Description overdue on 11/17/2014
- Latin name: Bactrim
- ATC code: J01EE01
- Active substance: Co-trimoxazole [Sulfamethoxazole + Trimethoprim] (Co-trimoxazole [sulfamethoxazole + trimethoprim])
- Manufacturer: F. Hoffmann-La Roche Ltd, Switzerland
- Composition
- Product form
- Pharmacological action
- Pharmacodynamics and pharmacokinetics
- Indications
- Contraindications
- Side effects
- Bactrim, instructions for use
- Overdose
- Cooperation
- Terms of sale
- Storage conditions
- Shelf life
- Cautions
- Analogs
- Synonyms
- Babies
- During pregnancy (and lactation)
- Reviews
- Price, where to buy
Composition
Oral suspension: 200 mg sulfamethoxazole + 40 mg trimethoprim - Active substance.
Additional ingredients: dispersible cellulose, propyl parahydroxybenzoate, methyl parahydroxybenzoate, polysorbate 80, sorbitol, banana, and vanilla flavors, purified water.
Tablets: 800 mg sulfamethoxazole + 160 mg trimethoprim - Active substance.
Additional ingredients: sodium starch glycolate, povidone, sodium docusate, magnesium stearate.
Product form
Suspension for oral administration - Bactrim 50 ml or 100 ml per pack, complete with measuring spoon.
Coated tablets - Bactrim Forte, 10, 20 or 50 pieces per pack.
Pharmacological action
Antibacterial.
Pharmacodynamics and pharmacokinetics
Bactrim (Bactrim) and Fort Bactrim (Bactrim forte) are bactericidal combination chemotherapeutic agents which include active ingredients sulfamethoxazole and trimethoprim ( co-trimoxazole ), Showing a synergistic effect. Mechanism of action co-trimoxazole It is to lock the two enzymes That boost in microorganisms stage serial Replication folinic acid . Thereby bactericidal effects (in vitro) are observed at concentrations at which the active ingredients separately, exhibit only bacteriostatic action .
Additionally, efficiency co-trimoxazole much more than the effect of a single component with respect to pathogens resistant to it. Antibacterial action co-trimoxazole (in vitro) covers many pathogenic Gram-positive and Gram-negative bacteria .
Following oral administration (orally) receiving co-trimoxazole rapidly and mostly absorbed in the upper part of the gastrointestinal tract.
In the blood reaches a Cmax in the period of time from one hour to four. Saves antibiotic concentration for 7 hours. One day after a single dose, observed in a small amount of plasma co-trimoxazole . The equilibrium concentration observed after the 2nd-3rd day.
Trimethoprim It binds to plasma proteins by 44%, and sulfamethoxazole 70%.
Biotransformation to inactive metabolites It occurs in the liver through acetylation . Distribution in the body passes evenly through the penetration gistogematicalkie barriers . In urine and light concentration co-trimoxazole higher than the plasma. The prostate gland secretion and bronchial; saliva; vaginal secretions; interstitial, and cerebrospinal fluids of the middle ear; bile ; bones; breast milk; eye mucous accumulates to a lesser extent.
Both the rate of elimination of active ingredients is the same. T1 / 2 increases according to age up to 12 months - 7-8 hours, up to ten years - 5-6 hours in adults -10-11 hours. If the kidney function in the elderly and T1 / 2 increases.
Write mainly kidneys in a ratio of 10-30% sulfamethoxazole and 50-70% trimethoprim .
Indications
Airways: bronchiectasis . lobar pneumonia . Pneumonia . bronchitis (chronic and acute) bronchopneumonia .
Urogenital: urethritis . pyelitis . cystitis . pyelonephritis , Venereal lymphogranuloma . epididymitis . prostatitis . gonorrhea (both sexes) soft chancre , Inguinal granuloma.
ENT organs: sinusitis . sore throat . otitis media . scarlet fever . laryngitis .
