Biotrim
Generic Name
Co-trimoxazole (Trimethoprim and Sulfamethoxazole)
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| biotrim 200 mg suspension | ৳ 22.00 | N/A |
Description
Overview of the medicine
Biotrim-200 mg Suspension is a combination antibacterial medication containing Trimethoprim and Sulfamethoxazole, used to treat various bacterial infections.
Uses & Indications
Dosage
Adults
Typically adults are treated with higher strength tablets. If suspension is used, dosage should be adjusted based on the severity of infection and renal function.
Elderly
Dose adjustment may be required in elderly patients due to potential renal impairment. Monitor renal function.
Renal_impairment
Significant dose reduction or increased dosing interval is necessary based on creatinine clearance.
How to Take
Shake well before use. Take orally with food or milk to minimize gastrointestinal upset. Ensure adequate fluid intake.
Mechanism of Action
Co-trimoxazole inhibits bacterial folic acid synthesis. Sulfamethoxazole inhibits the synthesis of dihydrofolic acid from para-aminobenzoic acid, and Trimethoprim inhibits the reduction of dihydrofolic acid to tetrahydrofolic acid.
Pharmacokinetics
Onset
Antibacterial effect typically observed within 1 hour.
Excretion
Mainly renal, through glomerular filtration and tubular secretion.
Half life
Sulfamethoxazole: 10-12 hours; Trimethoprim: 8-10 hours.
Absorption
Well absorbed orally, with peak plasma concentrations occurring 1-4 hours after administration.
Metabolism
Primarily hepatic (N-acetylation and glucuronidation for sulfamethoxazole; oxidation and hydroxylation for trimethoprim).
Side Effects
Contraindications
- Hypersensitivity to sulfamethoxazole or trimethoprim
- Severe renal impairment (CrCl <15 mL/min)
- Severe hepatic impairment
- Porphyria
- Megaloblastic anemia due to folate deficiency
- Infants less than 2 months of age
Drug Interactions
Warfarin
Potentiates anticoagulant effect, increasing risk of bleeding.
Phenytoin
Increases phenytoin levels, leading to toxicity.
Methotrexate
Increases methotrexate toxicity due to competition for plasma protein binding and renal tubular secretion.
Thiazide Diuretics
Increased risk of thrombocytopenia with purpura in elderly patients.
Storage
Store below 30°C. Protect from light and moisture. Do not freeze. Keep out of reach of children.
Overdose
Symptoms may include nausea, vomiting, dizziness, confusion, and bone marrow depression. Management involves gastric lavage, forced diuresis, and administration of folinic acid to counteract folate deficiency.
Pregnancy & Lactation
Pregnancy Category C. Avoid in late pregnancy and in nursing mothers due to the risk of kernicterus in neonates. Use only if potential benefit justifies the potential risk to the fetus.
Side Effects
Contraindications
- Hypersensitivity to sulfamethoxazole or trimethoprim
- Severe renal impairment (CrCl <15 mL/min)
- Severe hepatic impairment
- Porphyria
- Megaloblastic anemia due to folate deficiency
- Infants less than 2 months of age
Drug Interactions
Warfarin
Potentiates anticoagulant effect, increasing risk of bleeding.
Phenytoin
Increases phenytoin levels, leading to toxicity.
Methotrexate
Increases methotrexate toxicity due to competition for plasma protein binding and renal tubular secretion.
Thiazide Diuretics
Increased risk of thrombocytopenia with purpura in elderly patients.
Storage
Store below 30°C. Protect from light and moisture. Do not freeze. Keep out of reach of children.
Overdose
Symptoms may include nausea, vomiting, dizziness, confusion, and bone marrow depression. Management involves gastric lavage, forced diuresis, and administration of folinic acid to counteract folate deficiency.
Pregnancy & Lactation
Pregnancy Category C. Avoid in late pregnancy and in nursing mothers due to the risk of kernicterus in neonates. Use only if potential benefit justifies the potential risk to the fetus.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years when unopened. Refer to the specific product label for exact dates.
Availability
Available in pharmacies and hospitals
Approval Status
Approved by DGDA (Bangladesh)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Co-trimoxazole has undergone extensive clinical trials supporting its efficacy for various bacterial infections since its introduction.
Lab Monitoring
- Complete Blood Count (CBC)
- Renal function tests (BUN, creatinine)
- Liver function tests (ALT, AST)
- Serum potassium levels
Doctor Notes
- Monitor complete blood counts, renal function, and liver function during prolonged therapy.
- Advise patients to report any signs of severe rash, unexplained bruising, or jaundice immediately.
- Ensure adequate hydration to prevent crystalluria.
Patient Guidelines
- Complete the full course of medication even if symptoms improve.
- Report any severe rash, difficulty breathing, or swelling immediately.
- Maintain adequate hydration throughout treatment.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double dose.
Driving Precautions
May cause dizziness; caution is advised when driving or operating machinery.
Lifestyle Advice
- Stay well-hydrated to prevent crystalluria.
- Avoid excessive sun exposure as this medicine can increase photosensitivity.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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