Cotrimoxazole

Pregnancy 2nd and 3rd trimester, impaired renal function, mild hepatic dysfunction, thyroid dysfunction, hypersensitivity to sulfonylureas, diuretics and sulfonamide-based antidiabetics, especially folic acid deficiency, fragile X chromosome in combination with mental retardation in children.

• Standard therapy: 2 times/day 2 tbl (80 mg TMP + 400 mg SM) p.o.
• For Pneumocystis carinii pneumonia:
  • Light PCP: double dosage i.v.
  • Heavy PCP: SM 1 time 100 mg/kg bw, TMP 20 mg/kg bw, e.g. 3 times 5 amp. in 500 ml NaCl over 90 min. for 21 days.
  • Prophylaxis of PCP: 4 Tbl. forte (160 mg TMP + 800 mg SMZ) 3 times/week p.o.

Pulmonary infiltrates, pneumonia, BB changes, gastrointestinal disorders, acute pancreatitis, petechiae, allergic reactions, Wissler syndrome, glossitis, gingivitis, headache, ataxia, hypoglycemia, metabolic acidosis, arthralgias. Cotrimoxazole is reported in versch. Cotrimoxazole is mentioned in various studies as the most frequent trigger of Stevens-Johnson syndrome (Micheletti RG et al. 2018).

1. Callen JP et al (2002) Neutrophilic dermatoses. Dermatol Clin 20: 409-419
2. Micheletti RG et al (2018) Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis: A Multicenter Retrospective Study of 377 Adult Patients from the United States. J Invest Dermatol 138:2315-2321.
   

Major drug interactions of cotrimoxazole