Co-Trimoxazole
- Co-Trimoxazole
- -
- Tablet
- 400/80 mg
- Blister
- 100 Tablets
-Each Tablet Contains:
Sulfamethoxazole 400mg
Trimethoprim 80mg
Sulfamethoxazole 400mg
Trimethoprim 80mg
• Chronic Bronchitis
• Meningitis, Bacterial
• Pneumocystis (Carinii) Jiroveci Pneumonia
• Sepsis
• Shigellosis
• Traveler's Diarrhea
• Urinary Tract Infections
• Meningitis, Bacterial
• Pneumocystis (Carinii) Jiroveci Pneumonia
• Sepsis
• Shigellosis
• Traveler's Diarrhea
• Urinary Tract Infections
Mechanism of Action
Co-Trimoxazole blocks 2 consecutive steps in the biosynthesis of nucleic acids and proteins essential to many bacteria.
Pharmacokinetics
Time to peak: 1-4 hours
Excretion: Urine
Contraindications
• Known hypersensitivity
• Age <2 months
• CrCl <15 mL/min when renal function status cannot be monitored
• Documented megaloblastic or folate deficiency anemia
• Significan hepatic impairment
• Contraindicated in pregnant patients at term and in nursing mothers, because sulfonamides, which pass the placenta and are excreted in the milk, may cause kernicterus
• History of drug-induced immune thrombocytopenia with use of trimethoprim and/or sulfonamides
Adverse Reactions
Anorexia, Nausea, Vomiting, Vertigo, Seizure, Peripheral neuritis, Erythema multiforme, Hyperkalemia, Rash, Urticaria, Immune hypersensitivity reaction, Stevens-Johnson syndrome, Toxic epidermal necrolysis, Agranulocytosis, Aplastic anemia, Hyponatremia, Disorder of hematopoietic structure, Fulminant hepatic necrosis
Major Drug Interactions
-
Warnings
• Caution when used in elderly individuals, risk of bone marrow suppression.
• Prolonged use may result in fungal or bacterial superinfection.
• Caution with impaired renal or hepatic function, patients with possible folate deficiency (eg, the elderly, chronic alcoholics, patients receiving anticonvulsant therapy, patients with malabsorption syndrome, and patients in malnutrition states), and patients with severe allergies or bronchial asthma.
Recommendations for Patient
• During treatment, adequate fluid intake and urinary output should be ensured to prevent crystalluria, patients who are “slow acetylators” may be more prone to idiosyncratic reactions to sulfonamides.
Pregnancy Considerations
Use during pregnancy only if potential benefit justifies potential risk to fetus.
Breastfeeding Considerations
Because of potential risk of bilirubin displacement and kernicterus on breastfed child, advise women to avoid breastfeeding during therapy.
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: Maybe acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Co-Trimoxazole blocks 2 consecutive steps in the biosynthesis of nucleic acids and proteins essential to many bacteria.
Pharmacokinetics
Time to peak: 1-4 hours
Excretion: Urine
Contraindications
• Known hypersensitivity
• Age <2 months
• CrCl <15 mL/min when renal function status cannot be monitored
• Documented megaloblastic or folate deficiency anemia
• Significan hepatic impairment
• Contraindicated in pregnant patients at term and in nursing mothers, because sulfonamides, which pass the placenta and are excreted in the milk, may cause kernicterus
• History of drug-induced immune thrombocytopenia with use of trimethoprim and/or sulfonamides
Adverse Reactions
Anorexia, Nausea, Vomiting, Vertigo, Seizure, Peripheral neuritis, Erythema multiforme, Hyperkalemia, Rash, Urticaria, Immune hypersensitivity reaction, Stevens-Johnson syndrome, Toxic epidermal necrolysis, Agranulocytosis, Aplastic anemia, Hyponatremia, Disorder of hematopoietic structure, Fulminant hepatic necrosis
Major Drug Interactions
-
Warnings
• Caution when used in elderly individuals, risk of bone marrow suppression.
• Prolonged use may result in fungal or bacterial superinfection.
• Caution with impaired renal or hepatic function, patients with possible folate deficiency (eg, the elderly, chronic alcoholics, patients receiving anticonvulsant therapy, patients with malabsorption syndrome, and patients in malnutrition states), and patients with severe allergies or bronchial asthma.
Recommendations for Patient
• During treatment, adequate fluid intake and urinary output should be ensured to prevent crystalluria, patients who are “slow acetylators” may be more prone to idiosyncratic reactions to sulfonamides.
Pregnancy Considerations
Use during pregnancy only if potential benefit justifies potential risk to fetus.
Breastfeeding Considerations
Because of potential risk of bilirubin displacement and kernicterus on breastfed child, advise women to avoid breastfeeding during therapy.
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: Maybe acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
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