Co-trimoxazole 480 mg, 10 pills

Active substance :

 400 mg sulfamethoxazole,

80 mg trimethoprim.

Co-trimoxazole is a broad-spectrum antibacterial.

It disrupts the synthesis of folate (prevents the acceptance of PABA), inhibits dihydrofolate reductase and the formation of folinic acid, reduces the synthesis of purines, pyrimidines, amino acids, protein in microbial cells.

Bacterial infections of the upper and lower respiratory tract, kidneys, urinary tract, gastrointestinal tract (including typhoid, paratyphoid and cholera), prostatitis; wound infections, gonorrhea, etc.

Hypersensitivity, severe liver disease, severe impaired renal function, blood diseases, pregnancy, lactation (it is necessary to stop breastfeeding), breast age (up to 2 months).

Digestive system: nausea, vomiting, diarrhea, glossitis, diarrhea, abdominal pain, lack of appetite, intestinal diphtheria inflammation, increased serum enzymes (enzymes) of the liver and creatinine, inflammation of the oral cavity, inflammation of the tongue, inflammation of the pancreas, cholestatic hepatitis.

Allergic reactions: allergic myocarditis, chills, drug fever, photosensitivity, anaphylactic symptoms, skin rash, Quincke's edema, Stevens-Jones syndrome, Lyell's syndrome,

from the hematopoiesis: leukopenia, neutropenia, thrombocytopenia, megranulobtosis.

From the urinary system: crystalluria, hematuria, interstitial nephritis.

Metabolism: hypokalemia, hyponatremia.

Nervous system: apathy, aseptic meningitis, motor coordination disorder, headache, depression, cramp, hallucinations, nervousness, tinnitus, inflammation of the spinal nerves.

Internal secretion organs: cross-allergy, hypoglycemia, increased pyuresis.

Musculoskeletal system: joint pain, muscle pain.

Respiratory: choking, coughing, lung infiltrates.

Other: weakening, feeling tired, insomnia.

Interaction with other drugs

With the simultaneous use of co-trimoxazole with indirect anticoagulants, the effect of the latter is significantly enhanced due to a slowdown in the inactivation of the latter, as well as their release from communication with plasma proteins.

When combined with certain sulfonylurea derivatives, an increase in the hypoglycemic effect is possible.

The simultaneous use of co-trimoxazole and methotrexate can lead to increased toxicity of the latter (in particular, the appearance of pancytopenia).

Under the influence of butadione, indomethacin, naproxen, salicylates and some other NSAIDs, the action of co-trimoxazole may be enhanced with the development of undesirable effects, since the release of active substances from the connection with blood proteins and an increase in their concentration.

The simultaneous use of diuretics and co-trimoxazole increases the likelihood of thrombocytopenia caused by the latter, especially in elderly patients. In the case of simultaneous administration of chloridine with co-trimoxazole, the antimicrobial effect is enhanced, since chloridine inhibits the formation of tetrahydrofolate acid, necessary for the synthesis of nucleic acids and proteins. In turn, sulfonamides inhibit the formation of dihydrofolic acid, which is a precursor of tetrahydrofolic acid. This combination is widely used in the treatment of toxoplasmosis. The absorption of co-trimoxazole when taken together with cholestyramine decreases as a result of the formation of insoluble complexes, which leads to a decrease in their concentration in the blood.

Assign inside. Adults and children over 12 years of age are usually given 2 tablets (for adults) 2 times a day (morning and evening after eating); in severe cases, 3 tablets are prescribed 2 times a day; for chronic infections - 1 tablet 2 times a day. Children from 2 to 5 years old are usually prescribed ½ tablets 2 times a day, from 5 to 12 years - 1 tablet 2 times a day.

The course of treatment lasts from 5 to 12-14 days, and in chronic infections it is longer and depends on the course of the disease.

Symptoms: anorexia, nausea, weakness, abdominal pain, headache, drowsiness, hematuria, crystalluria.

Treatment: heavy drinking, gastric lavage, correction of electrolyte disturbances. If necessary, hemodialysis is prescribed.

Chronic overdose is characterized by inhibition of bone marrow (pancytopenia).

Treatment and prevention: folic acid administration (5-15 mg daily).

A sufficient amount of fluid should be consumed during therapy. The drug is prescribed with caution to patients with a possible deficiency of folic acid, allergic reactions in history, bronchial asthma, impaired liver, kidney, thyroid gland. With prolonged use of the drug, studies of the pattern of peripheral blood, the functional state of the liver and kidneys should be systematically carried out.

Older patients are advised to supplement folic acid. In case of impaired renal function, the dose should be reduced, and the intervals between doses should be increased.

Taking the drug is not recommended for young children.