Description
Therapeutic action
– Combination of a sulfonamide with another antibacterial
Indications
– First-line treatment of pneumocystosis and isosporiasis
– Prophylaxis of pneumocystosis, toxoplasmosis and isosporiasis
– Brucellosis (when doxycycline is contra-indicated)
Presentation
– 400 mg SMX + 80 mg TMP and 800 mg SMX + 160 mg TMP tablets
– 100 mg SMX + 20 mg TMP tablet for paediatric use
– 200 mg SMX + 40 mg TMP/5 ml oral suspension
Dosage and duration
– Treatment of pneumocystosis
Child: 100 mg SMX + 20 mg TMP/kg/day in 2 divided doses
Adult: 4800 SMX + 960 TMP/day in 3 divided doses
Treatment of isosporiasis
Adult: 3200 mg SMX + 640 mg TMP/day in 2 divided doses
–Prophylaxis of pneumocystosis, toxoplasmosis and isosporiasis
Child: 50 mg SMX + 10 mg TMP/kg once daily, as long as necessary
Adult: 800 mg SMX + 160 mg TMP once daily, as long as necessary
–Brucellosis
Child: 40 mg SMX + 8 mg TMP/kg/day in 2 divided doses
Adult: 1600 mg SMX + 320 mg TMP/day in 2 divided doses
Duration
– Pneumocystosis: 14 to 21 days depending on severity; isosporiasis: 10 days; brucellosis: 6 weeks
Contra-indications, adverse effects, precautions
– Do not administer to children under 1 month.
– Do not administer to sulfonamide-allergic patients; patients with severe renal or hepatic impairment.
– May cause:
- gastrointestinal disturbances, hepatic or renal disorders (crystalluria, etc.), metabolic disorders
(hyperkalaemia); neuropathy, photosensitivity, haemolytic anaemia in patients with G6PD deficiency;
- allergic reactions (fever, rash, etc.) sometimes severe (Lyell’s and Stevens-Johnson syndromes,
haematological disorders, etc.). In these cases, stop treatment immediately;
- megaloblastic anaemia due to folinic acid deficiency in patients receiving prolonged treatment (in this
event, administer calcium folinate).
– Adverse effects occur more frequently in patients with IV infection.
– In the event of prolonged treatment, monitor blood count if possible.
– Do not combine with methotrexate and phenytoin.
– Avoid combination with drugs inducing hyperkalaemia: potassium, spironolactone, enalapril, NSAIDs,
heparin (increased risk of hyperkalaemia).
– Monitor combination with zidovudine (increased haematotoxicity).
– Drink a lot of liquid during treatment.
–Pregnancy: no contra-indication. However, avoid using during the last month of pregnancy (risk of
–jaundice and haemolytic anaemia in the newborn infant).
Breast-feeding: avoid if premature infant, jaundice, low-birth weight, infant under one month of age. If cotrimoxazole is used, observe the infant for signs of jaundice.
Remarks
Storage: below 5°C Once the bottle has been opened, the oral suspension keep.
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