Seftrim-DS
Generic Name
Co-trimoxazole (Sulfamethoxazole 800mg + Trimethoprim 160mg)
Manufacturer
Acme Laboratories Ltd.
Country
Bangladesh
Loading images...
Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| seftrim ds 800 mg tablet | ৳ 1.50 | N/A |
Description
Overview of the medicine
Seftrim-DS is an antibiotic combination containing sulfamethoxazole and trimethoprim, used to treat various bacterial infections.
Uses & Indications
Dosage
Adults
For most infections, 1 Seftrim-DS tablet (800 mg Sulfamethoxazole/160 mg Trimethoprim) orally every 12 hours (twice daily).
Elderly
Similar to adults, but dosage adjustment may be necessary in elderly patients with impaired renal function. Monitor renal function closely.
Renal_impairment
For creatinine clearance (CrCl) 15-30 mL/min, half the usual dose. For CrCl < 15 mL/min, generally not recommended or requires significant dose reduction and careful monitoring.
How to Take
Take orally with a full glass of water, preferably with food or milk to minimize gastrointestinal upset. Complete the full course of medication as prescribed.
Mechanism of Action
Co-trimoxazole acts by sequentially blocking two enzymes involved in bacterial folic acid synthesis. Sulfamethoxazole inhibits dihydropteroate synthase, and trimethoprim inhibits dihydrofolate reductase, leading to synergistic bactericidal action.
Pharmacokinetics
Onset
Onset of action varies depending on the infection type.
Excretion
Mainly renal excretion through glomerular filtration and tubular secretion.
Half life
Sulfamethoxazole: 10-12 hours; Trimethoprim: 8-10 hours.
Absorption
Both sulfamethoxazole and trimethoprim are rapidly and well absorbed after oral administration. Peak plasma levels are reached within 1-4 hours.
Metabolism
Primarily hepatic metabolism. Sulfamethoxazole is acetylated, and trimethoprim is hydroxylated.
Side Effects
Contraindications
- Hypersensitivity to sulfamethoxazole, trimethoprim, or any excipients.
- Severe renal impairment (CrCl < 15 mL/min) if not managed appropriately.
- Severe hepatic damage.
- Megaloblastic anemia due to folate deficiency.
- Infants less than 2 months of age (risk of kernicterus).
Drug Interactions
Warfarin
Increased anticoagulant effect, leading to increased bleeding risk.
Phenytoin
Increased phenytoin levels due to inhibition of its metabolism.
Cyclosporine
Increased nephrotoxicity and decreased cyclosporine levels.
Methotrexate
Increased methotrexate toxicity (e.g., bone marrow suppression) due to displacement from plasma proteins and inhibition of renal excretion.
Diuretics (especially thiazides)
Increased risk of thrombocytopenia with purpura, particularly in elderly patients.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of acute overdose include nausea, vomiting, diarrhea, dizziness, headache, and mental depression. Chronic overdose can lead to bone marrow depression. Management involves gastric lavage, forced diuresis, alkalinization of urine (for sulfamethoxazole crystalluria), and folinic acid supplementation for trimethoprim effects.
Pregnancy & Lactation
Pregnancy Category C. Avoid use in late pregnancy due to potential for kernicterus in neonates. Excreted in breast milk; use with caution in lactating mothers, weighing benefits against risks.
Side Effects
Contraindications
- Hypersensitivity to sulfamethoxazole, trimethoprim, or any excipients.
- Severe renal impairment (CrCl < 15 mL/min) if not managed appropriately.
- Severe hepatic damage.
- Megaloblastic anemia due to folate deficiency.
- Infants less than 2 months of age (risk of kernicterus).
Drug Interactions
Warfarin
Increased anticoagulant effect, leading to increased bleeding risk.
Phenytoin
Increased phenytoin levels due to inhibition of its metabolism.
Cyclosporine
Increased nephrotoxicity and decreased cyclosporine levels.
Methotrexate
Increased methotrexate toxicity (e.g., bone marrow suppression) due to displacement from plasma proteins and inhibition of renal excretion.
Diuretics (especially thiazides)
Increased risk of thrombocytopenia with purpura, particularly in elderly patients.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of acute overdose include nausea, vomiting, diarrhea, dizziness, headache, and mental depression. Chronic overdose can lead to bone marrow depression. Management involves gastric lavage, forced diuresis, alkalinization of urine (for sulfamethoxazole crystalluria), and folinic acid supplementation for trimethoprim effects.
Pregnancy & Lactation
Pregnancy Category C. Avoid use in late pregnancy due to potential for kernicterus in neonates. Excreted in breast milk; use with caution in lactating mothers, weighing benefits against risks.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture.
Availability
Pharmacies, Hospitals
Approval Status
Approved (Globally widely used, date varies by country)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Co-trimoxazole has been extensively studied since its introduction, with numerous clinical trials supporting its efficacy in a wide range of bacterial infections. Ongoing research focuses on its use in resistant infections and specific patient populations.
Lab Monitoring
- Complete Blood Count (CBC) with differential, especially with prolonged therapy or in susceptible patients.
- Renal function tests (e.g., serum creatinine, BUN) to monitor kidney function.
- Liver function tests (LFTs) periodically.
- Serum potassium levels, especially in patients with renal impairment or those taking potassium-sparing diuretics.
Doctor Notes
- Emphasize the importance of completing the full course to prevent resistance.
- Monitor CBC, renal function (creatinine, BUN), and potassium levels regularly, especially in elderly, immunocompromised, or renally impaired patients.
- Advise patients to maintain adequate hydration to prevent crystalluria.
- Be vigilant for signs of severe skin reactions (SJS/TEN) and advise immediate medical attention if they occur.
Patient Guidelines
- Complete the entire prescribed course of medication, even if symptoms improve, to prevent recurrence and development of antibiotic resistance.
- Drink plenty of fluids while taking this medication to prevent crystalluria.
- Report any severe skin rash, persistent sore throat, fever, or unusual bruising/bleeding immediately to your doctor.
- Avoid prolonged exposure to sunlight or tanning beds, as this medicine can cause photosensitivity.
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
May cause dizziness or fatigue in some individuals. Caution should be exercised when driving or operating machinery until you know how this medicine affects you.
Lifestyle Advice
- Maintain good hydration.
- Avoid excessive alcohol consumption.
- Protect skin from sun exposure.
Alternative Medicines in Bangladesh
Similar medicines available in the market
Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.