In the literature, a single case of toxic delirium has been reported after concomitant intake of sulfamethoxazole/trimethoprim and amantadine. Or, you might notice a red rash with swelling of the face, lips or lymph nodes in your neck or under your arms. . Keep out of the reach of children and pets. NOTE: This medicine is only for you. Select one or more newsletters to continue. Cross-sensitivity may exist with these agents. Brumfitt W, Pursell R. Trimethoprim/Sulfamethoxazole in the Treatment of Bacteriuria in Women. The range of prescription discounts provided under this discount plan will vary depending on the prescription and pharmacy where the prescription is purchased and can be up to 80% off the cash price. While there are no large, well-controlled studies on the use of sulfamethoxazole and trimethoprim in pregnant women, Brumfitt and Pursell, & Articles, All Skipping doses could make your infection resistant to medication. (sulfamethoxazole and Sulfamethoxazole and trimethoprim is contraindicated in patients with a known hypersensitivity to trimethoprim or sulfonamides, in patients with a history of drug-induced immune thrombocytopenia with use of trimethoprim and/or sulfonamides, and in patients with documented megaloblastic anemia due to folate deficiency. Haemophilus influenzae when in the judgment of the physician sulfamethoxazole and trimethoprim offers some advantage over the use of other antimicrobial agents. Patients who are "slow acetylators" may be more prone to idiosyncratic reactions to sulfonamides. Children Streptococcus pneumoniae or An identical daily dosage is used for 5 days in the treatment of shigellosis. 2002. We anticipate reposting the images once we are able identify and filter out images that do not match the information provided in the drug labels. Pharmacy names, logos, brands, and other trademarks are the property of their respective owners.Towers Administrators LLC (operating as 'SingleCare Administrators') is the authorized prescription discount plan organization with its administrative office located at 4510 Cox Road, Suite 111, Glen Allen, VA 23060. Greenville, SC 29605 This medicine may affect certain medical test results. The sulfonamides bear certain chemical similarities to some goitrogens, diuretics (acetazolamide and the thiazides) and oral hypoglycemic agents. Acidification of the urine will increase renal elimination of trimethoprim. Keep all appointments. COMMON BRAND NAME (S): Septra, Sulfatrim, Sulfatrim Pediatric, Sultrex Pediatric. Household spoons are not accurate. Dosing. Signs and symptoms of overdosage reported with sulfonamides include anorexia, colic, nausea, vomiting, dizziness, headache, drowsiness and unconsciousness. It may not cover all possible information. The MIC values should be interpreted according to the following criteria: When testing either It is also used to prevent and treat a certain type of pneumonia (pneumocystis-type).This medication should not be used by children less than 2 months of age due to the risk of serious side. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Dosing Calculator Adult Dosing . Sulfamethoxazole and trimethoprim may inhibit the hepatic metabolism of phenytoin. Marinella Mark A. While this medication may be prescribed for children as young as 2 months for selected conditions, precautions do apply. Do not take it more often than directed. They do not treat viral infections (e.g., the common cold). Fatalities and serious adverse reactions, including severe cutaneous adverse reactions (SCARs), including Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms (DRESS), acute febrile neutrophilic dermatosis (AFND), acute generalized erythematous pustulosis (AGEP); fulminant hepatic necrosis; agranulocytosis, aplastic anemia and other blood dyscrasias; acute and delayed lung injury; anaphylaxis and circulatory shock have occurred with the administration of sulfamethoxazole and trimethoprim products, (see WARNINGS). Enterobacter species Bactrim; Bactrim DS; Sulfatrim Pediatric; Therapeutic Category. The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. pregnancy, upcoming surgery, etc. In elderly patients concurrently receiving certain diuretics, primarily thiazides, an increased incidence of thrombocytopenia with purpura has been reported. Copyright 2023 Elsevier Inc. All Rights Reserved. The following table is a guideline for the attainment of this dosage: When renal function is impaired, a reduced dosage should be employed using the following table: The usual adult dosage in the treatment of acute exacerbations of chronic bronchitis is four teaspoonfuls (20 mL) sulfamethoxazole and trimethoprim oral suspension every 12 hours for 14 days. Sulfamethoxazole and trimethoprim is a synthetic antibacterial combination product containing 200 mg sulfamethoxazole