| GENERIC NAMES: Sulfamethoxazole
and trimethoprim; cotrimoxazole
BRAND NAMES: Bactrim; Septra
DRUG CLASS AND MECHANISM: Cotrimoxazole
is a combination of sulfamethoxazole and trimethoprim
in a ratio of 5:1 or 1:2. Trimethoprim and sulfamethoxazole
both block the production of folic acid, a necessary
chemical for both bacteria and humans, and each is an
effective antibiotic when used alone. For more information
on the individual drugs, please visit their respective
sites in the Pharmacy section. Cotrimoxazole was approved
by the FDA in 1973.
PRESCRIPTION: yes
GENERIC AVAILABLE: yes
PREPARATIONS: Tablets containing 160mg trimethoprim
and 800mg sulfamethoxazole (Bactrim, Septra); 320mg
trimethoprim and 160mg sulfamethoxazole (Bactrim DS;
Septra DS).
STORAGE: The tablets should be kept at room
temperature, 15-30癈 (59-86癋).
PRESCRIBED FOR: Cotrimoxazole is used for
urinary tract infections, respiratory tract infections,
middle ear infections, for prevention of infections
due to pneumococcus in transplant recipients, for the
treatment or prevention of Pneumocystis carinii pneumonia,
chancroid, and prevention of toxoplasma encephalitis
in patients with AIDS.
DOSING: Cotrimoxazole is taken two to three
times daily, with or without meals, depending on the
type and severity of infection. It should be taken with
6 to 8 ounces of liquid to prevent crystals from forming
in the urine. Persons with advanced kidney disease may
require lower doses.
DRUG INTERACTIONS: Please read articles
sulfamethoxazole and trimethoprim.
PREGNANCY: The effects of the sulfonamide
class of antibiotics, including sulfamethoxazole, on
the fetus have not been adequately studied. Physicians
may elect to use cotrimoxazole if its benefits are deemed
to outweigh potential risks. On the other hand, use
of sulfonamides near term (that is, by the ninth month)
may cause bilirubin to be displaced from proteins in
the infant's blood. Displacement of bilirubin can lead
to jaundice and a dangerous condition called kernicterus
in the infant. For this reason, cotrimoxazole should
not be used near term in pregnant women.
NURSING MOTHERS: Please read the sulfamethoxazole
and trimethoprim articles.
SIDE EFFECTS: Please read the sulfamethoxazole
and trimethoprim articles.
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