Children's dipyrimidine tablets
Function and Efficacy
This product is a compound preparation of sulfadiazine (SD) and trimethoprim (TMP). The combination of the two has a synergistic antibacterial effect. It has good antibacterial activity against non-enzyme-producing Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, Escherichia coli, Klebsiella, Salmonella, Proteus, Morganella, Shigella and other Enterobacteriaceae, Neisseria gonorrhoeae, Neisseria meningitidis, and Haemophilus influenzae. In addition, it also has antimicrobial activity against trachomatis, Nocardia asteroides, Plasmodium and Toxoplasma in vitro. In recent years, bacterial resistance to this product is common, especially bacteria of the Enterobacteriaceae family such as Shigella. The mechanism of action of this product is that sulfonamides act on dihydrofolate synthase, interfering with the first step of folic acid synthesis, while trimethoprim acts on the second step of folic acid anabolism, selectively inhibiting the action of dihydrofolate reductase. Therefore, the combination of the two can double-block the folic acid metabolism of bacteria, have a synergistic antibacterial effect, and reduce the number of drug-resistant strains compared with single drugs. The sodium bisulfate contained in it can alkalize urine and reduce the possibility of sulfonamide drug crystallization in urine.
Ingredients
This product is a compound preparation, and its components are: each tablet contains 0.19-0.21g of sulfadiazine, 22.5-27.5mg of trimethoprim, and 0.1425-0.1575g of sodium bicarbonate.
| Name | Description | Content | CAS NO. | Manufacturer |
|---|---|---|---|---|
| SulfadiazineIngredients |
Acts on dihydrofolate synthase, interfering with the first step of folic acid synthesis; combined with trimethoprim, it can double block the folic acid metabolism of bacteria and has a synergistic antibacterial effect More |
68-35-9 | 14 | |
| TrimethoprimIngredients |
It acts on the second step of folic acid anabolism and selectively inhibits the action of dihydrofolate reductase; combined with sulfadiazine, it can double block the folic acid metabolism of bacteria and has a synergistic antibacterial effect. More |
738-70-5 | 44 | |
| Sodium bicarbonateExcipients |
Alkalinize urine to reduce the possibility of urinary crystallization of sulfonamides More |
144-55-8 | 44 |
Appearance
This product is white tablets.
Indication
It is suitable for the following infections caused by sensitive strains: 1. Urinary tract infections caused by sensitive strains of Escherichia coli, Klebsiella, Proteus mirabilis, Proteus vulgaris and Morganella. 2. Acute otitis media caused by Streptococcus pneumoniae or Haemophilus influenzae. 3. Prevention of meningitis caused by meningococci.
Usage and Dosage
Oral. Common dosage for children: Infants and young children aged 2 months and above and weighing less than 40 kg take SD 20-30 mg/kg and TMP 4-6 mg/kg orally according to body weight, once every 12 hours.
Adverse Reactions
1. Allergic reactions are common and may manifest as drug eruptions. In severe cases, exudative erythema multiforme, exfoliative dermatitis, and bullous epidermolysis atrophic dermatitis may occur. There are also serum sickness-like reactions such as photosensitivity, drug fever, joint and muscle pain, and fever. 2. Neutropenia or deficiency, thrombocytopenia, and occasionally aplastic anemia. Patients may experience sore throat, fever, and bleeding tendency. 3. Hemolytic anemia and hemoglobinuria. This is easy to occur in patients who lack glucose-6-phosphate dehydrogenase after using sulfonamides, and is more common in newborns and children. 4. Hyperbilirubinemia and neonatal kernicterus. Because sulfonamides compete with bilirubin for protein binding sites, free bilirubin can increase. Neonatal liver function is not perfect, so hyperbilirubinemia and neonatal jaundice are more likely to occur, and kernicterus may occasionally occur. 5 Liver damage. Jaundice and liver dysfunction may occur, and acute liver necrosis may occur in severe cases. 6. Kidney damage. Crystalluria, hematuria and tubular urine may occur. Occasionally, patients may develop serious adverse reactions such as interstitial nephritis or tubular necrosis. 7. Nausea, vomiting, decreased appetite, diarrhea, headache, fatigue, etc., generally mild symptoms, do not affect continued medication. Occasionally, patients develop Clostridium difficile enteritis, and the drug should be discontinued at this time. 8. Occasionally, thyroid enlargement and hypofunction occur. 9. Central nervous system toxicity may occasionally occur, manifested as mental confusion, disorientation, hallucinations, euphoria or depression. Once it occurs, the drug should be discontinued immediately. 10. Occasionally, aseptic meningitis may occur, with headache, stiff neck, nausea, etc. Serious adverse reactions caused by sulfonamides are rare, but can be fatal, such as exudative erythema multiforme, exfoliative dermatitis, epidermolysis bullosa atrophic dermatitis, fulminant liver necrosis, agranulocytosis, aplastic anemia and other blood system abnormalities. Treatment should be closely monitored and the drug should be discontinued immediately if a rash or other early signs of a reaction appear.
