Sulphadiazine and pyrimethamine are used in combination to treat equine protozoal myeloencephalitis (EPM). These drugs interfere with folic acid (folate) metabolism, a vitamin essential for survival of the causative protozoon Sarcocystis neurona. In human patients, these drugs can cause folate deficiency. Signs of deficiency include bone marrow suppression and ulcerations of the tongue

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