Co-trimoxazole tab 480mg 10 pieces Pharmstandard

Description

Composition
Active substance:
1 tablet contains: sulfamethoxazole – 100 mg or 400 mg, trimethoprim – 20 mg or 80 mg.
Excipients:
Microcrystalline cellulose, potato starch, povidone (polyvinylpyrrolidone, low molecular weight medical 12600 ± 2700), crospovidone (Kollidon CL), magnesium stearate.
Product form:
Tablets of 120 mg or 480 mg.
Packing 10 or 20 tablets.
Contraindications
Hypersensitivity (including trimethoprim and sulfonamides), severe cardiovascular disease, hepatic, renal failure, aplastic anemia, B12 deficiency anemia, agranulocytosis, leukopenia, deficiency of glucose-6-phosphate dehydrogenase, pregnancy, lactation, infancy up to 3 years, hyperbilirubinemia in children.
Carefully.
When folate deficiency, bronchial asthma, thyroid diseases.
Indications
– infections of urogenital organs: urethritis, cystitis, pyelitis, pyelonephritis, prostatitis, epididymitis, gonorrhea (male and female), chancroid, lymphogranuloma venereum, granuloma inguinale; – respiratory tract infections bronchitis (acute and chronic), bronchiectasis, lobar pneumonia, bronchopneumonia, Pneumocystis pneumonia; – infections of upper respiratory tract: otitis media, sinusitis, laryngitis, sore throat; scarlet fever; – gastro-intestinal infections: typhoid, paratyphoid, salmonellonositelstvo, cholera, dysentery, cholecystitis, cholangitis, gastroenteritis, caused by enterotoksichnymi strains of Escherichia coli; – Skin and soft tissue infections: acne, furunculosis, pyoderma, wound infections; osteomyelitis (acute and chronic), etc .; – osteoarticular infection, brucellosis (acute), South American blastomycosis, malaria (Plasmodium falciparum), toxoplasmosis (in the complex therapy).
Interaction with other drugs
Not recommended for use with thiazide diuretic because of the risk of thrombocytopenia (bleeding).
Not recommended simultaneous use of the drug with salicylates butadionom, naproxen and derivatives of para-aminobenzoic acid.
Enhances the anticoagulant activity of warfarin and phenytoin protivosudoruzhnuyu. Potenziruet (TMP) action of hypoglycemic drugs, sulfonylurea derivatives.
Rifampicin reduces T1 / 2 trimethoprim.
Combined assignment Co-trimoxazole and cyclosporin postoperative state worsens renal patients.
Reduces the reliability of an oral contraceptive (inhibits intestinal flora, reduce gastro-hepatic circulation hormonal compounds).
Pyrimethamine at doses exceeding 25 mg / week, increases the risk of anemia megoblastnoy.
Reduce the effect of benzocaine, procaine, procainamide (et al. PM, which is formed as a result of hydrolysis PABA).
Between diuretics (thiazides, furosemide et al.) And oral hypoglycemic drugs (sulfonylurea derivatives), on the one hand and antimicrobial sulfaniamidami – with others, may develop an allergic cross-reaction..
Phenytoin, barbiturates, Pasco enhance manifestation of folic acid deficiency.
Salicylic acid derivatives enhance the effect.
Ascorbic acid, hexamethylenetetramine (et al. PM, acidifying the urine) increases the risk of crystalluria.
Cholestyramine reduces absorption, however it should be taken within 1 h after or for 4 – 6 h before reception Co-trimoxazole.
Drugs that suppress bone marrow blood, increases the risk of myelosuppression.
Overdose
Symptoms include nausea, vomiting, intestinal colic, dizziness, headache, drowsiness, depression, fainting, confusion, blurred vision, fever, hematuria, crystalluria; For prolonged overdose – thrombocytopenia, leukopenia, megaloblastic anemia, jaundice.
Treatment: gastric lavage, urine acidification increases the excretion of trimethoprim, acquisition of liquid inside, intramuscularly – 5 – 15 mg / day calcium folinate (trimethoprim eliminates effect on the bone marrow), if necessary – hemodialysis.
pharmachologic effect
Pharmacological group:
Antimicrobial agents of different groups.
Pharmacodynamics:
Combined antimicrobial agent consisting of sulfamethoxazole and trimethoprim. Sulfamethoxazole similar in structure to para-aminobenzoic acid (PABA), gives dihydrofolic acid synthesis in bacterial cells by inhibiting incorporation of PABA in its molecule. Trimethoprim Sulfamethoxazole enhances the effect, disrupting recovery dihydrofolic acid into tetrahydrofolic – the active form of folic acid that is responsible for protein metabolism, and division of microbial cells. It is a bactericidal broad-spectrum drugs, active against the following microorganisms: Streptococcus spp. (Hemolytic strains are more sensitive to penicillin), Staphylococcus spp., Streptococcus pneumoniae, Neisseria meningitidis, Neisseria gonorrhoeae, Escherichia coli (including strains enterotoksogennye), Salmonella spp. (Including Salmonella typhi and Salmonella paratyphi), Vibrio cholerae, Bacillus anthracis, Haemophilus influenzae (including the ampicillin resistance strains), Listeria spp., Nocardia asteroides, Bordetella pertussis, Enterococcus faecalis, Klebsiella spp., Proteus spp., Pasteurella spp., Francisella tularensis , Brucella spp., Mycobacterium spp. . (Including Mycobacterium leprae), Citrobacter, Enterobacter spp, Legionella pneumophila, Providencia, some species Pseudomonas (except Pseudomonas aeruginosa), Serratia marcescens, Shigella spp, Yersinia spp, Morganella spp, Pneumocystis carinii…; Chlamydia spp. (Including Chlamydia trachomatis, Chlamydia psittaci); protozoa: Plasmodium spp, Toxoplasma gondii, pathogenic fungi, Actinomyces israelii, Coccidioides immitis, Histoplasma capsulatum, Leishmania spp..
Resistant to the drug: Corynebacterium spp, Pseudomonas aeruginosa, Mycobacterium tuberculosis, Treponema spp, Leptospira spp, viruses…. Inhibits vital activity of Escherichia coli, which leads to a decrease of synthesis of thymine, riboflavin, nicotinic acid, and others. B vitamins in the intestine. The duration of the therapeutic effect of 7 hours.
Pharmacokinetics:
When ingestion of the two components of the drug is completely absorbed from the gastrointestinal tract. The maximum concentration of the active drug components is observed after 1 – 4 hours.
Trimethoprim is well into the cells and through the tissue barriers – in the lungs, kidneys, prostate, bile, saliva, sputum, cerebrospinal fluid. Protein binding of 50%. half-life is normally 8.6 – 17 hours is derived primarily by the kidneys, 50% -. unaltered.
Sulfamethoxazole binds to plasma proteins 66%, half-life in normal – 9 -. 11 hours is derived mainly kidneys, 15 – 30% – active form.
Conditions of supply of pharmacies
On prescription.
side effects
From the nervous system: headache, dizziness; in some cases – aseptic meningitis, depression, apathy, tremor, peripheral neuritis.
The respiratory system: bronchospasm, pulmonary infiltrates.
From the digestive system: nausea, vomiting, decreased appetite, diarrhea, gastritis, abdominal pain, glossitis, stomatitis, cholestasis, increased activity of “liver” transaminases, hepatitis, gepatonekroz, pseudomembranous enterocolitis.
From the side of hematopoiesis: leukopenia, neutropenia, thrombocytopenia, agranulocytosis, megaloblastic anemia.
From the urinary system: polyuria, interstitial nephritis, renal failure, crystalluria, hematuria, increasing concentrations of urea, hypercreatininemia, toxic nephropathy with oliguria and anuria.
On the part of the musculoskeletal system: arthralgia, myalgia.
Allergic reactions include itching, photosensitivity rash, erythema multiforme (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell’s syndrome), exfoliative dermatitis, allergic myocarditis, fever, angioneurotic edema, hyperemia sclera.
Local reactions: thrombophlebitis (where venipuncture), pain at the injection site.
Other: hypoglycemia.
special instructions
Avoid excessive sun and UV radiation.
Precautions prescribers with folic acid deficiency in the body, bronchial asthma, allergic history.
Storage conditions
In a dry, dark place at a temperature not higher than 25 ° C.
Dosing and Administration
Inside, after meals, with a sufficient amount of liquid.
Dose set individually.
Babies: 3 to 5 years – 240 mg (2 tablets of 120 mg), 2 times a day; from 6 to 12 years – 480 mg (4 tablets of 120 mg and 1 tablet of 480 mg), 2 times a day.
Adults and children over 12 years: 960 mg 2 times a day, with long-term therapy – 480 mg 2 times a day. The course of treatment is 5 – 14 days, with severe and / or chronic form of the disease single dose can be increased by 30 – 50%.
When pneumonia – 0.1 g / kg / day (calculated as sulfamethoxazole), the interval between doses 6 hours, rate – 14 days.
. In gonorrhea – 2 g (based on sulfamethoxazole), 2 times a day at intervals of 12 hours if treatment exceeds 5 days and / or necessary to increase the dose, therapy should be administered under the hematology control; when changing a picture of blood must assign folic acid at 5 – 10 mg / day.
Information
Appearance may differ from that depicted in the picture. There are contraindications. You need to read the manual or consult with a specialist