Compound sulfamethoxazole dispersible tablets
Function and Efficacy
This product is a compound preparation of sulfamethoxazole (SMZ) and trimethoprim (TMP). It has good antibacterial effects on non-enzyme-producing Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, Escherichia coli, Klebsiella, Salmonella, Proteus, Morganella, Shigella and other Enterobacteriaceae, Neisseria gonorrhoeae, Neisseria meningitidis, Haemophilus influenzae, especially the antibacterial effect on Escherichia coli, Haemophilus influenzae, Staphylococcus aureus is significantly enhanced compared with SMZ alone. In addition, it also has good antimicrobial activity against Chlamydia trachomatis, Nocardia asteroides, protozoa, Toxoplasma gondii, etc. in vitro. The mechanism of action of this product is that SMZ acts on dihydrofolate synthase, interfering with the first step of folic acid synthesis, and TMP acts on the second step of folic acid anabolism, selectively inhibiting the action of dihydrofolate reductase. The combination of the two can double-block the folic acid metabolism of bacteria. The synergistic antibacterial effect of this product is stronger than that of a single drug, and the number of strains resistant to it is reduced. However, in recent years, the resistance of bacteria to this product has also been increasing.
Ingredients
This product is a compound preparation, each tablet contains the active ingredients 0.4g of sulfamethoxazole and 0.08g of trimethoprim.
| Name | Description | Content | CAS NO. | Manufacturer |
|---|---|---|---|---|
| SulfamethoxazoleIngredients |
It acts on dihydrofolate synthase, interfering with the first step of folic acid synthesis; combined with trimethoprim, it can double block the bacterial folic acid metabolism and enhance the synergistic antibacterial effect. More |
723-46-6 | 33 | |
| TrimethoprimIngredients |
It acts on the second step of folic acid anabolism and selectively inhibits the action of dihydrofolate reductase; when used in combination with sulfamethoxazole, it can double-block the folic acid metabolism of bacteria and enhance the synergistic antibacterial effect. More |
738-70-5 | 44 |
Appearance
This product is white tablets.
Indication
In recent years, many common clinical pathogens are often resistant to this product, so it is necessary to refer to the drug sensitivity results when treating bacterial infections. The main indications of this product are the following infections caused by sensitive strains: 1. Urinary tract infections caused by sensitive strains of Escherichia coli, Klebsiella, Enterobacter, Proteus mirabilis, Proteus vulgaris and Morganella. 2. Acute otitis media in children over 2 years old caused by Streptococcus pneumoniae or Haemophilus influenzae. 3. Acute exacerbation of chronic bronchitis in adults caused by Streptococcus pneumoniae or Haemophilus influenzae. 4. Intestinal infections and Shigella infections caused by sensitive strains of Shigella flexneri or Shigella sonnei. 5. This product is the first choice for the treatment of Pneumocystis carinii pneumonia. 6. For the prevention of Pneumocystis carinii pneumonia, it can be used in patients with a history of at least one attack of Pneumocystis carinii, or H
Usage and Dosage
1Used dosage for adults to treat bacterial infections: 160 mg of trimethoprim and 800 mg of sulfamethoxazole once every 12 hours. For the treatment of Pneumocystis carinii pneumonia, 3.75-5 mg/kg of trimethoprim and 18.75-25 mg/kg of sulfamethoxazole once every 6 hours. Preventive medication for adults: Initially give 160 mg of trimethoprim and 800 mg of sulfamethoxazole twice a day, followed by the same dose once a day, or 3 times a week. 2Used dosage for children: Contraindicated for infants under 2 months old. For the treatment of bacterial infections, infants over 2 months old and weighing less than 40 kg can take SMZ 20-30 mg/kg and TMP 4-6 mg/kg orally according to body weight once every 12 hours; the same dosage is used for children weighing >40 kg.
Adverse Reactions
1. Allergic reactions are relatively common and may manifest as drug rashes. In severe cases, exudative erythema multiforme, exfoliative dermatitis, and epidermolysis bullosa atrophic dermatitis may occur; there are also serum sickness-like reactions such as photosensitivity reactions, drug fever, joint and muscle pain, and fever. Anaphylactic shock is occasionally seen. 2. Neutropenia or deficiency, thrombocytopenia, and aplastic anemia. Patients may present with sore throat, fever, pallor, and bleeding tendency. 3. Hemolytic anemia and hemoglobinuria. This is prone to occur in patients who lack glucose-6-phosphate dehydrogenase after using sulfonamides, and is more common in newborns and children than in adults. 4. Hyperbilirubinemia and neonatal kernicterus. Because this product competes with bilirubin for protein binding sites, it can cause an increase in free bilirubin. Newborns have imperfect liver function and are not suitable for them.
Precautions
1. Patients who are allergic to SMZ and TMP are contraindicated to use this product. 2. Since this product blocks the metabolism of folic acid and aggravates the folate deficiency in patients with megaloblastic anemia, this product is contraindicated for patients with this disease. 3. Infants under 2 months old are contraindicated to use this product. 4. Patients with severe liver and kidney damage are contraindicated to use this product.
