Co-Trimoxazole

Cotrimoxazole is a combination of trimethoprim and sulfamethoxazole. Cotrimoxazole is used to treat a variety of bacterial infections such as uncomplicated UTIs, respiratory tract infections, and gastrointestinal infections.


Adult Dose
Dose: 960 mg
Single Dose: 960 (960)
Frequency: 12 hourly
Route: PO
Instructions:
Neonatal
Dose: 15 to 30 mg/kg
Single Dose: 22 (22.5)
Frequency: 12 hourly
Route: oral
Instructions:
Paedriatic
Dose: 24 mg/kg
Single Dose: 24 (24)
Frequency: 12 hourly
Route: Oral
Instructions: -
Characteristics
. It is of Synthetic origin and belongs to Sulphonamide, Trimethoprim. It belongs to Antibiotic, Sulphonamide Derivative pharmacological group.The Molecular Weight of Co-Trimoxazole is 253.21. Its pKa is 5.6.
Contraindications
Co-Trimoxazole is contraindicated in conditions like Impaired renal function,Liver parenchymal damage,Hypersensitivity,Haematological disorders.
Effects
The severe or irreversible adverse effects of Co-Trimoxazole, which give rise to further complications include Thrombocytopenia, Aplastic anemia, Hemolytic anemia, Aplastic anemia, Hemolytic anemia, Stevens johnson syndrome, Stevens johnson syndrome, Leucopenia, Neutropenia, Agranulocytosis, Interstitial nephritis, Acute renal failure, Methemoglobinemia, Hemolytic anemia, Megaloblastic anemia, Crystalluria, Methemoglobinemia, Aplastic anemia.The symptomatic adverse reactions produced by Co-Trimoxazole are more or less tolerable and if they become severe, they can be treated symptomatically, these include Nausea, Vomiting, Skin reactions, Skin rashes, GI symptoms, Exfoliative dermatitis, Skin rashes.
Indications
Co-Trimoxazole is primarily indicated in conditions like Acute exacerbation of chronic bronchitis, Anorectal infections, Brucellosis, Chancroid, Cholera, Chronic bronchitis, Diarrhoea, Genitourinary tract infections, GI infections, Gonorrhoea, Metastatic germ cell cancer, Oliguria due to renal failure, Oliguria due to renal failure, Oropharangeal candidiasis, Orophyrangeal infections, Osteomyelitis, Otitis media, Pneumocystis carinii infections, Pneumonia, Respiratory tract infections, Septicaemia, Skin infections, Squamous cell carcinoma, Travelers diarrhoea, Uncomplicated UTIs, and can also be given in adjunctive therapy as an alternative drug of choice in Cancer, Infections, Oliguria, Prostatic cancer, Salmonellosis.
Interactions
Co-Trimoxazole is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementCyclosporin ADigoxinFosphenytoinLamivudineMethotrexateNicoumalonePhenindionePhenytoin (Na)Procainamide (HCl)PyrimethaminePyrimethamineRifampicinSulphamethoxazoleWarfarin (Na)Zidovudine These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Overstimation of serum creatinine with alkaline picrate reaction.
Risks
Drug should not be given to Pregnant Mothers, patients suffering from Liver Malfunction, Geriatrics, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Warnings
Co-trimoxazole should be used with caution in patients with history of hypersensitivity to it or to sulphonamides or trimethomprim. Avoid use in patients with hepatic impairment. It should be used with caution in patients with known renal impairment and special measures should be adopted. Regular monthly blood counts, urinalyses and renal function tests should be carried out in patients receiving prolonged treatment with co-trimoxazole. Folate supplementation may be necessary in patients predisposed to folate deficiency, such as elderly patients and when high dose of co-trimoxazole are given for a prolonged period. Drug should be discontinued at first appearance of skin rash. Exercise caution when treating patients with severe hepatic parenchymal damage. It should be given with caution in patients with severe allergy or bronchial asthma.
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