and 40 mg trimethoprim per 5 mL for oral administration. In those concurrently receiving certain diuretics, primarily thiazides, an increased incidence of thrombocytopenia with purpura has been reported. Call your pharmacist if the medicine looks cloudy, has changed colors, or has particles in it. Sulfatrim is not indicated for prophylactic or prolonged . Copy the URL below and paste it into your RSS Reader application. Alcohol NMT 0.5%, Pharmaceutical Cleveland Clinic is a non-profit academic medical center. Diarrhea is a common problem caused by antibiotics which usually ends when the antibiotic is discontinued. For children, the recommended dose is 750 mg/m2/day sulfamethoxazole with 150 mg/m2/day trimethoprim given orally in equally divided doses twice a day, on 3 consecutive days per week. Sulfamethoxazole and trimethoprim is not indicated for prophylactic or prolonged administration in otitis media at any age. A history of mild intolerance to sulfamethoxazole and trimethoprim oral suspension in AIDS patients does not appear to predict intolerance of subsequent secondary prophylaxis.6 However, if a patient develops skin rash or any sign of adverse reaction, therapy with sulfamethoxazole and trimethoprim should be reevaluated (see Sulfamethoxazole/trimethoprim-induced thrombocytopenia may be an immune-mediated disorder. To view updated drug label links, paste the RSS feed address (URL) shown below into a RSS reader, or use a browser which supports RSS feeds, such as Safari for Mac OS X. If you are breast-feeding or plan to breast-feed. January 27, 2023. Clinical signs, such as rash, pharyngitis, fever, arthralgia, cough, chest pain, dyspnea, pallor, purpura or jaundice may be early indications of serious reactions. Drugs A-Z provides drug information from Everyday Health and our partners, as well as ratings from our members, all in one place. Life threatening hyperkalemia and acidosis secondary to trimethoprim-sulfamethoxazole treatment. Storage & Compatibility. 1996-2023 Everyday Health, Inc., a Ziff Davis company. Pharmacokinetics parameters for sulfamethoxazole were similar for geriatric subjects and younger adult subjects. At least 5 days or until patient is asymptomatic for 48 hours. 7. Peritoneal dialysis is not effective and hemodialysis is only moderately effective in eliminating sulfamethoxazole and trimethoprim. Dosage forms: SUSP: 200 mg/40 mg per 5 mL Special Note [dosing clarification] Info: dosing based on trimethoprim (TMP) component infections, mild-moderate bacterial [160 mg TMP PO bid] To date, there is limited data on the safety of repeated use of Sulfatrim in pediatric patients under two years of age. Be careful to avoid injuries. Sulfamethoxazole and trimethoprim have been shown to be active against most strains of the following microorganisms, both Urinalyses with careful microscopic examination and renal function tests should be performed during therapy, particularly for those patients with impaired renal function. Sulfatrim pediatric Dosage & Precautions. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation and COVID-19 information. You are fully responsible for paying your prescriptions at the pharmacy at the time of service, but you will be entitled to receive a discount from the pharmacy in accordance with the specific pre-negotiated discounted rate schedule. Sulfamethoxazole and trimethoprim should be discontinued at the first appearance of skin rash or any sign of a serious adverse reaction. Use of sulfamethoxazole and trimethoprim at high doses and/or for extended periods of time may cause bone marrow depression manifested as thrombocytopenia, leukopenia and/or megaloblastic anemia. Call your doctor if the diarrhea becomes severe, does not stop, or is bloody. This medication may cause serious skin reactions. If you are taking a water pill. Sulfamethoxazole and Trimethoprim Oral Suspension USP, containing 200 mg sulfamethoxazole and 40 mg trimethoprim per teaspoonful (5 mL), is a cherry flavored suspension available in: NDC 0121-0854-16: 16 fl oz (473 mL) bottle. C. difficile, and surgical evaluation should be instituted as clinically indicated. Pharmacokinetic Profile of Trimethoprim-Sulfamethoxazole in Man. Keep the container tightly closed. You should not use this medicine if you are allergic to sulfamethoxazole or trimethoprim, or if you have: May cause birth defects. Keep all medicine out of the reach of children. Streptococcus pneumoniaef: f. These zone diameter interpretative standards are applicable only to tests performed using Mueller-Hinton agar supplemented with 5% defibrinated sheep blood when incubated in 5% CO2.5. Sulfamethoxazole and trimethoprim oral suspension should be given with caution to patients with impaired renal or hepatic function, to those with possible folate deficiency (e.g., the elderly, chronic alcoholics, patients receiving anticonvulsant therapy, patients with malabsorption syndrome, and patients in malnutrition states) and to those with severe allergies or bronchial asthma. If you think you or someone else may have overdosed on: If someone collapses or isn't breathing after taking. Everyday Health is among the federally registered trademarks of Everyday Health, Inc. and may not be used by third parties without explicit permission. 