Trimozole 480
Co-trimoxazole
Indication
It is indicated in uncomplicated urinary tract infections, prostatitis, acute exacerbations of chronic bronchitis, acute otitis media, susceptible strains of shigella and salmonella infections, nocardiosis, treatment and prophylaxis of Pneumocystis jiroveci pneumonia.
Dosage and Administration
Co-trimoxazole should be used for adults and children over 12 years or recommended by Healthcare Professionals. Co-trimoxazole in child (2 months to 12 years) must be strictly taken under the control of physician. It should be taken on an empty stomach but taken with food if nausea or diarrhea occur...
Urinary Tract Infections: 480 - 960 mg every 12 hours daily for 10 to 14 days.
Acute exacerbations of chronic bronchitis: 480 - 960 mg every 12 hours daily for 14 days.
Treatment of Pneumocystis jiroveci pneumonia: 120 mg/kg in 2 to 4 divided doses for 14 to 21 days.
Prophylaxis of Pneumocystis jiroveci pneumonia: 960 mg once daily, reduced if not tolerated to 480 mg daily; alternatively, 960 mg once daily on alternate days (alternate day dose to be given 3 times weekly); alternatively, 960 mg twice daily on alternate days (alternate day dose to be given 3 times...
Composition
Each tablet contains:
Trimethoprim B.P ... 80 mg
Sulfamethoxazole B.P ... 400 mg.
Description
Trimozole, Co-trimoxazole, is a broad-spectrum antibacterial combination of Trimethoprim and Sulfamethoxazole.
Trimethoprim is 5-(3,4,5-Trimethoxybenzyl)pyrimidine-2,4-diamine with chemical formula ofC14H18N,03 and molecular weight of 290.3. Sulfamethoxazole is 4-Amino-N-(5-methylisoxazol-3-yl) benzenesulfonamide with chemical formula of C10H11N303S and molecular weight of 253.3.
Clinical Pharmacology
Co-trimoxazole is a mixture of trimethoprim and sulfamethoxazole. Trimethoprim prevents the reduction of dihydrofolic acid to tetrahydrofolic acid by competitive inhibition of dihydrofolate reductase, thereby interfering with cell replication. Sulfamethoxazole inhibits dihydropteroate reductase, whi...
Pharmacokinetics
Co-trimoxazole is rapidly and almost completely absorbed from the bowel reaching peak plasma concentration l - 4 hrs after ingestion. Sulfamethoxazole is 65% and trimethoprim is 45% protein bound. Trimethoprim/sulfamethoxazole is distributed to sputum, vaginal fluid and middle ear fluid; trimethopri...
However, patients with severely impaired renal function exhibit an increase in half-lives of both components. Trimethoprim/sulfamethoxazole is primarily eliminated by the kidneys through glomerular filtration and tubular secretion. Urine concentrations are higher than blood concentrations.
Contraindication
Co-trimoxazole is contraindicated in patients with known hypersensitivity to trimethoprim or sulfonamides; in patients with severe liver or kidney problems, thrombocytopenia, megaloblastic anaemia due to folate deficiency and in pediatric patients less than 2 months of age.
Precaution
Use with caution in patients with folic acid deficiency, impaired renal or hepatic function, G6PD deficiency, hypoglycaemia, a rare blood problem called porphyria, hypothyroidism, pregnancy and lactation, under-weighed or malnourished patients and elderly.
Adverse Effects
Common adverse effects are muscle cramps or pain, irregular heartbeats, unusual tiredness or weakness, headache, nausea, diarrhea, skin rash and urticaria.
Drug Interaction
Diuretics (primarily thiazides): increased incidence of thrombocytopenia.
Warfarin: Co-trimoxazole may prolong prothrombin time Phenytoin: Co-trimoxazole may inhibit the hepatic metabolism of Phenytoin.
Methotrexate: Sulfonamides can displace methotrexate from plasma protein binding sites and compete with renal transport of methotrexate, thus increasing free methotrexate concentrations.
Cyclosporine: marked but reversible nephrotoxicity Digoxin: increased digoxin level especially in elderly patients.
Indomethacin: increased sulfamethoxazole blood levels Tricyclic antidepressants: efficacy of tricyclic antidepressants decreased.
Oral hypoglycaemics: Co-trimoxazole potentiates the effect of oral hypoglycaemics.
Laboratory Test: Trimethoprim can interfere with serum methotrexate assay; Co-trimoxazole may interfere with Jaffe's alkaline picrate reaction assay for creatinine.
Storage
Store below 30°C in cool, dry place. Protect from light and moisture. Keep out of reach and sight of children.
Presentation
10 x 10's Blisters, 100's Bottles.