotrimoxazole, pyrimethamine + sulphadiazine or dapsone is indicated after the attack therapy.
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