Precautions
1. Patients allergic to sulfonamides and trimethoprim are prohibited from using this product. Infants under 22 months old and premature infants are prohibited from using this product. 3. Patients with poor liver and kidney function and blood diseases (such as leukopenia, thrombocytopenia, purpura, etc.) are prohibited from using this product.
Special Population Medication
Precautions for children: Sulfonamides can compete with bilirubin for binding sites on plasma proteins, and the acetyltransferase system of newborns is not fully developed, so the free blood concentration of sulfonamides increases, which increases the risk of kernicterus. Therefore, this type of drug is contraindicated in newborns and infants under 2 months old. Precautions for pregnancy and lactation: Not yet clear. Precautions for the elderly: Not yet clear.
Drug Interactions
1. When used in combination with urine alkalinizing drugs, the solubility of sulfonamide drugs in alkaline urine can be increased, which increases excretion. 2. Para-aminobenzoic acid can replace sulfonamide and be taken up by bacteria, antagonizing the antibacterial effect of sulfonamide drugs, so the two should not be used together. It is also not suitable to be used in combination with local anesthetics containing para-aminobenzoyl such as procaine, benzocaine, tetracaine, etc. 3. When used in combination with oral anticoagulants, oral hypoglycemic drugs, methotrexate, phenytoin sodium and thiopental sodium, the above drugs need to be adjusted in dose, because the sulfadiazine in this product can replace the protein binding sites of these drugs, or inhibit their metabolism, resulting in prolonged drug action time or toxic reactions. Therefore, when these drugs are used at the same time as this product, or after using this product, their doses need to be adjusted. 4. When bone marrow suppressive drugs are used in combination with this product, the adverse reactions of such drugs to the hematopoietic system may be enhanced, such as leukopenia and thrombocytopenia, and possible toxic reactions should be closely observed. 5. When used in combination with thrombolytic drugs, their potential toxic effects may be increased. 6. 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. 7. When used in combination with photosensitizing drugs, photosensitization may be additive. 8. Patients receiving sulfonamide treatment have an increased need for vitamin K. 9. Hexamethylenetetramine can decompose in acidic urine to produce formaldehyde, which can form insoluble precipitates with sulfonamides, increasing the risk of crystalluria. Therefore, the two drugs should not be used at the same time. 10. Sulfonamides can replace the plasma protein binding site of phenylbutazone. When the two are used in combination, the effect of phenylbutazone can be enhanced. 11. Because this product may interfere with the bactericidal effect of penicillins, it is best to avoid using it at the same time with such drugs. 12. When used in combination with sulfinpyrazone, the secretion of sulfadiazine in this product from the renal tubules can be reduced, and its blood concentration will increase and last for a long time, which is prone to toxic reactions. Therefore, the dose of this product may need to be adjusted during or after the use of sulfinpyrazone. 13TMP can inhibit the metabolism of warfarin and enhance its anticoagulant effect. 14TMP combined with cyclosporine can increase renal toxicity. 15Rifampicin combined with this product can significantly increase TMP clearance and shorten serum half-life. 16TMP should not be used simultaneously 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. 17Combined with dapsone will increase the blood concentrations of both dapsone and TMP. The increase in dapsone concentration increases and aggravates adverse reactions, especially the occurrence of methemoglobinemia. 18When used in combination with procainamide, the TMP in this product can reduce the renal clearance of procainamide, resulting in increased blood concentrations of procainamide and its metabolites.
Storage
Keep away from light and store in a sealed container.
Packaging Specification
Sulfadiazine 0.2g, trimethoprim 25mg, sodium bicarbonate 0.15g
Validity Period
24 months
Manufacturer
Jiangxi Pharmaceutical Co., Ltd.
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Founded in:
1996-06-10 -
Address:
No. 758, Huiren West Avenue, Xiaolan Industrial Park, Nanchang County, Nanchang City, Jiangxi Province -
Tax NO.:
913600001582615429 -
Registered Funds:
295.8 million yuan -
Website:
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Email: