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Sulfamethoxazole and Trimethoprim Tablets, USP


Rx only


DESCRIPTION


CLINICAL PHARMACOLOGY


Geriatric Pharmacokinetics


Microbiology


Aerobic gram-positive microorganisms


Aerobic gram-negative microorganisms


Other Organisms


Susceptibility Testing Methods


Dilution Techniques


Diffusion Techniques


INDICATIONS AND USAGE


Urinary Tract Infections


Acute Otitis Media


Acute Exacerbations of Chronic Bronchitis in Adults


Shigellosis


Pneumocystis Carinii Pneumonia


Traveler's Diarrhea in Adults


CONTRAINDICATIONS


WARNINGS


PRECAUTIONS


General


Use in the Treatment of and Prophylaxis for Pneumocystis Carinii Pneumonia in Patients with Acquired Immunodeficiency Syndrome (AIDS)


Information for Patients


Laboratory Tests


Drug Interactions


Drug/Laboratory Test Interactions


Carcinogenesis, Mutagenesis, Impairment of Fertility


Carcinogenesis


Mutagenesis


Impairment of Fertility


Pregnancy


Teratogenic Effects


Nonteratogenic Effects


Nursing Mothers


Pediatric Use


Geriatric Use


ADVERSE REACTIONS


OVERDOSAGE


Acute


Chronic


DOSAGE AND ADMINISTRATION


Urinary Tract Infections and Shigellosis in Adults and Pediatric Patients, and Acute Otitis Media in Children


Adults


Children

WeightDose–every 12 hours
lbkgTablets
2244668810203040–11½2 or 1 DS tablet

For Patients with Impaired Renal Function

Creatinine Clearance (mL/min)Recommended Dosage Regimen
Above 3015–30Below 15Usual standard regimen½ the usual regimenUse not recommended

Acute Exacerbations of Chronic Bronchitis in Adults


Pneumocystis Carinii Pneumonia


Treatment


Adults and Children

For the lower limit dose (75 mg/kg sulfamethoxazole and 15 mg/kg trimethoprim per 24 hours) administer 75% of the dose in the above table.

WeightDose–every 6 hours
lbkgTablets
1835537088106141176816243240486480–11½2 or 1 DS tablet2½3 or 1½  DS tablets4 or 2 DS tablets5 or 2½ DS tablets

Prophylaxis


Adults


Children

Body Surface AreaDose–every 12 hours
(m2)Tablets
0.260.531.06–½1

Traveler’s Diarrhea in Adults


HOW SUPPLIED

Bottles of 30NDC 54868-4711-0
Bottles of 10NDC 54868-0021-6
Bottles of 14NDC 54868-0021-2
Bottles of 15NDC 54868-0021-5
Bottles of 20NDC 54868-0021-1
Bottles of 30NDC 54868-0021-7
Bottles of 60NDC 54868-0021-4
Bottles of 100NDC 54868-0021-0
Bottles of 120NDC 54868-0021-3

REFERENCES

  • Kremers P, Duvivier J, Heusghem C. Pharmacokinetic Studies of Co-Trimoxazole in Man after Single and Repeated Doses. J Clin Pharmacol. Feb-Mar 1974; 14:112-117.
  • Kaplan SA, et al. Pharmacokinetic Profile of Trimethoprim-Sulfamethoxazole in Man. J Infect Dis. Nov 1973; 128 (Suppl): S547-S555.
  • Varoquaux O, et al Pharmacokinetics of the trimethoprim-sulfamethoxazole combination in the elderly. Br J Clin Pharmacol. 1985;20:575-581.
  • Rudoy RC, Nelson JD, Haltalin KC. Antimicrobial Agents Chemother. May 1974;5:439-443.
  • National Committee for Clinical Laboratory Standards. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria that Grow Aerobically; Approved Standard - Fourth Edition. NCCLS document M7-A4, Vol.17, No. 2, NCCLS, Wayne, PA, January, 1997.
  • Hardy DW, et al. A controlled trial of trimethoprim-sulfamethoxazole or aerosolized pentamidine for secondary prophylaxis of Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome. N Engl J Med. 1992; 327:1842-1848.
  • Marinella Mark A. 1999. Trimethoprim-induced hyperkalemia: An analysis of reported cases. Gerontol. 45:209-212.
  • Margassery, S. and B. Bastani. 2002. Life threatening hyperkalemia and acidosis secondary to trimethoprim-sulfamethoxazole treatment. J. Nephrol. 14:410-414.
  • Brumfitt W, Pursell R. Trimethoprim/Sulfamethoxazole in the Treatment of Bacteriuria in Women. J Infect Dis. Nov 1973; 128 (Suppl):S657-S663.
  • Masur H. Prevention and treatment of Pneumocystis pneumonia. N Engl J Med. 1992; 327:1853-1880.
  • Recommendations for prophylaxis against Pneumocystis carinii pneumonia for adults and adolescents infected with human immunodeficiency virus. MMWR. 1992; 41(RR-4):1-11.
  • CDC Guidelines for prophylaxis against Pneumocystis carinii pneumonia for children infected with human immunodeficiency virus. MMWR. 1991; 40(RR-2):1-13. 

SPL UNCLASSIFIED SECTION

Relabeling and Repackaging by:Physicians Total Care, Inc.Tulsa, OK      74146