COTRIM EPHAC Sulfamethoxazole 400 mg + Trimethoprime 80 mg

Indication

COTRIM EPHAC is a combined antibiotic containing sulfamethoxazole and trimethoprim (co-trimoxazole). It is used for treatment of urinary tract infections, respiratory tract infections (including Pneumocystis pneumonia prophylaxis), gastrointestinal infections (including typhoid and shigellosis), and certain sexually transmitted infections.

Ingredients

• Sulfamethoxazole 400 mg
• Trimethoprim 80 mg

Direction

Adults: 2 tablets twice daily (equivalent to 800 mg sulfamethoxazole + 160 mg trimethoprim) for 5–14 days. Children: dose based on body weight (approximately 20 mg/kg/day of sulfamethoxazole component). Take with a full glass of water and with food.

Side effects

• Nausea and vomiting.
• Skin rash (including severe reactions).
• Haematological effects (leucopenia
• thrombocytopenia) with prolonged use.
• Hyperkalaemia with high doses.
• Increased serum creatinine.
• Photosensitivity.

Precautions

• Contraindicated in patients with sulphonamide or trimethoprim hypersensitivity.
• Contraindicated in patients with severe hepatic or renal impairment.
• Maintain adequate fluid intake to prevent crystalluria.
• Risk of serious skin reactions (Stevens
• Johnson syndrome
• toxic epidermal necrolysis) — discontinue at first sign of rash.
• Monitor blood counts with prolonged use (folate antagonism).
• Not recommended in pregnancy (especially first trimester and near term) or in neonates.
• May interact with warfarin
• phenytoin
• and methotrexate.