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Sulphamethoxazole + Trimethoprim

Indications

Cotrimoxazole is bactericidal in vitro to a wide range of Gram-positive and Gram-negative organisms, including Streptococcus, Staphylococcus, Pneumococcus, Neisseria, B. catarrhalis, Escherichia coli, Klebsiella, Proteus spp., Haemophilus, Salmonella, Shigella, Vibrio cholerae, Brucella, Pneumocystis carinii, Nocardia and Bordetella. A particularly high degree of activity is exhibited against Haemophilus influenzae, E. coli and Proteus spp., making Cotrimoxazole particularly suitable for the treatment of chronic bronchitis and urinary tract infections. Cotrimoxazole exerts its bactericidal action by the sequential blockade of two bacterial enzyme systems in the biosynthesis of Folinic acid in the micro-organisms. The synergy thus produced accounts for the high degree of bactericidal activity.

This combination is indicated in:

  • Respiratory tract infections, including acute and chronic bronchitis (treatment and prophylaxis), bronchiectasis, lung abscess, lobar and broncho-pneumonia, Pneumocystis carinii pneumonitis, sinusitis and otitis media.
  • Genito-urinary tract infections, including urethritis, acute and chronic cystitis, pyelonephritis, prostatitis and gonorrhoea.
  • Gastro-intestinal tract infections, caused by Salmonella typhi and Salmonella paratyphi, including the chronic carrier state.
  • Other infections, caused by a wide range of organisms confirmed to be susceptible to Cotrimoxazole and where the therapeutic benefits are considered to outweigh the possible occurrence of adverse events.
  • Such infections include acute and chronic osteomyelitis, acute brucellosis, skin infections including pyoderma, abscesses and wound infections, septicaemia, bacillary dysentery and cholera (as an adjuvant to fluid and electrolyte replacement), nocardiosis and mycetoma.

* রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Pharmacology

Cotrimoxazole having broad spectrum bactericidal activity against a wide range of gram-positive & gram-negative bacteria and some protozoa. Co-trimoxazole containing Trimethoprim and Sulphamethoxazole in a 1:5 combination exerts its bactericidal action by the sequential blockade of two bacterial enzyme systems in the biosynthesis of folinic acid in the microorganism.

Dosage & Administration

Cotrimoxazole double strength tablet: Over 12 years

  • For mild to moderate infections: 1 tablet twice daily.
  • For severe infections: 1.5 tablets twice daily.
  • Long term therapy (>14 days): 0.5 tablet twice daily.
  • Gonorrhoea: 2 tablets every 12 hours for two days or 2.5 tablets followed by a further dose of 2.5 tablets after 8 hours.

Cotrimoxazole tablet: over 12 years

  • For mild to moderate infections: 2 tablets twice daily.
  • For severe infections: 2 tablets thrice daily.
  • Long term therapy: (>14 days): 1 tablet twice daily.

Cotrimoxazole suspension: Under 12 years

  • 6-12 years: 2 teaspoonful twice daily.
  • 6 month-5 years: 1 teaspoonful twice daily.
  • 6 weeks-6 months: 0.5 teaspoonful twice daily.

Contraindications

  • Hypersensitivity to trimethoprim or sulphonamides.
  • Patients with documented megaloblastic anaemia due to folate deficiency.
  • Patients showing marked liver parenchymal damage, blood dyscrasia, severe renal insufficiency, glucose 6-phosphate dehydrogenase deficiency.

Side Effects

The side effects like crystalluria, allergic reactions, haemolysis, thrombocytopenia, neutropenia, agranulocytosis etc. have been reported rarely with Sulphamethoxazole-Trimethoprim combination. Other side effects are less serious in nature such as malaise, headache, nausea and vomiting. These are normally transient and do not require withdrawal of treatment.

Pregnancy & Lactation

Pregnancy and during the nursing period, because sulphonamides pass the placenta and are excreted in the breast milk and may cause kernicterus.

Precautions & Warnings

Prolonged full dose treatment with sulfamethoxazole-trimethoprim combination is associated with the risk of macrocytic anaemia due to the drug’s interference in the conversion of Folic acid into Folinic acid. If this occurs, it can be reversed by giving Folinic acid. Care should be taken when giving this combination to diabetic patients receiving sulphonylurea drug for possible potentiation of action of sulphonylurea.

