Cotrim EPHAC 480mg

Indication

Cotrim EPHAC (Co-trimoxazole 480 mg = Trimethoprim 80 mg + Sulfamethoxazole 400 mg) is a combination antibiotic used to treat urinary tract infections, respiratory tract infections (including Pneumocystis jirovecii pneumonia), ear infections (otitis media), gastrointestinal infections (traveller's diarrhoea, shigellosis), and some skin infections.

Ingredients

• Trimethoprim 80 mg
• Sulfamethoxazole 400 mg

Direction

Adults: 960 mg (2 standard tablets or 1 double-strength tablet = 2×480 mg) twice daily for 5–14 days depending on the infection. Pneumocystis pneumonia (prophylaxis): 480 mg once daily. Children: dose by weight. Take with food and drink plenty of fluids.

Side effects

• Nausea and vomiting.
• Diarrhoea.
• Skin rash.
• Stevens
• Johnson syndrome (rare but serious).
• Photosensitivity.
• Bone marrow suppression (with prolonged use).
• Hyperkalaemia (especially with high doses or renal impairment).
• Crystalluria (inadequate hydration).

Precautions

• Do not use in patients with sulfonamide allergy or trimethoprim allergy.
• Do not use in patients with severe renal or hepatic impairment without medical supervision.
• Avoid in patients with blood dyscrasias or significant folate deficiency.
• Maintain adequate fluid intake to prevent crystalluria.
• Avoid in the first trimester of pregnancy and near term.
• Monitor blood counts in patients on prolonged therapy.
• May enhance the anticoagulant effect of warfarin.
• Avoid in patients with G6PD deficiency.
• Keep out of reach of children.