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Generic Name: Co-trimoxazole
Brand Name(s):
Information updated: April 1, 2000
Overview
This popular antibiotic is a combination of two sulfa drugs, sulfamethoxazole
and trimethoprim.
It is frequently prescribed for urinary tract
infections, middle ear infections, chronic bronchitis, diarrhea caused by
Shigella, and pneumonia due to Pneumocystis carinii.
It is occasionally
prescribed for travelers' diarrhea.
Co-trimoxazole is available in
single- and double-strength tablets and suspensions for pediatric use.
Side Effects and Interactions
Side effects from co-trimoxazole may include
nausea, vomiting, diarrhea, stomach ache, hives, peeling of skin, itching,
headache, insomnia, weakness, dizziness, and depression.
Blood disorders
and liver damage are unusual but potentially serious. If a rash appears, contact
the doctor without delay. Severe skin reactions, while rare, begin with a
rash.
Co-trimoxazole can make skin and eyes more sensitive to the sun. It
is wise to prevent problems by using sunscreen, protective clothing, a hat, and
effective sunglasses.
Remember to report any symptoms or suspected side
effects to your physician. Notify the doctor immediately if you develop sore
throat, fever, chills, yellowing of skin or eyes, and unusual bleeding or
bruising.
Co-trimoxazole may interact with Coumadin,
diabetes pills such as Diabinese, Orinase or Tolinase, hydrochlorothiazide or
certain other diuretics, Dymelor, methotrexate, cyclosporine, and Dilantin.
Be sure to check with your physician and pharmacist before taking
co-trimoxazole together with any other drugs.
Special Precautions
If you are allergic to sulfa drugs, alert your physician immediately.
People who have reacted to other sulfa drugs, including diabetes pills and thiazide blood pressure medicines, should not take co-trimoxazole.
Symptoms such as breathing difficulty, wheezing, sneezing, hives, itching, and skin rash require immediate emergency treatment.
Life-threatening anaphylactic shock may produce an inability to breathe and cardiovascular collapse and can occur within minutes of exposure.
Co-trimoxazole is not prescribed for women at or after 36 weeks of pregnancy, for breastfeeding mothers, or babies less than two months old.
Elderly people may need lower doses, especially if kidneys or liver are not functioning well.
Prolonged use of an antibiotic like co-trimoxazole sometimes leads to an overgrowth of fungus or resistant bacteria known as superinfection. If this occurs, the doctor may need to have you discontinue this drug and take a different medication.
Taking the Medicine
Co-trimoxazole is best swallowed on an empty stomach, at least one hour before or two hours
after a meal, with a full glass of water.
If it causes stomach upset, it may be taken at
mealtime.
Be sure to finish the entire prescription unless your doctor directs you to
stop.
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Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Their syndicated radio show can be heard on public radio.
© 2000