Sulfamoxole + Trimethoprim


Concise Prescribing Info
Indications/Uses
Susceptible infections.
Dosage/Direction for Use
Adult : PO Per tab contains sulfamoxole 400 mg and trimethoprim 60 mg: Initial: 2 tab, then 1 tab twice daily. Per 5 mL contains sulfamoxole 200 mg and trimethoprim 40 mg: Initial: 20 mL, then 10 mL twice daily.
Dosage Details
Oral
Ear, nose and/or throat infections, Gastrointestinal infections, Genital infections, Respiratory tract infections, Skin infections, Susceptible infections, Urinary tract infections
Adult: Each tablet contains sulfamoxole 400 mg and trimethoprim 60 mg: Initially, 2 tablets, followed by 1 tablet bid. Each 5 ml contains sulfamoxole 200 mg and trimethoprim 40 mg: Initially, 20 ml, followed by 10 ml bid.
Child: Each 5 ml contains sulfamoxole 200 mg and trimethoprim 40 mg: 4-12 mth: Initially, 2.5-5 ml followed by 1.2-2.5 ml bid; 1-6 yr: Initially, 5-10 ml, followed by 2.5-5 ml bid, 6-12 yr: Initially, 10-15 ml, followed by 5-10 ml bid.
Renal Impairment
Dose reduction is advisable.
Contraindications
Hypersensitivity to sulfonamides; severe renal or hepatic impairment; porphyria, SLE; serious haematological disorders; megaloblastic anemia secondary to folate depletion. Infants <2 mth; pregnancy (3rd trimester), lactation.
Special Precautions
Renal insufficiency, elderly, blood dyscrasias, G6PD deficiency, AIDS, patient with potential folate deficiency, children with fragile X chromosome associated with mental retardation. Perform regular haematological examination.
Adverse Reactions
Nausea, vomiting, anorexia, diarrhoea, glossitis, stomatitis, drowsiness, headache, depression, hallucinations, hypersensitivity skin reaction, photosensitivity, drug fever, crystalluria, elevation of liver enzymes, hypothyroidism, hyponatremia, hyperkalemia, kernicterus in premature neonates, aseptic meningitis, cholestatic jaundice.
Potentially Fatal: Anaphylaxis; Stevens-Johnson syndrome; blood dyscrasias e.g. agranulocytosis, aplastic anaemia; toxic epidermal necrolysis.
Overdosage
Nausea, vomiting, allergic reactions. If within 3 hrs of ingestion, gastric lavage to be performed, followed by IM folinic acid, vitamin B12 and supportive treatment. Perform LFT once a wk and FBC twice a wk for 3 wks.
Drug Interactions
Concurrent use increases risk of blood dyscrasias with azathioprine, methotrexate, pyrimethamine; increased risk of hyperkalaemia with ACE inhibitors; increased risk of hyponatraemia when used with both potassium-sparing diuretics and thiazides; increases risk of bleeding with warfarin; increases risk of lithium toxicity; increases digoxin, phenytoin, procainamide, lamivudine, stavudine, repaglinide, rosiglitazone, dofetilide serum levels; decreases ciclosporin levels. Concurrent use with dapsone increases serum levels of both and increases risk of dapsone toxicity. Concurrent may potentiate antidiabetic effect of sulphonylureas.
Potentially Fatal: Concurrent use increases risk of blood dyscrasias with clozapine and pyrimethamine.
Lab Interference
Interference with tests for urea, creatinine, urinary glucose, urobilinogen, serum methotrexate ( when dihydrofolate reductase is used) and creatinine assay (when Jaffe reaction is used).
Action
Description: Sulfamoxole interferes with nucleic acid synthesis in microorganisms by blocking the conversion of p-aminobenzoic acid to the coenzyme dihydrofolic acid. Trimethoprim inhibits the conversion of bacterial dihydrofolic acid to tetrahydrofolic acid which is important for the synthesis of DNA.
Storage
Store below 25°C
Disclaimer: This information is independently developed by MIMS based on Sulfamoxole + Trimethoprim from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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