Introduction
Pharmatrim is a combination medicine that is used to treat various types of bacterial infections such as pneumonia, bronchitis, infections of urinary tract, ear, and abdomen. It prevents the growth of microorganisms to cure the infection.
Pharmatrim is a prescription medicine that is advised to be taken as suggested by the doctor. It should be taken with food and it must be taken at a fixed time to ensure better efficacy. Do not consume more than the recommended dose, as an overdose of it may have harmful effects on your body. If you miss a dose, take it as soon as you remember. The treatment must be completed even if you feel better to ensure a complete recovery.
Pharmatrim may lead to some side effects such as nausea, vomiting, stomach pain, loss of appetite, headache, etc. To overcome any such side effects, it is advised to eat a healthy balanced diet and drink plenty of fluid. If any of the side effects get aggravated, contact your doctor immediately. If you experience any allergic reaction (rashes, itching, swelling, shortness of breath, etc.), you must consult your doctor immediately.
Before taking this medicine, you should tell your doctor if you have any problems with your liver or kidneys. Also, tell your doctor if you are on any medication for any health condition. Pregnant or breastfeeding women should also consult with the doctors before taking it. Avoid drinking alcohol as it can cause excessive dizziness with this medicine. It usually does not impair your ability to drive, but you should not drive if it makes you feel sleepy or dizzy. If you are a known allergic to the medicine, you must refrain from using this medicine and consult your doctor. It is advised to take proper rest during the course of treatment for the medicine to work effectively.
Side effects of Pharmatrim
Common
- Nausea
- Vomiting
- Skin rash
- Allergic reaction
How to use Pharmatrim
Take this medicine in the dose and duration as advised by your doctor. Check the label for directions before use. Measure it with a measuring cup and take it by mouth. Shake well before use. Pharmatrim is to be taken with food.
How Pharmatrim works
Pharmatrim is a combination of two antibiotics: Sulfamethoxazole and Trimethoprim. These antibiotics work by preventing the bacteria from producing folic acid, a nutrient required for bacterial multiplication. Together, they treat your infection effectively.
Indication
Upper and lower respiratory tract infections, Gastrointestinal tract infections, Renal and urinary tract infections, Skin and wound infections, Septicaemias
Adult Dose
Oral
Acute exacerbations of chronic bronchitis ; Acute otitis media; Urinary tract infections, GI infections; Resp and urinary tract infections; Susceptible infections
Adult:
Tablet : 2 tablet of 480mg twice daily. In severe cases, 3 times/day.
DS Tablet : 1 tablet (960mg) twice daily.
Suspension : 1-2 teaspoonful twice daily.
Pneumocystis (carinii) jiroveci pneumonia
Up to 120 mg/kg/day in 2-4 divided doses for 14-21 days.
Prophylaxis of Pneumocystis (carinii) jiroveci pneumonia
960 mg once daily for 7 days; 960 mg once daily 3 times wkly on alternate days; or 960 mg bid 3 times wkly on alternate days.
Infection prophylaxis in AIDS patients
960 mg/day.
Hepatic impairment: Severe: Contraindicated.
Child Dose
Child:
Oral
8–10 mg TMP/kg/day q12h
2 mg TMP/kg/day for UTI prophylaxis q24h
15–20 mg TMP/kg/day for Pneumocystis (carinii) jiroveci pneumonia treatment q6–8h
150 mg TMP/m2/day, OR 5 mg TMP/kg/day for Pneumocystis (carinii) jiroveci pneumonia prophylaxis q12h, 3 times a week OR q24h
Renal Dose
Renal impairment:
CrCl (ml/min) Dosage Recommendation
<15 Not recommended.
15-30 Half the standard dose.
Contraindication
Known hypersensitivity to trimethoprim or sulfonamides; severe hepatic failure or marked liver parenchymal damage, jaundice; serious haematological disorders and porphyria; severe renal insufficiency where repeated measurements of the plasma concentration cannot be performed; history of drug-induced immune thrombocytopenia w/ use of trimethoprim and/or sulfonamides; megaloblastic anaemia due to folate deficiency. Neonates <6 wk, except for the treatment/prophylaxis of P. jiroveci in infants >4 wk. Treatment of Group A β-haemolytic streptococcia. Pregnancy, esp in the period prior to birth. Concomitant use w/ clozapine. Concomitant use w/ leucovorin for the treatment of P. jiroveci in HIV positive patients.
Mode of Action
Co-trimoxazole exhibits the synergistic actions of its components (sulfamethoxazole and trimethoprim) by 10-fold. Sulfamethoxazole inhibits dihydrofolic acid formation from PABA, thus interfering with synthesis and growth of bacterial folic acid. Trimethoprim inhibits enzymes folic acid pathway, preventing the reaction of the dihydrolic acid to tetrahydrofolate. Co-trimoxazole possesses bactericidal effects against E coli, Klebsiella spp, Enterobacter spp, M morganii, P mirabilis, P vulgaris, H influenzae, Strep pneumoniae, Pneumocystis (carinii) jiroveci, Cyclospora spp.
Precaution
Patient w/ severe allergy, bronchial asthma, thyroid dysfunction. Renal and mild to moderate hepatic impairment. Lactation. Patient Counselling May impair ability to drive or operate machinery. Monitoring Parameters Monitor CBC, serum K, creatinine, BUN.
Side Effect
Allergic myocarditis, erythema multiforme, exfoliative dermatitis, angioedema, drug fever, chills, Henoch-Schoenlein purpura, serum sickness-like syndrome, generalised allergic reactions, generalised skin eruptions, photosensitivity, conjunctival and scleral inj, pruritus, urticaria, rash, periarteritis nodosa, SLE; elevated serum transaminase and bilirubin, pseudomembranous enterocolitis, pancreatitis, stomatitis, glossitis, nausea, emesis, abdominal pain, diarrhoea, anorexia; renal failure, interstitial nephritis, elevated BUN and serum creatinine, toxic nephrosis w/ oliguria and anuria; hyperkalaemia; aseptic meningitis, convulsions, peripheral neuritis, ataxia, vertigo, tinnitus, headache; hallucinations, depression, apathy, nervousness; dieresis, hypoglycaemia; arthralgia, myalgia; rhabdomyolysis; cough, shortness of breath, pulmonary infiltrates; weakness, fatigue, insomnia; QT prolongation, haemolysis, impaired phenylalanine metabolism.
Potentially Fatal: Severe skin, hepatic and blood disorders, aplastic anaemia, hypersensitivity of the resp tract; Stevens-Johnson syndrome, toxic epidermal necrolysis; Clostridium difficile-associated diarrhoea; severe and symptomatic hyponatraemia.
Interaction
Reduced ciclosporin concentrations in blood when used concurrently. Increases toxicity of methotrexate. Inhibits phenytoin clearance. Potentiates warfarin and oral hypoglycaemics.
Potentially Fatal: Co-admin with pyrimethamine causes megaloblastic anaemia. Enhancement of renal damage by ciclosporin.