What are the uses of Cotrimoxazole 480mg?

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Cotrimoxazol 480mg is commonly found in prescriptions to treat some bacterial infections such as pneumonia, bronchitis, urinary tract infections, diarrhea... This is a combination antibiotic that works by blocking growth of bacteria, the drug has no effect on viruses.

1. What is Cotrimoxazol 480mg?

The active ingredients in cotrimoxazol include: Sulfamethoxazole 400 mg and Trimethoprim 80 mg along with a system of excipients such as corn starch, povidone K30, croscarmellose sodium, starch sodium glycolate, magnesium stearate.
In which, Sulfamethoxazole is a sulphonamide antibiotic that competitively inhibits the synthesis of folic acid in bacteria, Trimethoprim is a derivative of pyrimidine, which specifically inhibits the bacterial enzyme dihydrofolate reductase. The combination of two active antibiotics trimethoprim and sulfamethoxazole will inhibit 2 consecutive stages of folic acid metabolism, thereby effectively inhibiting the synthesis of purine, thymidine and final DNA of microorganisms. bacteria, for bactericidal effect. This synergistic mechanism also makes the drug resistant to the development of drug-resistant bacteria and makes the drug effective even when bacteria are already resistant to each component of the drug cotrimoxazole.
Microorganisms that are relatively susceptible to cotrimoxazole :
E. coli ; Klebsiella spp.; Enterobacter spp.; Morganella morganii; Proteus mirabilis; Proteus indol positive, including P.vulgaris; H. influenzae; S. pneumoniae ; Shigella flexneri and Shigella sonnei; Pneumocystis carinii; Cotrimoxazole may have some effect on Plasmodium falciparum and Toxoplasma gondii. Organisms commonly resistant to cotrimoxazole are:
Enterococcus; Pseudomonas; Campylobacter; Anaerobic bacteria (Anaerobic); Meningococcus; Gonococcus; Mycoplasma.

2. What are the effects of Cotrimoxazole?

What disease does cotrimoxazole treat?
Acute otitis media ; Chronic urinary tract infections; Recurrent urinary tract infections; Prostatitis ; Respiratory tract infections ; Gastrointestinal infections; brucellosis ; Cholera; Plague Pneumonia caused by Pneumocystis jiroveci (Pneumocystis carinii); Toxoplasmosis.

3. Dosage of Cotrimoxazol 480mg

Cotrimoxazole is taken orally, can be taken with food or drink to minimize the possibility of digestive upset. The dose of cotrimoxazole is calculated according to the amount of trimethoprim in a fixed combination tablet containing sulfamethoxazole and trimethoprim mg as follows:
Treatment of acute otitis media in children 2 months of age and older: The usual dose of cotrimoxazole is 8 mg of trimethoprim. /kg/day, divided into 2 small doses, taken 12 hours apart, treatment time is usually 10 days. Chronic urinary tract infections, recurrent urinary tract infections or prostatitis: Adults: 160mg trimethoprim every 12 hours, cotrimoxazole for 10-14 days for chronic urinary tract infections or relapse, take cotrimoxazole for 3-6 months for prostatitis; Prophylaxis of chronic or recurrent urinary tract infections: Adults take a dose of 40-80 mg trimethoprim/day or 3 times/week for 3-6 months; children 2 months and older use the usual dose of 8 mg trimethoprim/kg/day, divided into 2 small doses, each dose is 12 hours apart; Respiratory tract infections: adults use a dose of 160mg trimethoprim/time, 12 hours apart, use cotrimoxazole for 14 days; Gastrointestinal infections caused by bacillus dysentery (S. flexneri or S.sonnei): Adults use a dose of 160mg trimethoprim/time, 12 hours apart; Children use a dose of 8mg trimethoprim/kg/day, divided into 2 small doses, 12 hours apart, using cotrimoxazole for 5 days; For brucellosis in children, the dose of trimethoprim is 10 mg/kg/day (maximum 480 mg/day), divided into 2 small doses, using cotrimoxazole for 4-6 weeks; Cholera: adults use a dose of 160mg trimethoprim, twice a day for 3 days; children use a dose of trimethoprim 4-5mg/kg, twice a day, for 3 days in combination with fluids and electrolytes; Prophylaxis for subjects who have contact with people with pneumonic plague: Adults take a dose of trimethoprim 320 - 640mg/day, divided into 2 small doses, taken 12 hours apart for 7 days; children who are at least 2 months old and older are given a dose of trimethoprim 8mg/kg/day, divided equally into 2 small doses, using cotrimoxazol for 7 days; Pneumocystis jiroveci pneumonia (Pneumocystis carinii): children over 2 months and adults receive trimethoprim 15 - 20 mg/kg/day, divided into 3 or 4 equally small doses and used for 14 - 21 days; Primary or secondary prevention in HIV-infected adults and adolescents: trimethoprim 160mg/time/day or 80mg/time/day; Primary or secondary prevention of HIV infection in children: intermittent oral dose of trimethoprim 150mg/m2, divided into 2 small doses, taken for 3 consecutive days in a week; Toxoplasmosis: the dose for primary prevention in adults and adolescents is trimethoprim 160mg once a day or 80mg once a day; primary prevention in HIV-infected children with a dose of trimethoprim 150mg/m2/day divided into 2 small doses;
For patients with renal impairment the dose is reduced as follows:
Creatinine clearance (ml/min) >30: use the usual dose; Creatinine clearance (ml/min) 15-30: 1/2 of the usual dose; Creatinine clearance (ml/min) <15: Do not use.