Bodies of the digestive tract: paratyphoid , typhoid fever, cholangitis . salmonellonositelstvo . dysentery . cholera . cholecystitis . gastroenteritis Provoked enterotoksichnymi bacteria strains Escherichia coli ;
Skin: furunculosis . pyoderma . acne , Infection of wounds;
Others: osteomyelitis (chronic and acute), and other infectious diseases osteoartikulyarnye, acute brucellosis . malaria (Plasmodium falciparum), the South American blastomycosis . toxoplasmosis (in treatment).
Contraindications
- hypersensitivity to co-trimoxazole, other components, including the sulfonamides ;
- failure of the liver;
- aplastic anemia;
- renal insufficiency with CC less than 15 ml / min;
- B12-deficiency anemia ;
- lack of glucose-6-phosphate dehydrogenase;
- leukopenia ;
- agranulocytosis ;
- period Lactation and pregnancy ;
- age up to 3 months;
- nursery hyperbilirubinemia .
Carefully:
- thyroid disease;
- porphyria ;
- bronchial asthma;
- failure folic acid .
Side effects
Bodies of blood:
- neutropenia ;
- leukopenia ;
- megaloblastnaya anemia ;
- thrombocytopenia ;
- agranulocytosis .
Nervous system:
- tremor ;
- headache ;
- dizziness ;
- apathy ;
- depression ;
- peripheral neuritis ;
- aseptic meningitis .
GI:
- decreased appetite;
- nausea It is turning into vomit;
- gastritis ;
- diarrhea ;
- stomach ache;
- stomatitis ;
- glossitis ;
- cholestasia ;
- hepatitis ;
- gepatonekroz ;
- pseudomembranous enterocolitis ;
- increased activity of liver transaminases.
Respiratory system:
- bronchospasm ;
- pulmonary infiltrates.
Urinary system:
- interstitial jade ;
- polyuria ;
- disorders of the kidneys;
- hematuria ;
- crystalluria ;
- hypercreatininemia ;
- increase of urea;
- toxic nephropathy Flowing with anuriei and oliguria .
Musculoskeletal system:
- myalgia ;
- arthralgia .
Allergic reactions:
- photosensitization ;
- rash ;
- itch ;
- exudative erythema multiforme (in particular, Stevens-Johnson syndrome);
- exfoliative dermatitis ;
- toxic epidermal necrolysis ;
- fever;
- allergic myocarditis ;
- hyperemia of the sclera;
- angionevrotich esky swelling .
Others:
- hypoglycemia .
Bactrim, instructions for use
The suspension Bactrim and Bactrim Forte tablets are taken orally after a meal, washed down with water pills.
Instructions for use Bactrim suspension
Admission requires Bactrim dosage of the drug through the part of the measuring spoon that holds 5 ml. From the age of 12 years, the usual dose is 20 ml Bactrim with the reception in the morning and evening. When long-term therapy is a morning dose of 10 ml and 10 ml in the evening. In severe disease may be receiving the morning and evening dose of 30 ml.
When acute infections Bactrim take at least 5 days, or until the time of complete disappearance of symptoms for 2 days. Conducting weekly therapy without signs of improvement in the patient's condition, it is an occasion to adjust the dose or change of treatment.
When treating chancroid Bactrim administered with 20 ml twice per day. In the absence of healing after 7 days of therapy may be extended for the next week. Note that treatment failure may be related to resistant pathogens .
In the treatment of uncomplicated acute urinary tract infections appoint women to a one-off in the volume of 40-60 ml. Take the suspension is recommended in the evening hours (at night).
In the treatment of patients undergoing the procedure Hemodialysis Take the first load usual dose of Bactrim, then move on to receive half or a third of the normal dose, with a break in the day or two.
When treating pneumonia Provoked Pneumocystis carinii , Administered prior to 20 mg trimethoprim to 100 mg sulfamethoxazole per day per kilogram of body weight. Bactrim take two weeks every 6 hours in equal parts. The maximum dose at 8 kg body weight is equal to 5 ml and increased to 5 ml per kg body weight following 8 respectively. For example, the body weight of 32 kg the dose would require 20 ml.
