Medicine Information

Cotrazen

Name: Cotrazen
Brand: Cotrazen
Rating: 4.5 (117 reviews)

Suspension200 mg per 5 mLAnthelminticATC: P02CA03

Generic Name

cotrazen-200-mg-suspension

Manufacturer

MediCare Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
cotrazen 200 mg suspension	৳ 21.36	N/A

Description

Overview of the medicine

Cotrazen 200 mg Suspension is an anthelmintic medication used to treat various parasitic worm infections in both children and adults.

Uses & Indications

Ascariasis (roundworm infection)

Hookworm infection (Ancylostomiasis, Necatoriasis)

Trichuriasis (whipworm infection)

Strongyloidiasis

Giardiasis (off-label use, but common)

Hydatid disease (cystic echinococcosis, alveolar echinococcosis)

Dosage

Adults

For common intestinal worms (e.g., Ascaris, Hookworm, Whipworm): 400 mg (10 mL of 200 mg/5 mL suspension) as a single dose. For Strongyloidiasis or Giardiasis: 400 mg once daily for 3 consecutive days. For systemic infections like Hydatid disease: 400 mg twice daily for 28 days, often with repeated cycles.

Elderly

No specific dosage adjustment is required for elderly patients, but caution is advised in those with pre-existing liver or renal impairment.

Renal_impairment

No dosage adjustment is generally considered necessary for patients with renal impairment, as the drug is primarily metabolized in the liver. However, caution is advised.

How to Take

Cotrazen Suspension should be taken orally with food to enhance absorption. Shake the bottle well before each use. A measuring cup or spoon should be used to ensure accurate dosing.

Mechanism of Action

Cotrazen works by inhibiting beta-tubulin polymerization in the intestinal cells of the worms, leading to impaired glucose uptake and depletion of the worm's energy reserves. This ultimately paralyzes and kills the worms, which are then expelled from the body.

Pharmacokinetics

Onset

Systemic effects, particularly for tissue infections, typically begin within 2-3 hours after administration. Local intestinal action is much quicker.

Excretion

Primarily excreted in the urine as metabolites, with a small portion excreted in bile. Less than 1% of the unchanged drug is recovered in urine.

Half life

The active metabolite (sulfoxide) has a plasma half-life of approximately 8-12 hours, allowing for once or twice daily dosing.

Absorption

Poorly absorbed orally, with less than 5% bioavailability. Absorption is significantly increased when taken with a fatty meal, enhancing systemic exposure.

Metabolism

Undergoes extensive first-pass metabolism in the liver. The primary active metabolite is Cotrazen sulfoxide, which is responsible for most of the anthelmintic activity.

Side Effects

Contraindications

Known hypersensitivity to Cotrazen or any excipients.
Pregnancy (especially first trimester).
Severe liver disease.

Drug Interactions

Phenytoin, Carbamazepine, Phenobarbital

May decrease plasma levels of Cotrazen's active metabolite, potentially reducing its efficacy.

Praziquantel, Cimetidine, Dexamethasone

May increase plasma levels of Cotrazen's active metabolite, potentially leading to increased efficacy or side effects.

Storage

Store below 30°C. Protect from light and moisture. Do not freeze. Keep out of reach of children.

Overdose

In case of an overdose, symptomatic and supportive treatment should be initiated. Gastric lavage and activated charcoal may be considered to reduce absorption if caught early.

Pregnancy & Lactation

Cotrazen is contraindicated in the first trimester of pregnancy due to potential embryotoxic and teratogenic effects. In later trimesters, it should only be used if the potential benefit justifies the potential risk to the fetus. Caution should be exercised during lactation, and a doctor should be consulted.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 mL Suspension bottle30 mL Suspension bottle

Shelf Life

24 months from the date of manufacture when stored under recommended conditions.

Availability

Pharmacies, Hospitals

Approval Status

Approved by DGDA

Patent Status

Patent Expired

WHO Essential Medicine

Yes

Clinical Trials

Several Phase III clinical trials have demonstrated the efficacy and safety of Cotrazen in treating various parasitic worm infections across diverse patient populations, including pediatric subjects.

Lab Monitoring

Liver function tests (LFTs) should be monitored before and during prolonged therapy.
Complete blood count (CBC) should be monitored for patients on extended high-dose treatment.

Doctor Notes

Advise patients on the importance of maintaining proper hygiene to prevent reinfection.
For extended therapy, monitor Liver Function Tests (LFTs) and Complete Blood Count (CBC) at regular intervals.
Not recommended for children under 1 year of age unless specifically indicated and under strict medical supervision.
Ensure proper patient education regarding administration with food and shaking the suspension.

Patient Guidelines

Complete the full course of treatment as prescribed, even if symptoms improve, to ensure complete eradication of worms.
Shake the suspension bottle well before each use to ensure uniform dosing.
Take with food to improve absorption and reduce gastrointestinal upset.
Maintain good personal hygiene to prevent reinfection and spread of infection.

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 the dose to catch up.

Driving Precautions

Cotrazen may cause dizziness in some individuals. Patients should be advised to exercise caution when driving or operating machinery if they experience such side effects.

Lifestyle Advice

Practice proper handwashing, especially before meals and after using the toilet.
Ensure food and water hygiene to minimize risk of reinfection.
Regularly wash bedding and clothes to eliminate worm eggs.