Yes

Antibiotic, Miscellaneous

Treatment of urinary tract infections due to susceptible strains of E. coli, P. mirabilis, K. pneumoniae, Enterobacter sp and coagulase-negative Staphylococcus including S. saprophyticus; acute otitis media in children; acute exacerbations of chronic bronchitis in adults; in combination with other agents for treatment of toxoplasmosis, Pneumocystis carinii; treatment of superficial ocular infections involving the conjunctiva and cornea

C

Hypersensitivity to trimethoprim or any component, megaloblastic anemia due to folate deficiency

Use with caution in patients with impaired renal or hepatic function or with possible folate deficiency

1% to 10%:

Dermatologic: Rash (3% to 7%), pruritus

Hematologic: Megaloblastic anemia (with chronic high doses)

<1%: Fever, exfoliative dermatitis, nausea, vomiting, epigastric distress, thrombocytopenia, neutropenia, leukopenia, hyperkalemia, cholestatic jaundice, increased LFTs, elevated BUN/serum creatinine

Symptoms of acute toxicity includes: nausea, vomiting, confusion, dizziness; chronic overdose results in bone marrow suppression

Treatment of acute overdose is supportive following GI decontamination; treatment of chronic overdose is use of oral leucovorin 5-15 mg/day

Increased effect/toxicity/levels of phenytoin; increased myelosuppression with methotrexate; may increase levels of digoxin

Protect the 200 mg tablet from light

Inhibits folic acid reduction to tetrahydrofolate, and thereby inhibits microbial growth

Absorption: Oral: Readily and extensive

Protein binding: 42% to 46%

Metabolism: Partially in the liver

Half-life: 8-14 hours, prolonged with renal impairment

Time to peak serum concentration: Within 1-4 hours

Elimination: Significantly in urine (60% to 80% as unchanged drug)

Oral:

Adults: 100 mg every 12 hours or 200 mg every 24 hours; in the treatment of Pneumocystis carinii pneumonia; dose may be as high as 15-20 mg/kg/day in 3-4 divided doses

Dosing interval in renal impairment: Cl_cr 15-30 mL/minute: Administer 50 mg every 12 hours

Hemodialysis: Moderately dialyzable (20% to 50%)

May cause folic acid deficiency, supplements may be needed.

Therapeutic: Peak: 5-15 mg/L; Trough: 2-8 mg/L

None reported

May cause neutropenia; use caution with clozapine and carbamazepine

No information available to require special precautions

No effects or complications reported

Take per recommended schedule. Complete full course of therapy; do not skip doses. Do not chew or crush tablets; swallow whole with milk or food. Maintain adequate hydration (2-3 L/day of fluids unless instructed to restrict fluid intake). You may experience nausea, vomiting, or GI upset (small frequent meals, frequent mouth care, sucking lozenges, or chewing gum may help). Report skin rash, redness, or irritation; feelings of acute fatigue or weakness; unusual bleeding or bruising; or other persistent adverse effects. Pregnancy precautions: Inform prescriber if you are or intend to be pregnant.

Monitor for signs of bone marrow suppression such as fever, sore throat, or bleeding; tablets can be crushed

Solution, oral: 50 mg (base)/5 mL

Tablet: 100 mg, 200 mg

Hoppu K, Koskimies O, and Vilska J, "Trimethoprim in the Treatment of Acute Urinary Tract Infections in Children," Int J Clin Pharmacol Ther Toxicol, 1988, 26(2):65-8.

Hoppu K, "Age Differences in Trimethoprim Pharmacokinetics: Need for Revised Dosing in Children?" Clin Pharmacol Ther, 1987, 41(3):336-43.

Varoquaux O, Lajoie D, Gobert C, et al, "Pharmacokinetics of the Trimethoprim-Sulfamethoxazole Combination in the Elderly," Br J Clin Pharmacol, 1985, 20:575-81.