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Functions & Usage

What is the drug Cotrimoxazole used for?

Trimethoprim / sulfamethoxazole is a drug used to treat serious infections such as pneumonia (lung infection), bronchitis (infection of the tubes leading to the lungs), and infections of the urinary tract, middle ear, and intestines.

Trimethoprim / sulfamethoxazole commonly called Cotrimoxazole or Co-trimoxazole. Apart from the above uses, this drug is also used to treat diarrhea.

How do you use Co-Trimoxazole?

Take Trimethoprim / sulfamethoxazole as instructed by your doctor or according to the information in the leaflet (leaflet), for example as follows:

• Take Trimethoprim / sulfamethoxazole either with or without food. To reduce symptoms of stomach upset, take this medication with a small amount of food.
• Drink plenty of fluids while taking this medicine to reduce the risk of crystals forming in the urine.
• Before drinking, Trimethoprim / sulfamethoxazole in the form of a suspension must be shaken first
• Use a measuring spoon to measure the correct dose of the suspension.
• Avoid using the usual teaspoon or tablespoon to administer the drug, because the dosage will not be accurate.
• Take medicine regularly and periodically. If you forget to take a dose, take it as soon as you remember. When it is already nearing the time for the next dose, just leave it. Do not take double doses when taking Trimethoprim / sulfamethoxazole
• Don't stop using it without consulting your doctor. Stopping doses without consulting a doctor will increase the chance that the infection will come back and that the bacteria will grow resistant to the antibiotic.

How do I store Co-Trimoxazole?

This medication should be stored at room temperature away from light and moisture. To prevent damage to the drug, you should not store this medication in the bathroom or freezer. There may be other brands of this medication that have different storage rules. Pay attention to the storage instructions on the packaging of your product, or ask your pharmacist. Keep all medicines out of reach of children and pets.

Do not flush this medication down the toilet or down the drain unless instructed to do so. Discard this product when it has expired or when it is no longer needed. Consult your pharmacist about how to safely dispose of your product.

Precautions & Warnings

What should be considered before using the drug Co-Trimoxazole?

Before using Trimethoprim / sulfamethoxazole, tell your doctor if you have:

• Allergies: Trimethoprim / sulfamethoxazole, excipient to use for dosage forms containing co-trimoxazole. This information is listed in detail in the product information leaflet.
• Allergy to other drugs, foods, dyes, preservatives, or animals.
• Children: Trimethoprim / sulfamethoxazole should not be used in children under 6 years of age without doctor's instructions.
• Elderly
• Other medical conditions, such as: thrombocytopenia, megaloblastic anemia

Is Co-Trimoxazole safe for pregnant and lactating women?

There are no adequate studies regarding the risks of using this drug in pregnant or breastfeeding women. Always consult your doctor to weigh the potential benefits and risks before using this medication. This drug is included in the risk of pregnancy category D according to the US Food and Drug Administration (FDA).

The following references the pregnancy risk categories according to the FDA:

• A = Not at risk
• B = No risk in several studies
• C = May be risky
• D = There is positive evidence of risk
• X = Contraindicated
• N = Unknown

Side effects

What are the possible side effects of Co-Trimoxazole?

When taking Trimethoprim / sulfamethoxazole, like any other medication, you may experience side effects ranging from very common to rare.

Very common side effects (occurring in more than 1 in 10 people) may include:

• Increased amount of potassium in the blood (hyperkalemia)

Common side effects (occurring in between 1 in 10 and 1 in 100 people) may include:

• Headache
• Diarrhea
• Nausea
• An overgrowth of Candida yeast, which can lead to infections such as thrush. Tell your doctor if you think that you have developed a new infection while taking this antibiotic.
• Rash

Rare side effects (occurring between 1 in 100 and 1 in 1000 people) may include:

• Gag

Very rare side effects (occurring in less than 1 in 10,000 people) may include:

