Co-trimoxazole is an antibiotic drug to treat bacterial infections, such as bronchitis, otitis media, and urinary tract infections. This drug is a combination consisting of: trimethoprim and sulfamethoxazole.
Co-trimoxazole works by killing bacteria that cause infection. This drug can also be used to treat and prevent Pneumocystis carinii pneumonia (PCP), especially in patients with weak immune systems, such as people with HIV/AIDS.
Keep in mind that cotrimoxazole cannot cure diseases caused by viral infections, such as colds and flu.
Co-trimoxazole trademarks: Bactrim, Bactrizol, Etamoxul, Erphatrim, Fasiprim, Hufacid, Licoprima, Novatrim, Primavon, Omegtrim, Ratrim, Sanprima, Zecatrim
What is Co-trimoxazole
| group | Prescription drugs |
| Category | Antibiotics |
| Benefit | Overcoming diseases caused by bacterial infections |
| Consumed by | Adults and children >2 months old |
| Co-trimoxazole for pregnant and lactating women | Category D: There is positive evidence of risks to the human fetus, but the benefits may outweigh the risks, for example in dealing with life-threatening situations. Co-trimoxazole may be absorbed into breast milk. If you are breastfeeding, do not use this medicine without consulting your doctor first. |
| Drug form | Tablet |
Precautions Before Taking Co-trimoxazole
Co-trimoxazole should not be used carelessly. Some things to consider before taking cotrimoxazole are:
- Do not take cotrimoxazole if you are allergic to this drug. Always tell your doctor about any allergies you have.
- Tell your doctor if you are taking certain medications, supplements, or herbal products.
- Tell your doctor if you have or are currently suffering from kidney disease, liver disease, porphyria, thyroid disease, HIV/AIDS, malnutrition, electrolyte disturbances, or asthma.
- Tell your doctor if you have low folic acid levels, anemia, thrombocytopenia, or G6PD deficiency.
- Avoid prolonged exposure to direct sunlight while taking co-trimoxazole, as this medicine can cause your skin to become more sensitive. Use clothing that covers the body, sunscreen, and sunglasses, when going outside.
- Tell your doctor if you are pregnant, breastfeeding, or planning a pregnancy.
- See your doctor immediately if you have an allergic drug reaction, serious side effect, or overdose after taking cotrimoxazole.
Dosis and Rules for Use Co-trimoxazole
The dose of cotrimoxazole given by the doctor depends on the goals and age of the patient. Here is the explanation:
Purpose: Treat acute exacerbation of chronic bronchitis, otitis media, urinary tract infections
- Mature: 960 mg (800 mg sulfamethoxazole and 160 mg trimethoprim), 2 times daily. For severe infections, the dose is 2,880 mg per day, divided into 2 consumption schedules.
- Children aged 2–5 months: 120 mg, 2 times a day.
- 6 month old child until 5 years: 240 mg, 2 times a day.
- Children aged 6–11 years: 480 mg, 2 times a day.
Purpose: Handle Pneumocystis pneumonia
- Mature: 960 mg (800 mg sulfamethoxazole and 160 mg trimethoprim) per day, divided into 2–4 doses for 14–21 days.
- Children >4 weeks old: Dosage is the same as adults.
Purpose: Prevent Pneumocystis pneumonia
- Mature: 960 mg (800 mg sulfamethoxazole and 160 mg trimethoprim), once daily, for a week or 960 mg, 2 times daily, 3 times weekly on different days.
- Children >4 weeks old: 15–30 mg/kg, 2 times a day. Doses are given 2-3 times a week on different days.
How to Take Co-trimoxazole Correctly
Follow your doctor's advice and read the instructions on the co-trimoxazole package label before starting to take it. Do not change the dose without consulting your doctor first.
Co-trimoxazole is better taken with food or water. During treatment with this drug, it is recommended to drink more water because it can help prevent the risk of side effects from the drug.
Take cotrimoxazole at the same time every day to get maximum results. If you forget, take the drug immediately if the interval with the next dose is not too close. Ignore and do not double the dose if it is close to the next dosing schedule.
Store cotrimoxazole at room temperature and in a closed container to avoid sun exposure, and keep out of reach of children.
Co-trimoxazole interactions with other drugs
There are several interactions that can occur if cotrimoxazole is taken with certain drugs, including:
- Increased risk of hyperkalemia if taken with ACE drugs inhibitor
- Increased risk of arrhythmias if taken with amiodarone
- Increased toxic effects of the drug dapsone
- Increased blood levels of rifampicin, lamivudine, digoxin, or zidovudine
- Increased risk of agranulocytosis in the bone marrow if taken with clozapine
- Increased risk of thrombocytopenia if taken with diuretic drugs
- Increased risk of megaloblastic anemia if taken with pyrimethamine
- Increased risk of crystalluria or the formation of crystals in the urine if taken with methenamine
- Increased risk of treatment failure for Pneumocystis pneumonia in HIV patients when used with leucovorin
Co-trimoxazole Side Effects and Dangers
There are several side effects that can occur after taking cotrimoxazole, including:
- Constantly blowing wind
- Headache
- Nausea and vomiting
- Feeling nervous
- Sleep disturbance
- Difficult to concentrate
- Appetite down
Check with a doctor if the complaints mentioned above do not go away or get worse. Call your doctor right away if you have an allergic reaction to the drug, such as a skin rash, or experience more serious side effects, such as:
- Black stool, dark urine, vomiting blood
- Chest pain
- Weak and not feeling well
- Headaches that are getting heavier
- Sore throat, thrush, bad breath
- Hyperkalemia
- Jaundice
- Muscle pain or joint pain
In addition, cotrimoxazole can also cause aplastic anemia, Steven Johnson syndrome, toxic epidermal necrolysis, hyponatremia, or diarrhea associated with infection Clostridium difficile.