Co-trimoxazole (Trimethoprim + Sulfamethoxazole)

Dose Adult - Dosage Range

Oral / I.V.

Adults: 960 mg every 12 hours. Severe infections: 2 tablets every 12 hours. PCP: high-dose weight-based regimen.

Paediatric: 4 mg/kg trimethoprim + 20 mg/kg sulfamethoxazole every 12 hours.

Brands; See below

Combinations; Fixed-dose Trimethoprim + Sulfamethoxazole.

Indications; UTI, RTI, otitis media, shigellosis, cholera, traveller's diarrhoea, nocardiosis, PCP treatment/prophylaxis, toxoplasmosis prophylaxis, HIV opportunistic infection prophylaxis.

Precautions; Monitor CBC, renal function, potassium and ensure hydration.

Contraindications; Sulfonamide allergy, infants <2 months, severe renal/hepatic disease.

Pregnancy/Lactation; Avoid first trimester and near term if possible.

MOASequential inhibition of bacterial folate synthesis by sulfamethoxazole and trimethoprim producing bactericidal activity.
Side EffectsRash, nausea, vomiting, bone marrow suppression, hyperkalaemia, nephrotoxicity, Stevens-Johnson syndrome.
PolypharmacyWarfarin, methotrexate, phenytoin, ACEIs, ARBs, spironolactone, sulfonylureas.
Drug CategoryDRUGS ACTING ON INFECTIONS
Drug Sub-CategorySulfonamide Antibacterial
Brand NameManufacturerDistributorStrengthPackFormulationStrength BasisApprox Price
SeptrinVariousVarious960 mg10Tabletper tabletKES 150-400
BactrimRocheVarious960 mg10Tabletper tabletKES 250-600
GenericVariousVarious240 mg/5 mL100 mLSuspensionper 5 mLKES 120-300