Sitrim
Generic Name
Sulfamethoxazole and Trimethoprim
Manufacturer
Popular brands from various manufacturers (e.g., Square, Beximco, Renata)
Country
Globally, manufactured in many countries
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| sitrim 400 mg tablet | ৳ 2.01 | ৳ 20.08 |
| sitrim 200 mg suspension | ৳ 20.07 | N/A |
Description
Overview of the medicine
Co-trimoxazole, also known as trimethoprim/sulfamethoxazole, is an antibiotic used to treat various bacterial infections, including urinary tract infections, respiratory tract infections, and certain types of pneumonia. It is a combination of two antibacterial agents, sulfamethoxazole and trimethoprim, which work synergistically to inhibit bacterial growth.
Uses & Indications
Dosage
Adults
For adults, typically 800 mg sulfamethoxazole / 160 mg trimethoprim every 12 hours for 5-14 days, depending on the infection.
Elderly
Dosage may need adjustment due to decreased renal function; monitor renal function closely.
Renal_impairment
Requires dose reduction based on creatinine clearance; contraindicated in severe renal impairment.
How to Take
Take orally with a full glass of water, with or without food. Taking with food or milk may reduce gastrointestinal upset. Complete the full course of treatment as prescribed.
Mechanism of Action
Sulfamethoxazole inhibits bacterial dihydrofolate synthesis by competing with para-aminobenzoic acid (PABA). Trimethoprim inhibits bacterial dihydrofolate reductase. Together, they block sequential steps in bacterial folic acid synthesis, leading to synergistic bactericidal activity.
Pharmacokinetics
Onset
Approximately 1-4 hours.
Excretion
Primarily renal excretion.
Half life
Trimethoprim: 8-10 hours; Sulfamethoxazole: 10-12 hours.
Absorption
Rapidly and almost completely absorbed from the gastrointestinal tract.
Metabolism
Primarily hepatic metabolism.
Side Effects
Contraindications
- Hypersensitivity to sulfamethoxazole, trimethoprim, or any excipients
- Severe renal impairment (creatinine clearance <15 mL/min)
- Severe hepatic damage
- Megaloblastic anemia due to folate deficiency
- Infants less than 2 months of age
Drug Interactions
Warfarin
May increase anticoagulant effect, leading to increased bleeding risk. Monitor INR closely.
Phenytoin
Increased phenytoin levels and toxicity. Monitor phenytoin concentrations.
Methotrexate
Increased risk of methotrexate toxicity due to inhibition of renal excretion and folate antagonism.
Storage
Store at room temperature (below 30°C), away from moisture and direct light. Keep out of reach of children.
Overdose
Symptoms include nausea, vomiting, dizziness, headache, mental depression, confusion, and bone marrow depression. Management involves gastric lavage or emesis, forced diuresis with urinary acidification, and symptomatic supportive care. Folinic acid may be administered to counteract folate deficiency effects.
Pregnancy & Lactation
Pregnancy Category C (first trimester) and D (late pregnancy). Avoid in late pregnancy due to risk of kernicterus in neonates. Excreted in breast milk; generally avoided during lactation, especially in premature or jaundiced infants.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture.
Availability
Available in pharmacies, hospitals, and clinics
Approval Status
Approved by regulatory authorities worldwide
Patent Status
Off-patent (generic available)
WHO Essential Medicine
YesClinical Trials
Extensively studied and validated in numerous clinical trials since its introduction for a wide range of bacterial infections. Ongoing research explores new applications and resistance patterns.
Lab Monitoring
- Complete Blood Count (CBC) (especially with prolonged use)
- Renal function tests (e.g., creatinine, BUN)
- Liver function tests
Doctor Notes
- Monitor complete blood count, renal function, and liver function during prolonged therapy or in patients at risk.
- Advise patients to maintain adequate hydration.
- Be aware of potential for severe skin reactions and discontinue at first sign of rash.
Patient Guidelines
- Complete the full course of medication, even if symptoms improve.
- Drink plenty of fluids to prevent kidney stone formation.
- Avoid prolonged sun exposure and use sunscreen due to photosensitivity.
- Report any severe rash, sore throat, fever, or unusual bleeding/bruising to your doctor immediately.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. Do not double the dose to catch up.
Driving Precautions
May cause dizziness or confusion in some individuals. Exercise caution when driving or operating machinery until you know how this medicine affects you.
Lifestyle Advice
- Maintain good hydration.
- Practice good personal hygiene to prevent recurrence of infections.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.