Megatrim®(trimethoprim) 40mg + (Sulfamethoxazole) 200mg Syrup 60ml

Generic

Sulphamethoxazole + Trimethoprim 

 

Indications

In vitro, cotrimoxazole is bactericidal against a wide range of Gram-positive and Gram-negative bacteria, including Streptococcus, Staphylococcus, Pneumococcus, Neisseria, B. catarrhalis, Escherichia coli, Klebsiella, Proteus spp., Haemophilus, Salmonella, Shigella, Vibrio cholerae, Bruce Cotrimoxazole has a high level of activity against Haemophilus influenzae, E. coli, and Proteus spp., which makes it ideal for the treatment of chronic bronchitis and urinary tract infections. Cotrimoxazole works by blocking two bacterial enzyme systems involved in the manufacture of Folinic acid in a sequential manner.

Respiratory tract infections, such as acute and chronic bronchitis (treatment and prophylaxis), bronchiectasis, lung abscess, lobar and bronchopneumonia, Pneumocystis carinii pneumonitis, sinusitis, and otitis media are among the indications.

Urethritis, acute and chronic cystitis, pyelonephritis, prostatitis, and gonorrhoea are examples of genito-urinary tract infections.

Infections of the gastrointestinal system caused by Salmonella typhi and Salmonella paratyphi, as well as the chronic carrier condition.

Other infections caused by a wide range of organisms that have been confirmed to be susceptible to Cotrimoxazole, and for which the therapeutic benefits are thought to outweigh the risk of side effects.

 

Pharmacology

Cotrimoxazole has broad bactericidal activity against gram-positive and gram-negative bacteria, as well as some protozoa. The bactericidal activity of Co-trimoxazole, which contains Trimethoprim and Sulphamethoxazole in a 1:5 ratio, is mediated by the successive inhibition of two bacterial enzyme systems involved in the manufacture of folinic acid in the bacterium.

 

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

Trimethoprim or sulphonamide hypersensitivity.

Patients who have been diagnosed with megaloblastic anemia as a result of a folate deficit.

Patients with significant parenchymal damage to the liver, blood dyscrasia, severe renal failure, and glucose 6-phosphate dehydrogenase deficiency.

 

Side Effects

Crystalluria, allergic responses, haemolysis, thrombocytopenia, neutropenia, agranulocytosis, and other adverse effects have been described seldom with the combination of Sulphamethoxazole and Trimethoprim. Malaise, headache, nausea, and vomiting are some of the less serious side effects. These are usually transitory and do not need treatment discontinuation.

 

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

Because the medicine interferes with the conversion of Folic acid to Folinic acid, prolonged full-dose treatment with the sulfamethoxazole-trimethoprim combination increases the risk of macrocytic anemia. Folinic acid can be given to reverse this if it happens. When delivering this combination to diabetic patients on a sulphonylurea treatment, it's important to keep in mind that the sulphonylurea's action may be potentiated.

 

Therapeutic Class

Anti-diarrhoeal Antimicrobial drugs, Sulphonamides & Trimethoprim