In order to prevent pneumonia Provoked Pneumocystis carinii , Patients over the age of 12 years should receive 20 ml suspension (4 tablespoons) per day. Children's daily dose is 150 mg / m2 trimethoprim and 750 mg / m2 sulfamethoxazole two equivalent reception every week for 3 consecutive days. The total dose over 24 hours should not exceed 320 mg trimethoprim and 1600 mg sulfamethoxazole .
Infants from 3 to 5 months showed morning and evening reception 2, 5 ml of suspension. Children from 6 months to 5 years, morning and evening reception 5 ml, from 6 to 12 years, morning and evening reception with 10 ml.
In the case of severe infections can be a half-fold increase in dose.
With Nocardiosis , Designate an adult for 60-80 ml for 3 months or longer (sometimes up to 1, 5 years). The dosage depends on the weight, renal function, age and severity of infectious disease.
When kidney disease CC 15-30 ml / min dose reduced by half, and do not recommend to accept with CC less than 15 ml / min.
Instructions for use Bactrim forte
The usual morning and evening dose to patients after 12 years, equal to 960 mg. During the long-term treatment can do half this dose, and in particularly difficult situations increase the usual dose in half.
Bactrim forte reception continues for at least 5 days, or until no symptoms within 48 hours. Conducting weekly therapy without signs of improvement in the patient's condition, it is an occasion to adjust the dose or change of treatment.
When treating chancroid 960 mg administered twice a day. In the absence of healing after 7 days of therapy may be extended for the next week. Note that treatment failure may be related to resistant pathogens .
In the treatment of uncomplicated acute urinary tract infections appoint women to a one-off 1920 - 2880 mg. Take the tablet before a meal is recommended in the evening hours (at night).
In the treatment of patients undergoing the procedure Hemodialysis Take the first load usual dose of Bactrim forte, then move on to receive half or one third of the normal dose, with a break in the day or two.
When treating pneumonia Provoked Pneumocystis carinii , Administered prior to 20 mg trimethoprim to 100 mg sulfamethoxazole daily in four divided doses equivalent portions over 2 weeks. The maximum dose at 32 kg body weight is equal to 960-minute mg (1 tablet) and increased by 480 mg on each subsequent 16 kg respectively. For example, the body weight of 48 kg the dose would require 1440 mg.
In order to prevent pneumonia Provoked Pneumocystis carinii , Patients aged over 12 years, the daily recommended intake of 1 tablet (960 mg). Patients younger than 12 years should receive Bactrim suspension.
With Nocardiosis designate an adult 3-4 tablets (2880-3840 mg) for 3 months or longer (sometimes up to 1, 5 years). The dosage depends on the weight, renal function, age and severity of infectious disease.
When kidney disease QC more than 30 ml / min take the usual dose of Bactrim forte, with CC less than 15 ml / min the drug is not recommended to take.
Bactrim is antibiotic or not?
Medications Bactrim and Bactrim forte are sulfonamides in combination, which, as well as antibiotics Exhibit Antibacterial action, but in contrast, they have a chemical rather than a natural or semi-synthetic structure. It is thanks to the combination of sulfamethoxazole and trimethoprim preparation, relative to the susceptible microorganisms Exhibits not only bacteriostatic , but also bactericidal action that is as effective as some of the action antibiotics .
Overdose
Overdose symptoms occur: nausea . vomiting . dizziness . intestinal colic , Headache, depression . sleepiness , Syncope, visual impairment, confusion . fever . crystalluria and hematuria. Overdose for a long time can lead to leukopenia . thrombocytopenia . jaundice and megaloblastic anemia .
Perform gastric lavage, the internal fluid intake, acidification of urine , To enhance removal trimethoprim . Recommend / m administration of 5-15 mg per day calcium folinate To eliminate the effects of trimethoprim on Bone marrow . If necessary, carry out hemodialysis .
Cooperation
Bactrim and Bactrim forte at a joint reception with indirect anticoagulants increase their activity, as well as enhance the effects of Methotrexate and hypoglycemic drugs .