10 The following table is a guideline for the upper limit of this dosage: 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. C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. A folate supplement should also be considered with prolonged high dosage of APO-SULFATRIM (see Adverse Reactions). PEDIATRIC Escherichia coli (including susceptible enterotoxigenic strains implicated in traveler's diarrhea), Klebsiella species Symptoms of ED include. NOTE: This sheet is a summary. Greenville, SC 29605, Report Adverse Do not use it if you had an allergic reaction to trimethoprim, sulfamethoxazole, or any sulfa drug. Sulfamethoxazole and trimethoprim could make you sunburn more easily. Prescribing sulfamethoxazole and trimethoprim in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria. Hepatitis (including cholestatic jaundice and hepatic necrosis) elevation of serum transaminase and bilirubin, pseudomembranous enterocolitis, pancreatitis, stomatitis, glossitis, nausea, emesis, abdominal pain, diarrhea, anorexia. Can I drink alcohol when taking sulfamethoxazole / trimethoprim DS? Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Policy, Get useful, helpful and relevant health + wellness information, 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, Stomach or intestine problems like colitis, An unusual or allergic reaction to sulfamethoxazole, trimethoprim, sulfa medications, other medications, foods, dyes, or preservatives, Certain medications for blood pressure, heart disease, Certain medications for depression, like amitriptyline, Certain medications for diabetes, like glipizide or glyburide, Certain medications that treat or prevent blood clots like warfarin, Allergic reactionsskin rash, itching, hives, swelling of the face, lips, tongue, or throat, Aplastic anemiaunusual weakness or fatigue, dizziness, headache, trouble breathing, increased bleeding or bruising, fever, chills, cough, or sore throat, Dry cough, shortness of breath or trouble breathing, High potassium levelmuscle weakness, fast or irregular heartbeat, Liver injury right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue, Low blood sugar (hypoglycemia)tremors or shaking, anxiety, sweating, cold or clammy skin, confusion, dizziness, rapid heartbeat, Low sodium levelmuscle weakness, fatigue, dizziness, headache, confusion, Redness, blistering, peeling, or loosening of the skin, including inside the mouth, Unusual vaginal discharge, itching, or odor. Sulfamethoxazole and trimethoprim oral is taken by mouth. Get emergency medical help if you have signs of an allergic reaction (hives, cough, chest pain, shortness of breath, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling). Cough, shortness of breath, pulmonary infiltrates, acute eosinophilic pneumonia, acute and delayed lung injury, interstitial lung disease, acute respiratory failure (see WARNINGS). This reaction is frequently dose-related. All rights reserved. For full . This reaction is frequently dose-related (see Approximately 70% of sulfamethoxazole and 44% of trimethoprim are bound to plasma proteins. Sulfatrim Pediatric (sulfamethoxazole and trimethoprim) is a brand-name prescription combination antibiotic that treats or prevents a range of bacterial infections in children, including urinary tract infections, middle ear infections, intestinal infections (shigellosis), and pneumocystis pneumonia. Store between 15 and 25 degrees C (59 to 77 degrees F). The recommended dosage for treatment of patients with documented Pneumocystis carinii pneumonia is 75 to 100 mg/kg sulfamethoxazole and 15 to 20 mg/kg trimethoprim per 24 hours given in equally divided doses every 6 hours for 14 to 21 days. We do not endorse non-Cleveland Clinic products or services. Tell your doctor if you also use the following: Amantadine, cyclosporine, digoxin, indomethacin, memantine, methotrexate, phenytoin, procainamide, pyrimethamine, warfarin, zidovudineBlood pressure medicine (including an ACE inhibitor)Diabetes medicine (including glipizide, glyburide, metformin, pioglitazone, repaglinide, rosiglitazone)Diuretic (water pill, including hydrochlorothiazide)Medicine to treat depression (including TCAs). Br J Clin Pharmacol. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Shigella sonnei when antibacterial therapy is indicated. 2023 SingleCare Administrators. Solution, Intravenous: Generic: Sulfamethoxazole 80 mg and trimethoprim 16 mg per mL (5 mL, 10 mL, 30 mL) Suspension, Oral: Sulfatrim Pediatric combines a sulfa drug (sulfamethoxazole) with an anti-folate agent (trimethoprim). Even treatment with recommended doses may cause hyperkalemia when trimethoprim is administered to patients with underlying disorders of potassium metabolism, with renal insufficiency, or if drugs known to induce hyperkalemia are given concomitantly. When testing As with standardized dilution techniques, diffusion methods require the use of laboratory control microorganisms that are used to control the technical aspects of the laboratory procedures. Generic name: SULFAMETHOXAZOLE 200mg in 5mL, TRIMETHOPRIM 40mg in 5mL However, after normalizing by body weight, the apparent total body clearance of trimethoprim was an average 19% lower in geriatric subjects compared with young adult subjects.3. Review/update the information highlighted below and resubmit the form. Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Keep out of the sun. INDICATIONS AND USAGE and To date, there are limited data on the safety of repeated use of sulfamethoxazole and trimethoprim in pediatric patients under two years of age. in vitro and in clinical infections as described in the 1992; 41(RR-4):111. This medicine may cause a severe allergic reaction. Measure a dose with the supplied measuring device (not a kitchen spoon). Streptococcus pneumoniaeb: a. For the treatment of travelers' diarrhea due to susceptible strains of enterotoxigenic Haemophilus influenzaee: e.These zone diameter standards are applicable only for disk diffusion testing with Haemophilus influenzae and Haemophilus Test Medium (HTM).5. A zone of inhibition 20 mm that is essentially free of fine colonies indicates a sufficiently low level of thymidine and thymine. This medication is a combination of two antibiotics: sulfamethoxazole and trimethoprim. Protect from light. DESCRIPTION Sulfamethoxazole and trimethoprim is a synthetic antibacterial combinationproductcontaining 200 mg sulfamethoxazole and 40 mg trimethoprim per 5 mL for oral administration.. A report of "Intermediate" indicates that the result should be considered equivocal, and, if the microorganism is not fully susceptible to alternative, clinically feasible drugs, the test should be repeated. It is a white to light yellow, odorless, bitter compound with a molecular weight of 290.3 and it has the following structural formula is: alcohol (less than 0.5%), carboxymethylcellulose sodium, citric acid, FD&C Red #40, FD&C Yellow #6, cherry flavor, methylparaben, microcrystalline cellulose and carboxymethylcellulose sodium, polysorbate 80, propylene glycol, propylparaben, purified water, saccharin sodium, simethicone emulsion, sucrose. In rats, oral doses of 533 mg/kg or 200 mg/kg produced teratologic effects manifested mainly as cleft palates. Generic Bactrim DS, sulfamethoxazole-trimethoprim, costs $24. Drug class: Sulfonamides. Sulfatrim Pediatric is administered as a flavored oral suspension. Overdose symptoms may include loss of appetite, vomiting, fever, blood in your urine, yellowing of your skin or eyes, confusion, or loss of consciousness. DailyMed will deliver notification of updates and additions to Drug Label information currently shown on this site through its RSS feed. Sulfamethoxazole and trimethoprim is not recommended for infants younger than 2 months of age (see Quantitative methods that require measurement of zone diameters also provide reproducible estimates of the susceptibility of bacteria to antimicrobial compounds. For the treatment of documented What drugs should be avoided with a sulfa allergy? The recommended dosage for prophylaxis in adults is four teaspoonfuls (20 mL) of the oral suspension daily.11. DailyMed will deliver this notification to your desktop, Web browser, or e-mail depending on the RSS Reader you select to use. Your doctor will tell you how much medicine to use. Dangerous effects could occur. Both sulfamethoxazole and trimethoprim distribute to sputum, vaginal fluid and middle ear fluid; trimethoprim also distributes to bronchial secretions, and both pass the placental barrier and are excreted in human milk. 2, NCCLS, Wayne, PA, January, 1997. Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once. Standard sulfamethoxazole/trimethoprim powder should provide the following range of values: c.This quality control range is applicable only to Haemophilus influenzae ATCC 49247 tested by broth microdilution procedure using Haemophilus Test Medium (HTM).4, d.This quality control range is applicable to tests performed by the broth microdilution method only using cation-adjusted Mueller-Hinton broth with 2% to 5% lysed horse blood.4. The trimethoprim component of sulfamethoxazole and trimethoprim may cause hyperkalemia when administered to patients with underlying disorders of potassium metabolism, with renal insufficiency or when given concomitantly with drugs known to induce hyperkalemia, such as angiotensin converting enzyme inhibitors. This medicine is not right for everyone. Because these reactions were reported voluntarily from a population of uncertain size, it is not possible to reliably estimate their frequency or establish a causal relationship to drug exposure: The amount of a single dose of sulfamethoxazole and trimethoprim that is either associated with symptoms of overdosage or is likely to be life-threatening has not been reported. https://dailymed.nlm.nih.gov/dailymed/labelrss.cfm?setid=c62086ea-ba15-40f5-8431-4639c60c9825, https://dailymed.nlm.nih.gov/dailymed/rss.cfm. Files, Presentations The recommended dosage for prophylaxis in adults is four teaspoonfuls (20 mL) of the oral suspension daily.11. Escherichia coli, Klebsiella species, Enterobacter species, Morganella morganii, Proteus mirabilis and It has been reported that sulfamethoxazole and trimethoprim may prolong the prothrombin time in patients who are receiving the anticoagulant warfarin. 3. Due to inconsistencies between the drug labels on DailyMed and the pill images provided by RxImage, we no longer display the RxImage pill images associated with drug labels. Proteus vulgaris Sulfatrim Pediatric has an average rating of 1.0 out of 10 from a total of 1 ratings on Drugs.com. Throw away any unused medication after the expiration date. This medication can make you more sensitive to the sun. Antimicrobial Agents Chemother. g.This quality control range is applicable only to Haemophilus influenzae ATCC 49247 tested by a disk diffusion procedure using Haemophilus Test Medium (HTM).5, h.This quality control range is applicable only to tests performed by disk diffusion using Mueller-Hinton agar supplemented with 5% defibrinated sheep blood when incubated in 5% CO2.5. In a separate survey, Brumfitt and Pursell also found no congenital abnormalities in 35 children whose mothers had received oral sulfamethoxazole and trimethoprim at the time of conception or shortly thereafter. An identical daily dosage is used for 5 days in the treatment of shigellosis. In vitro studies have shown that bacterial resistance develops more slowly with both sulfamethoxazole trimethoprim in combination than with either sulfamethoxazole or trimethoprim alone. An identical daily dosage is used for 5 days in the treatment of shigellosis. Talk with your doctor if you have concerns about this. Compare prices for generic sulfatrim substitutes: Sulfatalpin, Sulfatrim 20/100, Sulfatrim 24% . Standardized susceptibility test procedures require the use of laboratory control microorganisms to control the technical aspects of the laboratory procedures. SULFATRIM- sulfamethoxazole and trimethoprim suspension, Escherichia coli, Klebsiella species, Enterobacter species, Morganella morganii, Proteus mirabilis, Acute Exacerbations of Chronic Bronchitis in Adults, Hypersensitivity and Other Serious or Fatal Reactions, Use in the Treatment of and Prophylaxis for, Carcinogenesis, mutagenesis, impairment of fertility, Urinary Tract Infections and Shigellosis in Adults and Pediatric Patients, and Acute Otitis Media in Children, For Patients with Impaired Renal Function, Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria that Grow Aerobically, sulfamethoxazole and trimethoprim suspension, All Drug Vitro studies have shown that bacterial resistance develops more slowly with both sulfamethoxazole trimethoprim in combination with... Identify pills, check interactions and set up your own personal medication records prolonged administration in otitis media any... 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Drug information, identify pills, check interactions and set up your own personal medication records products or services sulfamethoxazole... A folate supplement should also be considered with prolonged high dosage of (. For geriatric subjects and younger adult subjects, a Ziff Davis company of laboratory control to. Generic Bactrim DS, sulfamethoxazole-trimethoprim, costs $ 24 a sufficiently low level of thymidine and thymine metabolism... Not endorse non-Cleveland Clinic products or services Ziff Davis company have: may cause birth defects acidosis secondary to treatment... Bactrim DS ; Sulfatrim Pediatric, Sultrex Pediatric of APO-SULFATRIM ( see Approximately 70 % of trimethoprim are to. Spoon ) in combination than with either sulfamethoxazole or trimethoprim alone concerns about this in media. Prolonged high dosage of APO-SULFATRIM ( see adverse reactions ) teaspoonfuls ( 20 mL ) of the sulfamethoxazole. Acidosis secondary to trimethoprim-sulfamethoxazole treatment recommended dosage for prophylaxis in adults is four teaspoonfuls ( 20 mL ) of oral!