Trimethoprim

Trimethoprim is an antibiotic medicine used to treat bacterial infections in your body. It helps to kill germs (bacteria) that cause various types of infections like infections of the urinary tract and respiratory tract. Trimethoprim should be taken in the dose and duration as advised by the doctor. You may take it with food. It is better to have this medicine at the same time each day to get the most benefit and you should keep on taking this medicine for as long as you are prescribed. Stopping it early may make the infection to come back and harder to treat. Some people may develop side effects like skin rash, vomiting, mouth ulcers, hives (urticaria) and headache. These side effects are usually temporary and go away during treatment as your body adjusts to the medicine. Consult your doctor if these side effects bother you or do not go away. Before starting treatment with this medicine, you should tell your doctor if you are pregnant, breastfeeding or suffering from any liver, kidney or heart problems or if you are allergic to any medicine. Your doctor may get regular blood, urine tests while you are on this medication. Trimethoprim is an antibiotic. It works by preventing synthesis of essential proteins required by bacteria to carry out vital functions. Thus, it stops the bacteria from growing, and prevents the infection from spreading.

• Bacterial infections

Trimethoprim inhibits the conversion of bacterial dihydrofolic acid to tetrahydrofolic acid which is important for the synthesis of DNA. It may be bacteriostatic or bactericidal depending on growth conditions. It is active against a wide range of gm-ve and gm+ve aerobes, as well as some protozoa.

Adult Dose: Oral Respiratory tract infections; Gastroenteritis; Susceptible infections; Uncomplicated urinary tract infections Adult: Acute infection: 100 or 200 mg twice daily, alternatively, 200 or 300 mg daily as a single dose may be used. For initial UTI episodes: 100 mg every 12 hr or 200 mg every 24 hr for 10 days. Intravenous Respiratory tract infections; Gastroenteritis; Treatment and prophylaxis of urinary tract infections Adult: 200 mg every 12 hr by Inj or infusion. Child Dose: Oral Respiratory tract infections; Gastroenteritis; Susceptible infections; Uncomplicated urinary tract infections Child: 6-8 mg/kg/day in 2 divided doses. Alternatively, 6 wk-5 mth: 25 mg bid, 6 mth-5 yr: 50 mg bid, 6-12 yr: 100 mg bid. Intravenous Respiratory tract infections; Gastroenteritis; Treatment and prophylaxis of urinary tract infections Child: 8 mg/kg daily in 2-3 divided doses. Renal Dose: Renal impairment: CrCl (ml/min) Dosage Recommendation 15-27 Normal dose for 3 days, thereafter half the normal doses. <15 Half the normal dose from the start of the treatment.

Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Trimethoprim is to be taken with food.

If you miss a dose of Trimethoprim, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.

Common: • Skin rash • Vomiting • Mouth ulcer • Hives • Feeling sick • Headache • Anemia (low number of red blood cells) • Nausea • Diarrhea

[SAFE] Trimethoprim does not usually affect your ability to drive. Your doctor has prescribed Trimethoprim to cure your infection and improve your symptoms. Do not skip any doses and finish the full course of treatment even if you feel better. Stopping it early may make the infection to come back and harder to treat. Your doctor will ensure that you are well hydrated during treatment with this medicine. Your doctor may get regular blood, urine tests while you are on this medication. Do not take Trimethoprim if you are pregnant or breastfeeding. Discontinue Trimethoprim and inform your doctor immediately if you get a rash, itchy skin, swelling of face and mouth, or have difficulty in breathing.

Hypersensitivity, serious haematological disorders, severe renal impairment, megaloblastic anaemia secondary to folate depletion.

Concurrent use increased risk of blood dyscrasias with azathioprine, methotrexate, pyrimethamine; increased risk of hyperkalaemia with ACE inhibitors; increased risk of hyponatraemia when used with both potassium-sparing diuretics and thiazides; increased risk of bleeding with warfarin; increased risk of lithium toxicity; increased digoxin, phenytoin, procainamide, lamivudine, stavudine, repaglinide, rosiglitazone, dofetilide serum levels; decreased ciclosporin levels. Concurrent use with dapsone increased serum levels of both and increased risk of dapsone toxicity.

[SAFE] Consuming alcohol with Trimethoprim does not cause any harmful side effects.

[CONSULT YOUR DOCTOR] Trimethoprim may be unsafe to use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing it to you. Please consult your doctor.

[SAFE IF PRESCRIBED] Trimethoprim is safe to use during breastfeeding. Human studies suggest that the drug does not pass into the breastmilk in a significant amount and is not harmful to the baby. There may be a possibility of skin rash in the baby.

[CAUTION] Trimethoprim should be used with caution in patients with kidney disease. Dose adjustment of Trimethoprim may be needed. Please consult your doctor. Use of Trimethoprim is not recommended in patients with severe kidney disease. [CAUTION] Trimethoprim should be used with caution in patients with liver disease. Dose adjustment of Trimethoprim may be needed. Please consult your doctor. Use of Trimethoprim is not recommended in patients with the severe liver disease.

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