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BACTRIM (sulfamethoxazole and trimethoprim) is a synthetic antibacterial combination product available in DS (double strength) tablets, each containing 800 mg sulfamethoxazole and 160 mg trimethoprim.
IMPORTANT INFORMATION:
Source: https://www.drugs.com/mtm/sulfamethoxazole-and-trimethoprim.html
You should not use this medication if you have severe liver or kidney disease, anemia caused by folic acid deficiency, or a history of low blood platelets caused by taking trimethoprim or any sulfa drug.
HOW TO USE BACTRIM
Source: https://www.webmd.com/drugs/2/drug-5530/bactrim-ds-oral/details
Take this medication by mouth, as directed by your doctor, with a full glass of water (8 ounces / 240 milliliters). If stomach upset occurs, take with food or milk. Drink plenty of fluids while taking this medication to lower the unlikely risk of kidney stones forming, unless your doctor advises you otherwise. Dosage is based on your medical condition and response to treatment.
For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same time(s) every day.
Continue to take this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping it too early may allow bacteria to continue to grow, which may result in a relapse of the infection.
Tell your doctor if your condition persists or worsens.
SIDE EFFECTS
Nausea, vomiting, diarrhea, and loss of appetite may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor right away if you have any serious side effects, including: muscle weakness, mental/mood changes, signs of kidney problems (such as change in the amount of urine, blood in the urine), extreme drowsiness, signs of low blood sugar (such as sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness, or tingling hands/feet).
Get medical help right away if you have any very serious side effects, including: persistent headache, neck stiffness, seizures, slow/irregular heartbeat.
This medication may rarely cause serious (possibly fatal) allergic reactions and other side effects such as a severe peeling skin rash (such as Stevens-Johnson syndrome), blood disorders (such as agranulocytosis, aplastic anemia), liver damage, or lung injury. If you notice any of the following, get medical help right away: skin rash/blisters, itching/swelling (especially of the face/tongue/throat), persistent sore throat or fever, paleness, joint pain/aches, persistent cough, trouble breathing, easy bleeding/bruising, yellowing eyes or skin, persistent nausea/vomiting, unusual fatigue, dark urine. This medication may rarely cause a severe intestinal condition (Clostridium difficile-associated diarrhea) due to a type of resistant bacteria. This condition may occur during treatment or weeks to months after treatment has stopped. Tell your doctor right away if you develop: persistent diarrhea, abdominal or stomach pain/cramping, blood/mucus in your stool.
Do not use anti-diarrhea products or narcotic pain medications if you have any of these symptoms because these products may make them worse.
Use of this medication for prolonged or repeated periods may result in oral thrush or a new yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
Applies to the following strengths:
400 mg-80 mg
800 mg-160 mg
200 mg-40 mg/5 mL
80 mg-16 mg/1mL
Usual Adult Dose for:
Source: https://www.drugs.com/dosage/sulfamethoxazole-trimethoprim.html
Oral: 15 to 20 mg/kg/day (based on the trimethoprim component) orally daily in 4 equally divided doses every 6 hours for 14 to 21 days
IV: 15 to 20 mg/kg/day (based on the trimethoprim component) IV daily in 3 or 4 equally divided doses every 6 to 8 hours for up to 14 days
Comments:
-IV formulation: One investigator noted that a total daily dose of 10 to 15 mg/kg was sufficient in 10 adult patients with normal renal function.