• Loss of appetite
• Decrease in white blood cells, red blood cells or platelets in the blood
• Low blood sugar level (hypoglycemia)
• Decrease in the amount of sodium in the blood (hyponatremia)
• Depression
• Hallucinations
• Seizures
• Dizzy
• Inflammation of the lining of the mouth (stomatitis)
• Inflammation of the lining of the intestine (colitis)
• Inflammation of the pancreas (pancreatitis)
• Cholestatic jaundice
• Liver or kidney problems
• Skin reactions, eg Stevens-Johnson syndrome, toxic epidermal necrolysis
• Pain in muscles or joints
• Cough
• Hard to breathe

Not everyone experiences these side effects. There may be some side effects not listed above. If you have concerns about certain side effects, consult your doctor or pharmacist.

Drug Interactions

What drugs can interfere with the drug Co-Trimoxazole?

Trimethoprim / sulfamethoxazole may interact with other medicines that you are taking, which can change the performance of the drug or increase the risk of serious side effects. To avoid drug interactions, keep a list of all the products you use (including prescription / non-prescription drugs and herbal products) and consult your doctor or pharmacist. For your safety, do not start, stop, or change the dose of any medication without your doctor's approval.

• Amantadine; angiotensin converting enzyme inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accipril), ramipril), and trandolapril (Mavik)
• Anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven); cyclosporine (Gengraf, Neoral, Sandimmune)
• Oral diabetes medications such as glipizide (Glucotrol), glyburide (Diabeta, Glynase), metformin (Fortamet, Glucophage), pioglitazone (Actos), repaglinide (Prandin), rosiglitazone (Avandia)
• Digoxin (Lanoxin)
• Diuretics ('water pills')
• Indomethacin (Indocin)
• Leucovorin (Fusilev)
• Medications for seizures such as phenytoin (Dilantin, Phenytek)
• Memantine (Namenda); methotrexate (Trexall); pyrimethamine (Daraprim). And tricyclic antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil)
• Nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil)

Your doctor may need to change the dose of your medication or monitor you carefully so that you don't have unwanted side effects.

Can certain foods and drinks interfere with the work of the Co-Trimoxazole drug?

Trimethoprim / sulfamethoxazole may interact with the foods you are taking, which can change the performance of your medication or increase your risk of serious side effects. Consult your doctor or pharmacist about food and alcohol that can potentially interact before using Trimethoprim / sulfamethoxazole.

What health conditions can interfere with the performance of the drug Co-Trimoxazole?

Any other health conditions you have can affect the use of this drug. Always tell your doctor if you have other health problems. Health conditions that may interact with Trimethoprim / sulfamethoxazole include:

• Hematological Toxicity
• Hypersensitivity reaction
• Liver disease
• Porphy
• Kidney dysfunction
• Folate Deficiency
• Colitis
• Kristaluria
• Hemodialysis
• Urinary obstruction
• Dialysis
• Kidney dysfunction

Dose

The information provided is not a substitute for a doctor's prescription. ALWAYS consult your doctor or pharmacist before starting treatment.

What is the dosage of Trimethoprim / sulfamethoxazole for adults?

Usual Adult Dose for Pneumcystis Pneumonia

15-20 mg / kg / day orally or IV in 3-4 divided doses every 6-8 hours over a duration of 14-21 days; followed by chronic suppressive therapy.

Usual Adult Dose for Pneumocystis Pneumonia Prophylaxis

Trimethoprim / sulfamethoxazole 160 mg - 800 mg (1 two-strength tablet) orally once a day or 3 times a week. In case of infection with toxoplasmosis, the dose of this drug should be doubled for 2 tablets.

Usual Adult Dose for Urinary Tract Infections

• For oral administration: Trimethoprim / sulfamethoxazole 160 mg - 800 mg (1 double-strength tablets) orally every 12 hours for 10 to 14 days.
• For intravenous administration: Severe infections: 8 to 10 mg / kg / day (trimethoprim component) intravenously in 2 to 4 divided doses every 6, 8, or 12 hours for up to 14 days; The maximum recommended dose is 960 mg (trimethoprim component) per day.

Usual Adult Dose for Pyelonephritis

Uncomplicated: Trimethoprim / sulfamethoxazole 160 mg - 800 mg (1 double-strength tablets) orally every 12 hours for 7 to 14 days.

Usual Adult Dose for Bronchitis

Acute exacerbation of chronic bacterial bronchitis: Trimethoprim - sulfamethoxazole 160 mg - 800 mg (1 double-strength tablets) orally every 12 hours for 14 days.

Usual Adult Dose for Traveler's Diarrhea

Trimethoprim / sulfamethoxazole 160 mg - 800 mg (1 double-strength tablets) orally every 12 hours for 5 days.

Usual Adult Dose for Shigellosis

• For oral administration: Trimethoprim / sulfamethoxazole 160 mg - 800 mg (1 double-strength tablets) orally every 12 hours for 5 days.
• For intravenous administration of 8-10 mg / kg / day (component Trimethoprim / sulfamethoxazole) IV in 2-4 divided doses every 6, 8, or 12 hours for 5 days; The maximum recommended dose is 960 mg (cotrimoxazole component) per day.

Usual Adult Dose for Otitis Media

Trimethoprim / sulfamethoxazole 160 mg - 800 mg (1 double-strength tablets) orally every 12 hours for 10-14 days.

Usual Adult Dose for Prophylactic Cystitis

Trimethoprim / sulfamethoxazole 80 mg - 400 mg (1 double-strength tablets) orally once a day or 3 times a week at bedtime.

Usual Adult Dose for Diverticulitis

Mild, outpatient: Trimethoprim / sulfamethoxazole 160 mg - 800 mg (1 double-strength tablets) orally every 12 hours in combination with metronidazole 500 mg orally every 6 hours for a duration of 7 to 10 days.

Usual Adult Dose for Epiglottitis

• For intravenous administration: 2.5 mg / kg (Trimethoprim / sulfamethoxazole component) intravenously every 6 hours or 3.3 mg / kg (Trimethoprim / sulfamethoxazole component) intravenously every 8 hours or 5 mg / kg (Trimethoprim / sulfamethoxazole component) intravenously each 12 hours.
• For oral administration: replaced after the patient has improved and is able to tolerate oral drugs.

Usual adult dose for granuloma inguinale

Trimethoprim / sulfamethoxazole 160 mg-800 mg (1 double-strength tablets) orally twice a day for 3 weeks.

Usual Adult Dose for Prophylactic Infection

Trimethoprim / sulfamethoxazole 160 mg-800 mg (1 double-strength tablet) orally twice a day.

Usual adult dose for melioidosis

5 mg / kg (trimethoprim component) orally twice a day plus doxycycline 100 mg orally twice a day plus Chloramphenicol 10 mg / kg orally four times a day

Duration: 20 weeks of trimethoprim / sulfamethoxazole and doxycycline; Chloramphenicol for the first 8 weeks

Usual Adult Dose for Meningitis

5mg / kg (Trimethoprim / sulfamethoxazole component) IV every 6, 8, or 12 hours for 21 days to 6 weeks used in combination with Chloramphenicol is an alternative for patients with beta-lactam allergy.

Usual adult dose for nocardiosis

• Cutaneous infection: 5-10 mg / kg / day (Trimethoprim / sulfamethoxazole component) intravenously or orally in 2-4 divided doses.
• Severe infections (lung / brain): 15 mg / kg / day (Trimethoprim / sulfamethoxazole component) in 2-4 divided doses for 3 to 4 weeks, then 10 mg / kg / day (Trimethoprim / sulfamethoxazole component) in 2-4 doses divided; can be started intravenously and converted to oral therapy (often converted to an approximate dose of an oral solid dosage form: 2 double-strength tablets every 8 to 12 hours).

Usual Adult Dose for Pneumonia

For intravenous administration: 2.5 mg / kg (Trimethoprim / sulfamethoxazole component) intravenously every 6 hours or 3.3 mg / kg (Trimethoprim / sulfamethoxazole component) intravenously every 8 hours or 5 mg / kg (Trimethoprim / sulfamethoxazole component) intravenously each 12 hours.

Duration: 21 days; Pneumococcal pneumonia can be completely treated in 7 to 10 days

Usual adult dose for prostatitis

Trimethoprim / sulfamethoxazole 160 mg-800 mg (1 double-strength tablets) orally every 12 hours.

Duration: acute, 10-14 days; chronic, 1-3 months.

Usual Adult Dose for Sinusitis

Trimethoprim / sulfamethoxazole 160 mg-800 mg (1 double-strength tablet) orally every 12 hours.

Duration: 10-14 days; in some cases of recurrent or refractory sinusitis, therapy may take up to 3 to 4 weeks.

Usual Adult Dose for Toxoplasmosis

5 mg / kg (Trimethoprim / sulfamethoxazole) IV every 12 hours

Duration: depending on the nature and severity of the infection; can be 4 weeks to 6 months or more.

Usual Adult Dose for Toxoplasmosis - Prophylaxis

Trimethoprim / sulfamethoxazole 160 mg-800 mg (1 double-strength tablet) or 80 mg-400 mg (1 single-strength tablet) orally once a day.

Usual Adult Dose for Upper Respiratory Infection

Trimethoprim / sulfamethoxazole 160 mg-800 mg (1 double-strength tablet) orally every 12 hours

What is the dose of the drug Trimethoprim / sulfamethoxazole for children?

Usual children's dosage for Otitis Media

For children 2 months of age or older: 4 mg / kg (Trimethoprim / sulfamethoxazole component) orally every 12 hours for 10 days.

Usual children's dosage for Urinary Tract Infections

For oral administration: For children 2 months of age or older: Oral: 4 mg / kg (Trimethoprim / sulfamethoxazole component) orally every 12 hours for 10-14 days.

For intravenous administration: Severe infection: 8-10 mg / kg / day (Trimethoprim / sulfamethoxazole components) IV in 2-4 divided doses every 6, 8, or 12 hours for up to 14 days; The maximum recommended dose is 960 mg (Trimethoprim / sulfamethoxazole component) per day.

Usual children's dosage for shigellosis

• For oral administration: For children 2 months of age or older: 4 mg / kg (Trimethoprim / sulfamethoxazole component) orally every 12 hours for 5 days.
• For intravenous administration: 8 to 10 mg / kg / day (Trimethoprim / sulfamethoxazole component) IV in 2-4 divided doses every 6, 8, or 12 hours for 5 days; The maximum recommended dose is 960 mg (Trimethoprim / sulfamethoxazole component) per day.

Usual children's dosage for Pneumocystis Pneumonia

For children 2 months of age or older: 15-20 mg / kg / day (Trimethoprim / sulfamethoxazole component) orally or intravenously in 3-4 divided doses every 6-8 hours for 14 to 21 days.

Usual children's dosage for Pneumocystis Pneumonia Prophylaxis

2 months or more: 75 mg / m2 (Trimethoprim / sulfamethoxazole component) orally twice daily, on 3 consecutive days per week.

The total daily dose should not exceed 320 mg (Trimethoprim / sulfamethoxazole components).

In what dosages and preparations Trimethoprim / sulfamethoxazole available?

Trimethoprim / sulfamethoxazole is available in the following dosages:

400 mg-80 mg; 800 mg-160 mg; 200 mg-40 mg / 5 mL; 80 mg-16 mg / mL

What to do in an emergency or overdose?

In case of an emergency or overdose, contact the local emergency services provider (118/119) or immediately to the nearest hospital emergency department.

What should I do if I forget to take medicine or forget to take medicine?

If you forget one Trimethoprim / sulfamethoxazole, take it as soon as possible. However, when it is nearing the time of the next dose, skip the missed dose and return to the usual dosing schedule. Don't double the dose.

Hello Health Group does not provide medical consultation, diagnosis or treatment.