4. Contraindications of the drug cotrimoxazol

Patients with hypersensitivity to sulfamethoxazole or trimethoprim or to any of the excipients of cotrimoxazole; Patients with severe liver damage; Severe renal failure when the clearance cannot be controlled below 15 ml/min; Macrocytic anemia due to folate deficiency; Pregnant and lactating women should not take cotrimoxazole; Children under 2 months old.

5. Cotrimoxazol side effects

Common side effects of cotrimoxazole: Nausea, vomiting, anorexia and diarrhea; Common hypersensitivity reactions: Fever, skin reactions such as rash, pruritus, photosensitivity, exfoliative dermatitis, erythema or more serious potentially fatal, toxic epidermal necrolysis, syndrome Stevens-Johnson syndrome ; Side effects of other cotrimoxazole drugs: systemic lupus erythematosus, cotrimoxazole aggravate existing diseases, cause nephrotoxicity such as interstitial nephritis and tubular necrosis, low back pain, hematuria, oliguria, dysuria ... Cotrimoxazol drugs cause blood disorders: agranulocytosis, aplastic anemia, thrombocytopenia and white blood cell count, decreased prothrombin, increased eosinophils; Liver enzyme disorders and cholestatic jaundice, methemoglobin cyanosis, acute hemolytic anemia.

6. Cotrimoxazole drug interactions with other drugs

Warfarin: the drug cotrimoxazole causes prolongation of the patient's blood clotting time by inhibiting the clearance of warfarin's metabolite; Phenytoin: the drug cotrimoxazole inhibits the metabolism of phenytoin; Methotrexate: sulfonamides can displace methotrexate when bound to plasma proteins, increasing the concentration of free methotrexate; Cyclosporin: signs of nephrotoxicity, however reversible, have been observed in renal transplant patients receiving cotrimoxazole with cyclosporin; Digoxin: The drug cotrimoxazole increases the concentration of digoxin in the serum, which is common in the elderly; Indomethacin: the drug cotrimoxazole increases the concentration of sulfamethoxazole in the blood plasma; Pyrimethamine: megaloblastic anemia occurred in patients taking cotrimoxazole and pyrimethamine more than 25 mg/week. Antidepressants: cotrimoxazole reduces the effectiveness of tricyclic antidepressants; Amantadine: Toxic delirium when cotrimoxazole is used with amantadine. Cotrimoxazol drugs are often found in prescriptions for the treatment of some bacterial infections such as pneumonia, bronchitis, urinary tract infections, diarrhea... To ensure effective treatment and avoid side effects, people patients need to take medicine according to prescription or consult a doctor or pharmacist.
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