Therapeutic Class

Anti-diarrhoeal Antimicrobial drugs, Sulphonamides & Trimethoprim

Storage Conditions

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

Available Brand Names

🌿
Actrim

Globe Pharmaceuticals Ltd.

Unit Price : ৳ 22.00
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Actrim DS

Globe Pharmaceuticals Ltd.

Unit Price : ৳ 2.00
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Albutrim

Albion Laboratories Limited

Unit Price : ৳ 2.00
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Albutrim

Albion Laboratories Limited

Unit Price : ৳ 20.00
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Alcot

Pacific Pharmaceuticals Ltd.

Unit Price : ৳ 1.00
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Alcot

Pacific Pharmaceuticals Ltd.

Unit Price : ৳ 20.00
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Alcot

Pacific Pharmaceuticals Ltd.

Unit Price : ৳ 2.00
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Alkatrim

Alkad Laboratories

Unit Price : ৳ 22.00
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Apcetrim

APC Pharma Ltd.

Unit Price : ৳ 2.00
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Apcetrim

APC Pharma Ltd.

Unit Price : ৳ 22.00
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Aptrim

Apollo Pharmaceutical Ltd.

Unit Price : ৳ 20.54
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Aptrim

Apollo Pharmaceutical Ltd.

Unit Price : ৳ 2.02
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Avlotrin

ACI Limited

Unit Price : ৳ 22.21
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Avlotrin DS

ACI Limited

Unit Price : ৳ 2.01
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Biotrim

Biopharma Limited

Unit Price : ৳ 1.49
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Biotrim

Biopharma Limited

Unit Price : ৳ 22.00
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Biotrim DS

Biopharma Limited

Unit Price : ৳ 2.01
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Cosat

Eskayef Pharmaceuticals Ltd.

Unit Price : ৳ 22.00
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Cosat-DS

Eskayef Pharmaceuticals Ltd.

Unit Price : ৳ 2.55
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Cotrazen

Zenith Pharmaceuticals Ltd.

Unit Price : ৳ 21.36
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Cotrazen

Square Pharmaceuticals PLC

Unit Price : ৳ 1.40
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Cotrazen DS

Zenith Pharmaceuticals Ltd.

Unit Price : ৳ 2.02
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Cotrim

Square Pharmaceuticals PLC

Unit Price : ৳ 1.49
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Cotrim

Square Pharmaceuticals PLC

Unit Price : ৳ 21.64
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Cotrim DS

Square Pharmaceuticals PLC

Unit Price : ৳ 2.66
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Cotrimox

Indo Bangla Pharmaceutical

Unit Price : ৳ 1.35
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Cotrimox

Indo Bangla Pharmaceutical

Unit Price : ৳ 21.00
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Cotrimox DS

Indo Bangla Pharmaceutical

Unit Price : ৳ 2.00
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Cots

Opsonin Pharma Ltd.

Unit Price : ৳ 22.14
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Deotrim

Desh Pharmaceuticals Ltd.

Unit Price : ৳ 17.50
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Deotrim

Desh Pharmaceuticals Ltd.

Unit Price : ৳ 1.20
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Deotrim DS

Desh Pharmaceuticals Ltd.

Unit Price : ৳ 1.80
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Editrim

Edruc Limited

Unit Price : ৳ 25.00
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Editrim-DS

Edruc Limited

Unit Price : ৳ 3.04
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G-Cotrimoxazole

Gonoshasthaya Pharma Ltd.

Unit Price : ৳ 1.20
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G-Cotrimoxazole

Gonoshasthaya Pharma Ltd.

Unit Price : ৳ 19.66
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G-Cotrimoxazole

Gonoshasthaya Pharma Ltd.

Unit Price : ৳ 30.00
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Hi Floxin

Hudson Pharmaceuticals Ltd.

Unit Price : ৳ Price not available.
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Hi Floxin

Hudson Pharmaceuticals Ltd.

Unit Price : ৳ Price not available.
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Jasotrim

Jayson Pharmaceutical Ltd.

Unit Price : ৳ 1.49
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Jasotrim

Jayson Pharmaceutical Ltd.

Unit Price : ৳ 21.68
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Litrim

Millat Pharmaceuticals Ltd.