Special Population Medication
Precautions for children: Since this product can compete with bilirubin for binding sites on plasma proteins, and the acetyltransferase system of newborns is not fully developed, the increased free blood concentration of sulfonamide can increase the risk of kernicterus. Therefore, the use of this type of drug in newborns and infants under 2 months old is contraindicated. Children are in the growth and development period, and their liver and kidney functions are not yet perfect, so the dosage should be reduced as appropriate. Precautions for pregnancy and lactation: 1. This product can cross the blood-placental barrier to the fetus, and animal experiments have found that it has teratogenic effects. There is still a lack of sufficient data for human research, so pregnant women should avoid using it. 2. This product can be secreted in breast milk, and the concentration in breast milk can reach about 50% to 100% of the maternal blood drug concentration. The drug may affect the baby. The use of this product in newborns with glucose-6-phosphate dehydrogenase deficiency may lead to hemolytic anemia. In view of the above reasons, this product should not be used by lactating women. Elderly patients are more likely to experience serious adverse reactions when using this product, such as severe skin allergic reactions such as rashes, and blood system abnormalities such as bone marrow suppression, leukopenia, and thrombocytopenia. This is more likely to occur when using diuretics at the same time. Therefore, elderly patients should avoid using this product, and only make a decision after weighing the pros and cons when there is an indication.
Drug Interactions
1. Urine alkalinizing drugs can increase the solubility of this product in alkaline urine and increase excretion. 2. It cannot be used in combination with para-aminobenzoic acid, which can replace this product for bacterial uptake, and the two are antagonistic. 3. When the following drugs are used together with this product, this product can replace the protein binding sites of these drugs, or inhibit their metabolism, resulting in prolonged drug action or toxic reactions. Therefore, when these drugs are used at the same time as this product, or when used after the application of this product, their dosages need to be adjusted. Such drugs include oral anticoagulants, oral hypoglycemic drugs, and methotrexate. 4. Combination with bone marrow suppressive drugs may enhance the adverse reactions of such drugs to the hematopoietic system. Such as leukopenia and thrombocytopenia, if there is an indication to use the two drugs together, possible toxic reactions should be closely observed. 5. Long-term combination with contraceptives (estrogens) can reduce the reliability of contraception and increase the chance of extramenstrual bleeding. 6. When used in combination with thrombolytic drugs, their potential toxic effects may be increased. 7 When used in combination with hepatotoxic drugs, the incidence of hepatotoxicity may increase. Liver function should be monitored for such patients, especially those who have been taking the drug for a long time and have a history of liver disease. 8 When used in combination with photosensitive drugs, photosensitization may be additive. 9 Patients receiving this product have an increased need for vitamin K. 10 It should not be used in combination with methenamine, because methenamine can decompose in acidic urine to produce formaldehyde, which can form insoluble precipitates with this product. The risk of crystalluria increases. 11 This product can replace the plasma protein binding site of phenylbutazone, and when the two are used together, the effect of phenylbutazone can be enhanced. 12 When sulfinpyrazone is used in combination with this product, the latter's secretion from the renal tubules can be reduced. The prolonged increase in its blood concentration is prone to toxic reactions. Therefore, the dose of this product may need to be adjusted during or after the application of sulfinpyrazone. When the course of sulfinpyrazone treatment is long, the blood concentration of this product should be monitored to help adjust the dose and ensure safe medication. 13 The TMP in this product can inhibit the metabolism of warfarin and enhance its anticoagulant effect. 14 The TMP in this product can increase nephrotoxicity when used in combination with cyclosporine. 15 When rifampicin is used in combination with this product, the clearance of TMP in this product can be significantly increased and the serum half-life can be shortened. 16 It is not suitable to be used in combination with anti-tumor drugs and 2,4-diaminopyrimidine drugs, nor should it be used between courses of treatment with other folic acid antagonists, because it may cause bone marrow aplasia or megaloblastic anemia. 17 It is not suitable to be used in combination with dapsone, because the blood concentration of both dapsone and TMP in this product can be increased when used in combination. The increase in dapsone concentration increases and aggravates adverse reactions, especially the occurrence of methemoglobinemia. 18 Avoid using it in combination with penicillins, because this product may interfere with the latter's bactericidal effect.
Storage
Keep away from light and store in sealed container.
Packaging Specification
Sulfadimethoxazole 0.4 g, trimethoprim 80 mg
Validity Period
3 years
Manufacturer
JiangXi NanChang Pharmaceutical Co., Ltd.
-
Founded in:
2004-07-19 -
Address:
No. 929, Fushan Avenue, Xiaolan Economic Development Zone, Nanchang County, Nanchang City, Jiangxi Province -
Tax NO.:
91360121158634281L -
Registered Funds:
23.716 million yuan -
Email: