DBL Sulfamethoxazole & Trimethoprim

DBL Sulfamethoxazole & Trimethoprim

sulfamethoxazole + trimethoprim

Manufacturer:

Pfizer

Distributor:

Zuellig Pharma

Marketer:

DKSH
Concise Prescribing Info
Contents
Per 5 mL Co-trimoxazole: Sulfamethoxazole (SMZ) 400 mg, trimethoprim (TM) 80 mg
Indications/Uses
Pre- & post-op infections associated w/ surgery, trauma or gynaecology; septicaemia & other infections due to sensitive organisms eg, typhoid & paratyphoid.
Dosage/Direction for Use
Adult & childn >12 yr Standard dose: 10 mL diluted & infused bd. Severe infections 15 mL diluted & infused bd. Childn ≤12 yr TM 6 mg & SMZ 30 mg/kg daily divided into 2 equal doses, 6-12 yr 5 mL diluted & infused bd, 6 mth-5 yr 2.5 mL diluted & infused bd, 2-5 mth 1.25 mL diluted & infused bd. Pneumocystis carinii pneumonitis TM 20 mg/kg & SMZ 100 mg/kg daily given in equally divided doses every 6 hr for 14 days. CrCl >25 mL/min 1 standard dose every 12 hr for up to 14 days, thereafter ½ standard dose every 12 hr, 15-25 mL/min 1 standard dose every 12 hr for 3 days, thereafter 1 standard dose every 24 hr, <15 mL/min 1 standard dose every 24 hr.
Contraindications
Hypersensitivity to sulfonamide or trimethoprim. Marked liver parenchymal damage, blood dyscrasias, documented megaloblastic anaemia secondary to folate deficiency. Streptococcal pharyngitis treatment. Severe renal insufficiency. Premature & newborn babies during 1st 8 wk of life.
Special Precautions
Discontinue use if skin rash appears. Anaphylaxis & life-threatening or less severe asthmatic episodes. AIDS, G6PD deficiency, urinary obstruction, blood dyscrasias, allergies or bronchial asthma, chronic alcoholics, RA, malabsorption syndromes, malnutrition states. Superinfection. Ensure adequate fluid intake. Monitor blood counts regularly on long-term therapy. Concomitant use w/ opiates, & diphenoxylate w/ atropine; anticonvulsants eg, phenytoin, primidone & barbiturates. Renal &/or hepatic impairment. Pregnancy & lactation. Elderly.
Adverse Reactions
Stevens-Johnson syndrome, toxic epidermal necrolysis, fulminant hepatic necrosis, agranulocystosis, aplastic anaemia & other blood dyscrasias. Nausea & vomiting; neutropenia & thrombocytopenia; dysuria, oliguria, anuria, haematuria, urgency & functional kidney changes; headache, insomnia, fatigue, apathy, nervousness, muscle weakness, ataxia, vertigo, tinnitus, peripheral neuritis, mental depression, aseptic meningitis, seizures, hallucinations; pain, local irritation, inflammation, thrombophlebitis; drug fever, chills, myalgia, pulmonary infiltrates, cough, shortness of breath, hypotension, periarteritis nodosa, positive lupus erythematous phenomenon.
Drug Interactions
Increased free methotrexate levels. Antagonised antibacterial effects w/ PABA or its derivatives. Increased warfarin anticoagulant activity. Increased phenytoin effects & side effects. Potentiated hypoglycaemia w/ sulphonylureas. Increased thrombocytopenia w/ diuretics when used in elderly. Deteriorated renal function of transplant patients w/ cyclosporin. Megaloblastic anaemia w/ pyrimethamine. Increased plasma digoxin levels. Increased sulfamethoxazole blood levels w/ urinary acidifiers, oral anticoagulants, phenylbutazone, oxyphenbutazone & indomethacin. Cross sensitisation w/ antithyroid agents, diuretics (acetazolamide & thiazides) & oral hypoglycaemics.
MIMS Class
Antibacterial Combinations
ATC Classification
J01EE01 - sulfamethoxazole and trimethoprim ; Belongs to the class of combinations of sulfonamides and trimethoprim, including derivatives. Used in the systemic treatment of infections.
Presentation/Packing
Form
DBL Sulfamethoxazole & Trimethoprim inj conc
Packing/Price
5 mL x 5 × 1's
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