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Co-trimoxazole

pronounced as (coe try mox' a zole)

Why is this medication prescribed?


Co-trimoxazole is used to treat certain bacterial infections, such as pneumonia (a lung infection),
bronchitis (infection of the tubes leading to the lungs), and infections of the urinary tract, ears,
and intestines. It also is used to treat 'travelers' diarrhea. Co-trimoxazole is a combination of
trimethoprim and sulfamethoxazole and is in a class of medications called sulfonamides. It works
by stopping the growth of bacteria. Antibiotics will not kill viruses that can cause colds, flu, or
other viral infections.
How should this medicine be used?
Co-trimoxazole comes as a tablet and a suspension (liquid) to take by mouth. It usually is taken
two times a day but may be taken up to four times a day when used to treat certain severe lung
infections. Follow the directions on your prescription label carefully, and ask your doctor or
pharmacist to explain any part you do not understand. Take co-trimoxazole exactly as directed.
Do not take more or less of it or take it more often than prescribed by your doctor.
You should begin to feel better during the first few days of treatment with co-trimoxazole. If your
symptoms do not improve or if they get worse, call your doctor.
Shake the liquid well before each use to mix the medication evenly.
Take co-trimoxazole until you finish the prescription, even if you feel better. Do not stop taking
co-trimoxazole without talking to your doctor. If you stop taking co-trimoxazole too soon or skip
doses, your infection may not be completely treated and the bacteria may become resistant to
antibiotics.
Other uses for this medicine
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more
information.
What special precautions should I follow?
Before taking co-trimoxazole,
tell your doctor and pharmacist if you are allergic to co-trimoxazole, any other medications, or
any ingredients in co-trimoxazole tablets and suspension. Ask your pharmacist for a list of
ingredients.
tell your doctor and pharmacist what other prescription and nonprescription medications,
vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to
mention the following: amantadine; angiotensin converting enzyme inhibitors such as benazepril
(Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil,
Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), and
trandolapril (Mavik); anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven);
cyclosporine (Gengraf, Neoral, Sandimmune); oral diabetes medications such as glipizide

(Glucotrol), glyburide (Diabeta, Glynase), metformin (Fortamet, Glucophage), pioglitazone


(Actos), repaglinide (Prandin), rosiglitazone (Avandia); digoxin (Lanoxin); diuretics ('water pills');
indomethacin (Indocin); leucovorin (Fusilev); medications for seizures such as phenytoin
(Dilantin, Phenytek); memantine (Namenda); methotrexate (Trexall); pyrimethamine (Daraprim).
and tricyclic antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), desipramine
(Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor),
protriptyline (Vivactil), and trimipramine (Surmontil). Your doctor may need to change the doses
of your medications or monitor you carefully for side effects.
tell your doctor if you have or have ever had thrombocytopenia (less than normal number of
platelets) caused by taking sulfonamides or trimethoprim; megaloblastic anemia (abnormal red
blood cells) caused by folate deficiency (low blood levels of folic acid), phenylketonuria (PKU, an
inherited condition in which a special diet must be followed to prevent mental retardation), or
liver or kidney disease. Your doctor may tell you not to take co-trimoxazole. Co-trimoxazole
should not be used in children less than 2 months of age.
tell your doctor if you have or have ever had severe allergies; asthma; low levels of folic acid in
the body which may be caused by malnutrition (you do not eat or cannot digest the nutrients
needed for good health); human immunodeficiency virus (HIV) infection; porphyria (an inherited
blood disease that may cause skin or nervous system problems); thyroid disease; or glucose-6phosphate dehydrogenase (G-6-PD) deficiency (an inherited blood disease).
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you
become pregnant while taking co-trimoxazole, call your doctor immediately. Co-trimoxazole can
harm the fetus.
plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing,
sunglasses, and sunscreen. Co-trimoxazole may make your skin sensitive to sunlight.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.
Drink plenty of fluids during your treatment with co-trimoxazole.
What should I do if I forget a dose?
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose,
skip the missed dose and continue your regular dosing schedule. Do not take a double dose to
make up for a missed one.
What side effects can this medication cause?
Co-trimoxazole may cause side effects. Tell your doctor if any of these symptoms are severe or
do not go away:
nausea
vomiting
loss of appetite
If you experience any of the following symptoms, call your doctor immediately:

rash
itching
sore throat
fever or chills
severe diarrhea (watery or bloody stools) that may occur with or without fever and stomach
cramps (may occur up to 2 months or more after your treatment)
shortness of breath
cough
unusual bruising or bleeding
yellowing of the skin or eyes
paleness
red or purple skin discolorations
joint or muscle pain
If you experience a serious side effect, you or your doctor may send a report to the Food and
Drug Administration's (FDA) MedWatch Adverse Event Reporting program online
(http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
What should I know about storage and disposal of this medication?
Keep this medication in the container it came in, tightly closed, and out of reach of children.
Store it at room temperature and away from excess heat and moisture (not in the bathroom).
Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about
the proper disposal of your medication.
In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has
collapsed or is not breathing, call local emergency services at 911.
What other information should I know?
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests
to check your response to co-trimoxazole.
Before having any laboratory test, tell your doctor and the laboratory personnel that you are
taking co-trimoxazole.
Do not let anyone else take your medication. Your prescription is probably not refillable. If you
still have symptoms of infection after you finish the co-trimoxazole, call your doctor.
It is important for you to keep a written list of all of the prescription and nonprescription (overthe-counter) medicines you are taking, as well as any products such as vitamins, minerals, or
other dietary supplements. You should bring this list with you each time you visit a doctor or if

you are admitted to a hospital. It is also important information to carry with you in case of
emergencies.
Brand names of combination products
Bactrim (containing Sulfamethoxazole, Trimethoprim)
Bactrim DS (containing Sulfamethoxazole, Trimethoprim)
Septra (containing Sulfamethoxazole, Trimethoprim)
Septra DS (containing Sulfamethoxazole, Trimethoprim)
Septra Suspension (containing Sulfamethoxazole, Trimethoprim)
Sulfatrim Suspension (containing Sulfamethoxazole, Trimethoprim)

This branded product is no longer on the market. Generic alternatives may be available.

This medicine may stop the oral typhoid vaccine from working. If you are due to have any vaccinations, make
sure the person treating you knows that you are taking it.
If you still feel unwell after completing your course of the antibiotic, make another appointment to see your
doctor.
Can co-trimoxazole cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone
experiences them. The table below contains some of the most common ones associated with co-trimoxazole.
You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted
effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if
any of the following continue or become troublesome.
Common co-trimoxazole
side-effects

What can I do if I experience this?

Feeling sick

Stick to simple foods - avoid rich or spicy foods

Diarrhoea

Drink plenty of water to replace any lost fluids

Headache

Ask your pharmacist to recommend a suitable painkiller

Skin rash

Contact your doctor for advice straightaway. Do not take any more
doses until you have spoken with a doctor

If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or
pharmacist for further advice.

How to store co-trimoxazole


Keep all medicines out of the reach and sight of children.
Store in a cool, dry place, away from direct heat and light.

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