Unit Price : ৳ 2.02
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Litrim

Millat Pharmaceuticals Ltd.

Unit Price : ৳ 21.50
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M-Trim

Modern Pharmaceuticals Ltd.

Unit Price : ৳ 1.46
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M-Trim

Modern Pharmaceuticals Ltd.

Unit Price : ৳ 21.24
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M-Trim DS

Modern Pharmaceuticals Ltd.

Unit Price : ৳ 2.02
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Meditrim

Medimet Pharmaceuticals Ltd.

Unit Price : ৳ 1.48
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Meditrim

Medimet Pharmaceuticals Ltd.

Unit Price : ৳ 2.60
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Meditrim

Medimet Pharmaceuticals Ltd.

Unit Price : ৳ 20.00
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Megatrim

Beximco Pharmaceuticals Ltd.

Unit Price : ৳ 22.17
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Megatrim DS

Beximco Pharmaceuticals Ltd.

Unit Price : ৳ 2.65
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Mikotrim

Pharmik Laboratories Ltd.

Unit Price : ৳ 21.25
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Pharmatrim

Pharmadesh Laboratories Ltd.

Unit Price : ৳ 21.58
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Pharmatrim

Pharmadesh Laboratories Ltd.

Unit Price : ৳ 1.30
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Pharmatrim DS

Pharmadesh Laboratories Ltd.

Unit Price : ৳ 2.60
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Politrim

ACME Laboratories Ltd.

Unit Price : ৳ 21.65
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Politrim

ACME Laboratories Ltd.

Unit Price : ৳ 1.43
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Politrim DS

ACME Laboratories Ltd.

Unit Price : ৳ 2.64
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Regtin

Rephco Pharmaceuticals Ltd.

Unit Price : ৳ 1.25
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Regtin

Rephco Pharmaceuticals Ltd.

Unit Price : ৳ 21.00
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Regtin DS

Rephco Pharmaceuticals Ltd.

Unit Price : ৳ 2.08
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Saltrim

Salton Pharmaceuticals Ltd.

Unit Price : ৳ 21.08
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Saltrim

Salton Pharmaceuticals Ltd.

Unit Price : ৳ 2.01
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Saltrim DS

Salton Pharmaceuticals Ltd.

Unit Price : ৳ 2.01
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Seematrin

Seema Pharmaceuticals Ltd.

Unit Price : ৳ 24.00
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Seftrim

Hudson Pharmaceuticals Ltd.

Unit Price : ৳ 17.00
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Seftrim DS

Hudson Pharmaceuticals Ltd.

Unit Price : ৳ 1.50
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Semotrim

Reliance Pharmaceuticals Ltd.

Unit Price : ৳ 22.00
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Semotrim

Reliance Pharmaceuticals Ltd.

Unit Price : ৳ 2.06
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Septra

Asiatic Laboratories Ltd.

Unit Price : ৳ 1.49
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Septra

Asiatic Laboratories Ltd.

Unit Price : ৳ 22.00
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Septra DS

Asiatic Laboratories Ltd.

Unit Price : ৳ 2.03
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Sinatrim

Ibn Sina Pharmaceuticals Ltd.

Unit Price : ৳ 2.10
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Sinatrim

Ibn Sina Pharmaceuticals Ltd.

Unit Price : ৳ 22.00
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Sitrim

Silva Pharmaceuticals Ltd.

Unit Price : ৳ 2.01
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Sitrim

Silva Pharmaceuticals Ltd.

Unit Price : ৳ 20.07
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Soma DS

Ambee Pharmaceuticals Ltd.

Unit Price : ৳ 2.03
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Sumetrolim

Ambee Pharmaceuticals Ltd.

Unit Price : ৳ 21.61
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Sytrim

Syntho Laboratories Ltd.

Unit Price : ৳ 21.25
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Sytrim DS

Syntho Laboratories Ltd.

Unit Price : ৳ 2.00
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Tricot

Reman Drug Laboratories Ltd.

Unit Price : ৳ 21.50
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Tricot DS

Reman Drug Laboratories Ltd.

Unit Price : ৳ 2.10
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Triprim

Supreme Pharmaceutical Ltd.

Unit Price : ৳ 21.00
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Triprim DS

Supreme Pharmaceutical Ltd.

Unit Price : ৳ 2.00