Bactrim (brand) Sulfamethoxazole - Trimethoprim




Contents
Per adult tab Co-trimoxazole: Trimethoprim (TM) 80 mg & sulfamethoxazole (SMZ) 400 mg. Per 5 mL syr TM 40 mg, SMZ 200 mg. Per 5 mL amp TM 80 mg, SMZ 400 mg.

MIMS Class
Antibacterial Combinations

Indications
Infection of resp tract, GUT, GIT, skin & soft tissues, acute & chronic osteomyelitis, acute brucellosis, nocardiosis, actinomycetoma, paracoccidioidomycosis, septicemia due to sensitive organisms.

Dosage
Tab Adult 2 tab bid. Long-term treatment: 1 tab bid. Syr Childn 6-12 yr 10 mL bid, 6 mth-5 yr 5 mL bid, 6 wk-5 mth 2.5 mL bid. Inj Given only when oral treatment is not possible.

Contraindication
Hypersensitivity to sulfonamides & trimethoprim. Marked liver parenchymal damage; severe renal & hepatic impairment; newborn infants.

Precautions
Haematological disorders; elderly; pregnancy; lactation; G6PD deficiency, folate deficiency, impaired renal function, patients w/ a history of severe allergy & bronchial asthma, phenylketonuria, porphyria or thyroid dysfunction, slow acetylators.

Adverse Reactions
GI upsets, stomatitis; skin reactions; tinnitus; erythema multiforme, Stevens-Johnson syndrome, Lyell's syndrome; leukopenia, neutropenia, thrombocytopenia. Rarely, agranulocytosis, megaloblastic anemia, pancytopenia or purpura, hyperkalaemia, hypoglycaemia. Disorders of the CNS, urinary system, musculoskeletal system, metabolism.

Drug Interaction
Increased incidence of thrombocytopenia w/ thiazide diuretics in elderly. May require dosage reduction of warfarin & phenytoin. May displace methotrexate from plasma protein-binding sites. Possible megaloblastic anemia w/ high dose of pyrimethamine. Potentiates nephrotoxicity of cyclosporin (reversible). Potentiates the effect of oral hypoglycemic agents.

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