Co-trimoxazole increases the action Warfarin and Phenytoin And reduces effectiveness oral contraceptives and tricyclic antidepressants .
Receiving Rifampicin affect the T1 / 2 trimethoprim in the direction of its contraction.
Diuretics increase the possibility of developing thrombocytopenia , a Pyrimethamine upon receiving a 25 mg 7 days, increases the possibility of megaloblastic anemia .
Combines reception co-trimoxazole from diuretics and oral hypoglycemic The drug can cause cross allergic reaction .
PAS . barbiturates and Phenytoin increase symptoms folic acid deficiency .
Parallel reception Indomethacin can lead to an increase in the blood concentration sulfamethoxazole .
Bactrim and Amantadine a joint application may cause toxic delirium .
While taking co-trimoxazole may increase serum concentrations Digoxin (especially in the elderly).
When therapy with co-trimoxazole , Reception Dofetilide contraindicated.
Terms of sale
Preparations Bactrim and Bactrim forte dispensed from pharmacies by prescription.
Storage conditions
Bactrim - 25 ° C.
Bactrim forte - 35 ° C.
Shelf life
Bactrim and Bactrim forte, in a sealed bag can be stored for 5 years.
Cautions
In the event of symptoms rash on the skin or other side effects severe, treatment Bactrim should be abolished.
Patients suffering asthma and prone to allergic reactions . co-trimoxazole administered with extreme caution.
The duration of therapy with co-trimoxazole It should be minimal, especially for patients in advanced age.
Renal failure require correction of Bactrim dosage.
During the long-term treatment there is a need for regular Bactrim determining the amount of blood formed elements . When significant decrease in the number of any of the element , Therapy should be discontinued. Patients with severe hematological abnormalities You can assign co-trimoxazole only in the most extreme cases.
When kidney failure, folic acid deficiency , In the elderly can be observed hematological changes that are disadvantageous folic acid . These changes are compensated by appointment folic acid .
In the case of long-term use co-trimoxazole Especially with kidney failure, requires regular monitoring of the composition of the urine and kidney function.
In order to prevent crystalluria It should provide the body with sufficient amount of liquid and ensure adequate diuresis .
Patients with insufficiency glucose 6-phosphate dehydrogenase You can assign co-trimoxazole only in minimal doses and for absolute indications.
Subject to proper diet, trimethoprim Violating exchange phenylalanine It does not affect the patients phenylketonuria .
Appointment co-trimoxazole It requires special care in diseases Thyroid and porphyria .
Patients in the metabolism of which is "slow acetylation", are more prone to the emergence of idiosyncrasy to sulfonamides .
Analogs
Biseptolum
Analogues of drugs co-trimoxazole presented medicament Sulfaton In the form of tablets or injection.
Synonyms
- Co-trimoxazole ;
- Biseptolum ;
- BBC Septin ;
- Dvaseptol ;
- Brifeseptol ;
- Metosulfabol .
Babies
Preparations Bactrim and Bactrim forte contraindicated for children under 3 months of age in the other appointed according to the recommendations for use.
During pregnancy (and lactation)
Preparations co-trimoxazole is contraindicated during Lactation and pregnancy .
Reviews of Bactrim
Different people taking these drugs, set aside completely opposite opinions about Bactrim and Bactrim forte. For some, these drugs have become an excellent tool for other taking them turned a side effect. It should be noted that the preparations co-trimoxazole really have many contraindications and quite considerable list of adverse effects, and therefore, their purpose is only advisable in the case of credible evidence, taking into account the history and response of the individual patient.
For children reviews of suspension Bactrim as varied and make it impossible to make a clear opinion on its effectiveness and safety. The only conclusion that can be drawn by examining the responses of parents that this drug should be prescribed only an experienced doctor, after all kinds of tests and studies, and only in this case the treatment will be effective and relatively safe.
Price Bactrim where to buy
In Russia, the average price of Bactrim in the suspension is 160 rubles, tablets Bactrim Forte 150 rubles.
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