Drug

 

 

Typical Dosing

 

 

Trimethoprim/Sulfamethoxazole

Bactrim®, Septra®, Cotrim®

Generics available

Pregnancy: C; Lactation: Unsafe

 

Tabs:

Single Strength (SS):

80 mg/400 mg

 

Double Strength (DS):

160 mg/800 mg

 

Oral Suspension:

40 mg/200 mg/5 mL

 

Children >2months: 6-12 mg/kg/day (TMP component) in divided doses twice daily (max 320 mg/day).

 

40 mg/200 mg/5 mL @ 8 mg/kg/day

10 kg (22 lb) = 1 tsp (5 mL) PO Q12H

20 kg (44 lb) = 2 tsp (10 mL) or 1 SS Tab PO Q12H

30 kg (66 lb) = 3 tsp or 1 tbsp (15 mL) or 11/2 SS Tab PO Q12H

40 kg (88 lb) = 4 tsp (20 mL) or 2 SS Tabs or 1 DS PO Q12H

 

Adult: 1 DS tab PO Q12H

 

Food: May be taken without regard to food. Maintain good hydration.

 

Important side effects: Photosensitivity, rashes, nausea, headache, diarrhea, dizziness, hypersensitivity reactions (possibly severe), renal dysfunction, hyperkalemia, bone marrow suppression.

 

Caution: Severe or fatal rashes, hepatic effects and hematologic effects have occurred. Encourage patient to report any side effects. Educate the patient regarding signs of granulocytopenia or thrombocytopenia. Do not use at term in pregnant patients. Use with caution in G-6-PD deficiency or liver disease.

 

Drug interactions may be significant, including: Warfarin, cyclosporine, phenytoin, methotrexate, sulfonylureas, zidovudine, and digoxin.

 

Reduce dose in renal failure:

CrCl 15-30 mL/min give 1/2 usual dose.

CrCl <15 mL/min avoid use.