Sulphamethoxazole

Indications
 Oral
Urinary tract infections, Otitis media, Chlamydial infections, Prophylaxis of meningococcal meningitis
Adult: Initially, 2 g followed by 1 g bid. Severe infections: 1 g tid.
Child: Initially, 50-60 mg/kg, followed by 25-30 mg/kg bid. Max daily dose: 75mg/kg.
Renal impairment: Dose reduction in renal impairment

Special Populations: Dose reduction in renal impairment.
Contraindications
 Severe renal or hepatic impairment, blood disorders, hypersensitivity to sulfonamides, porphyria, SLE, infants <2 mth, pregnancy (3rd trimester) and lactation.
Warnings / Precautions
 Renal or hepatic impairment, history of allergy or asthma, AIDS, G6PD deficiency, elderly, ensure adequate fluid intake to reduce risk of crystalluria. Pregnancy.
Adverse Reactions
 Nausea, vomiting, anorexia, diarrhoea, hypersensitivity reactions, blood disorders, serum sickness-like syndrome, hypoglycaemia, hypothyroidism, pseudomembranous colitis, kernicterus in premature neonates.
Drug Interactions
 Concurrent use increases phenytoin and methotrexate levels; increased risk of bleeding with warfarin and acenocoumarol; may potentiate antidiabetic effect of sulphonylureas.
Potentially Fatal: Concurrent use increased risk of blood dyscrasias with clozapine and pyrimethamine.
See Below for More sulfamethoxazole Drug Interactions
Lab Interactions
 Interference with tests for urea, creatinine, urinary glucose, urobilinogen.
Mechanism of Actions
 Sulfamethoxazole is an intermediate-acting sulfonamide which interferes with the synthesis of nucleic acids in sensitive organisms by blocking the conversion of PABA to the coenzyme dihydrofolic acid. Its action is bacteriostatic, although it can be bactericidal where concentrations of thymine are low in the surrounding medium. It has broad spectrum of action though its usefulness has been greatly reduced by widespread resistance.
Administration
 Should be taken on an empty stomach (i.e. At least one hour before food or two hours after food).
ATC Classification
 J01EC01 - sulfamethoxazole ; Belongs to the class of intermediate-acting sulfonamides. Used in the systemic treatment of infections.
Available As
  • Sulphamethoxazole 10 mg
  • Sulphamethoxazole 100 mg
  • Sulphamethoxazole 1250 mg
  • Sulphamethoxazole 160 mg
  • Sulphamethoxazole 200 mg
  • Sulphamethoxazole 400 mg
  • Sulphamethoxazole 500 mg
  • Sulphamethoxazole 80 mg
  • Sulphamethoxazole 800 mg
  • Sulphamethoxazole 820 mg

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