-Sulfamethoxazole-trimethoprim 800 mg-160 mg (1 double strength tablet) orally once a day
-Maximum dose: The total daily dose should not exceed 1600 mg sulfamethoxazole and 320 mg trimethoprim
Use: For prophylaxis against P jiroveci pneumonia in individuals who are immunosuppressed and considered to be at an increased risk of developing P jiroveci pneumonia
Oral: Sulfamethoxazole-trimethoprim 800 mg-160 mg orally every 12 hours for 10 to 14 days
IV:
Severe infection: 8 to 10 mg/kg/day (based on the trimethoprim component) IV in 2 to 4 equally divided doses every 6, 8, or 12 hours for up to 14 days; maximum recommended dose is 960 mg (based on the trimethoprim component) per day
Use: For the treatment of severe or complicated urinary tract infections due to susceptible strains of Escherichia coli, Klebsiella species, Enterobacter species, Morganella morganii, Proteus mirabilis, and Proteus vulgaris
Oral: Sulfamethoxazole-trimethoprim 800 mg-160 mg (1 double strength tablet or 2 single strength tablets) orally every 12 hours for 5 days
IV: Severe infection: 8 to 10 mg/kg/day (based on the trimethoprim component) IV in 2 to 4 equally divided doses every 6, 8, or 12 hours for 5 days; maximum recommended dose is 960 mg (based on the trimethoprim component) per day
Comments:
-The patient should be instructed to use extraordinary sanitary precautions since Shigella is transmitted by the fecal-oral route, primarily by hand-to-mouth contact. Use: For the treatment of enteritis caused by susceptible strains of Shigella flexneri and Shigella sonnei
Sulfamethoxazole-trimethoprim 800 mg-160 mg (1 double strength tablet or 2 single strength tablets) orally every 12 hours for 14 days
Use: For acute exacerbations of chronic bronchitis due to susceptible strains of Streptococcus pneumoniae or Haemophilus influenzae when the physician deems that sulfamethoxazole and trimethoprim could offer some advantage over the use of a single antimicrobial agent
Sulfamethoxazole-trimethoprim 800 mg-160 mg (1 double strength tablet or 2 single strength tablets) orally every 12 hours for 5 days
Use: For the treatment of traveler's diarrhea due to susceptible strains of enterotoxigenic E coli
Uncomplicated: Sulfamethoxazole-trimethoprim 800 mg-160 mg (1 double strength tablet) orally every 12 hours for 10 days
Use: Uncomplicated pyelonephritis (off-label use)
Sulfamethoxazole-trimethoprim 800 mg-160 mg (1 double strength tablet) orally every 12 hours for 10 to 14 days Use: Otitis media (off-label use in adults)
Sulfamethoxazole-trimethoprim 400 mg-80 mg (1 single-strength tablet) orally once a day or 3 times a week at bedtime
Comments: -Some clinicians recommend that their female patients take this low dose postcoitally or 3 times a week, whichever is less frequent. Therapy should be continued for as long as the patient is at risk for infection.
Use: Cystitis prophylaxis (off-label use)
Sulfamethoxazole-trimethoprim 800 mg-160 mg (1 double strength tablet) orally 2 times a day for at least 3 weeks
Use: Granuloma inguinale (off-label use)
10 to 20 mg/kg (based on the trimethoprim component) IV every 6 to 12 hours
Comments: Use in combination with chloramphenicol is an alternative for patients with beta-lactam allergy
Use: Bacterial meningitis (off-label use)
Cutaneous infection: 5 to 10 mg/kg/day (based on the trimethoprim component) IV or orally in 2 to 4 divided doses
Severe infection (pulmonary/cerebral): 15 mg/kg/day (based on the trimethoprim component) in 2 to 4 divided doses for 3 to 4 weeks, then 10 mg/kg/day (based on the trimethoprim component) in 2 to 4 divided doses; may be initiated IV and converted to oral therapy (frequently converted to approximate dosages of oral solid dosage forms: 2 double strength tablets [320 mg-1600 mg] every 8 to 12 hours)
Duration: Not well standardized; most experts recommend at least 6 months for local disease in immunocompetent patients and 6 to 12 months or more for immunocompromised patients or patients with CNS disease
Comments: -Off-label use.
-Measurement of serum levels are advisable. Maximum plasma concentrations (Cmax) of 100 to 150 mcg/mL are recommended. Severe disease is often treated with addition of other agents, such as ceftriaxone, imipenem, or amikacin.
Sulfamethoxazole-trimethoprim 800 mg-160 mg (1 double strength tablet) orally every 12 hours
Duration: Acute, 10 to 14 days; chronic, 1 to 3 months
Comments: -Off-label use.
5 mg/kg (based on the trimethoprim component) IV every 12 hours
Duration: 4 weeks to 6 months or more, depending on the nature and severity of the infection; patients with AIDS are usually given high dose therapy for 4 to 6 weeks then maintained on oral trimethoprim-sulfamethoxazole for life
Comments: -Off-label use.
Acute bacterial exacerbation of chronic bronchitis: Trimethoprim-sulfamethoxazole 160 mg-800 mg (1 double-strength tablet) orally every 12 hours for 14 days
Sulfamethoxazole-trimethoprim 800 mg-160 mg (1 double strength tablet) orally every 12 hours
Comments:-Off-label use.