Composition
Each 5ml (teaspoonful) contains: Trimethoprim (40mg) and Sulphamethoxazole (200mg) Each tablet contains: Trimethoprim (80mg) and Sulphamethoxazole (400mg)

Description

Cotrimoxazole is a chemotherapeutic agent exhibiting bactericidal activity against gram-positive and gram-negative bacteria. The combination acts on two levels in the biosynthesis of Tetrahydrofolic acid: Sulphamethoxazole inhibits the incorporation of PABA (Para Amino Benzoic Acid) into folic acid, whereas Trimethoprim blocks the reduction of Dihydrofolic acid to Tetrahydrofolic acid.

Indications

• Respiratory Tract Infections

• Urinary Tract Infections

• Gastro-intestinal tract infection, including typhoid and paratyphoid fever, dysentery,

   cholera, traveller’s diarrhoea

• Skin and soft tissue infections

Dosage and Administration

Suspension 6 weeks-5 months: ½ teaspoonful every 12 hours for as long as the physician prescribed 6 months-5 years: 1 teaspoonful every 12 hours for as long as the physician prescribed 6 years-12 years: 2 teaspoonfuls every 12 hours for as long as the physician prescribed

Tablets Children (6-12 years)- One tablet every 12 hours Adults (over 12 years)- Two tablets every 12 hours

Contraindications

Cotrimoxazole is contra-indicated in patients with severe hepatic parenchymal damage. Co-trimoxazole should be given unsupervised to patients with serious haematological disorders. Co-trimoxazole should not be given to neonate or premature babies. Co-trimoxazole should not be given to patients with history of hypersensitivity to sulphonamides, trimethoprim or co-trimoxazole.

Warning and Precautions

Folate supplements should be considered when giving Co-trimoxazole to suspected folate-deficient subjects, to the elderly, or in prolonged high dosage. Regular monthly blood counts are advised whenever treatment is given for long periods. Evidence of crystalluria in vivo is rare, but an adequate urinary output should be maintained at all times. In the treatment of tonsillo-pharyngitis due to Group A beta-haemolytic streptococci, eradication of these organisms from the oropharynx is less effective than with penicillin. The safety of Co-trimoxazole in human pregnancy has not been established. Sulphonamide containing products should not be administered in late pregnancy because of the risk of kernicterus.

Side Effects

At the recommended dosages, co-trimoxazole is usually well tolerated. Most reported adverse reactions are mild and comprises of nausea, with or without vomiting and skin rashes. Diarrhoea and glossitis are uncommon and monilial overgrowth is very rare. Pseudomembranous colitis has been rarely reported. Isolated cases of severe skin sensitivity reactions such as erythema multiforme bullosa (Stevens-Johnson syndrome) and tonic epidermal necrolysis (Lyell syndrome) have occurred. Various haematological changes have been reported, the majority being mild and reversible when treatment was stopped. Although most changes are clinically asymptomatic, they may become severe in isolated cases, especially in the elderly, those with hepatic or renal dysfunction and those with poor folate status. Co-trimoxazole may induce haemolysis in certain susceptible G-6-PD deficient patients.

Presentation

Cotrimoxazole is available as Suspension (50ml) and tablets (100’s & 1000’s) .