The information below is about trimethoprim tablets. There is a separate page about nitrofurantoin capsules, the alternative antibiotic available from Dr Fox for cystitis in women. General information about cystitis and standby treatment, and selecting the right antibiotic, can be found at the cystitis medical information page. Please also read the manufacturer's patient information leaflet supplied with trimethoprim tablets.
Trimethoprim is an antibiotic commonly used to treat uncomplicated cystitis in women, and other urine infections. In the last few years antibiotic resistance to trimethoprim has increased. About 30% of the bacteria which cause cystitis are now resistant to trimethoprim and it is no longer always the first choice antibiotic by GPs. The antibiotic nitrofurantoin is now often more effective and is often the first choice, although trimethoprim is still widely prescribed and many women find it effective and prefer it.
Trimethoprim is not suitable for everyone. Patients with some medical conditions or who are also taking some other medicines cannot take it. Checks for suitability are carried out in the online consultation which is part of the ordering process.
In very rare cases (fewer than 1 in 10,000), there may be an acute allergic reaction leading to angioedema or anaphylaxis. If affected, stop taking trimethoprim, and contact your GP, out-of-hours service, or telephone 111 or see 111.nhs.uk online. In an emergency telephone 999.
If you are breastfeeding, it is usually fine to take a short course of trimethoprim, although small amounts are found in breast milk. The manufacturer recommends asking your doctor or pharmacist for advice before taking trimethoprim when breastfeeding.
Trimethoprim affects folic acid metabolism, and this is how it works as an antibiotic. Folic acid is very important in the development of the foetus. It is therefore recommended to avoid trimethoprim during pregnancy, particularly in the first trimester when the foetal spinal cord is developing.
Antibiotic resistant bacteria are becoming more common. With cystitis, more of the common bacteria are resistant to trimethoprim than nitrofurantoin. If taking repeated courses of antibiotics to treat repeat urine infections, using a different antibiotic each time may help to reduce development of resistance. In particular, taking a further course of trimethoprim within 3 months of a previous course is linked to developing trimethoprim resistant infections, so take nitrofurantoin instead.
Do not take BACTRIM DS TABLET if you are allergic to Sulphamethoxazole, trimethoprim, sulphonamide medicines (such as gliclazide, glibenclamide) or to thiazide diuretics (such as Bendroflumethiazide).
2. Tyler R. Kemnic, Meghan Coleman. Trimethoprim Sulfamethoxazole. StatPearls. NIH. National Library of Medicine. National Center for Biotechnology Information. PMC. PubMed Central. November 2022. [Accessed on 16th February 2023]. ::text=Trimethoprim%2Fsulfamethoxazole%2C%20also%20known%20as,for%20many%20types%20of%20illnesses.
3. Erwin L. van der Veen, Anne G. M. Schilder, Tim K. Timmers, Maroeska M. Rovers, Ad C. Fluit, Marc J. Bonten, Maurine A. Leverstein-van Hall. Effect of long-term trimethoprim/sulfamethoxazole treatment on resistance and integron prevalence in the intestinal flora: a randomized, double-blind, placebo-controlled trial in children. Journal of Antimicrobial Chemotherapy. Oxford Academic. May 2009. [Accessed on 16th February 2023].
Trimethoprim belongs to a class of medications known as antibiotics. Trimethoprim is frequently combined with other drugs, including sulfamethoxazole to make Bactrim and polymyxin B to make Polytrim, due to theoretical synergistic effects between the medications. Trimethoprim is frequently used as part of a treatment strategy for urinary tract infections, eye infections, outer ear infections and some types of diarrhea. Trimethoprim works by interfering with bacterial DNA synthesis by blocking the production of a DNA precursor known as tetrahydrofolic acid.
Trimethoprim prescription medication is often prescribed as a combination medication to be used in ophthalmic solutions and suspensions. When prescribed as tablets, trimethoprim is sometimes prescribed as trimethoprim 100 mg twice per day for a period of time in adults. Ultimately, the trimethoprim dosing regimen prescribed depends on the health needs of the patient and the judgement of the prescribing medical provider. Following oral administration, the half life of trimethoprim is ten hours in healthy people and excretion occurs primarily in the urine. Trimethoprim is considered affordable, costing approximately 40 cents per trimethoprim 100 mg tablet at most pharmacies in the United States. Trimethoprim coupons are sometimes available online. People with insurance may want to check with their insurance plan to see if costs associated with trimethoprim medication prescriptions are partially or fully covered.
Trimethoprim is a prescription medication meaning that one needs to consult a medical provider and get a trimethoprim prescription before being able to obtain it in the United States. Because of this, trimethoprim OTC is not available at pharmacies and one cannot just buy trimethoprim online without first going through a consultation process. People who might need a trimethoprim prescription, however, can use Push Health to connect with a medical provider who can prescribe trimethoprim sulfate medication when appropriate to do so.
Trimethoprim medication can cause side effects and concerns should be discussed with a qualified medical provider prior to using trimethoprim medication. Side effects that may result from trimethoprim use include nausea, rash, vomiting, diarrhea, itching, joint pain and bruising. Trimethoprim can interact with other medications and care should be taken when prescribed as part of a larger drug regimen. Trimethoprim and alcohol should not be used concomitantly. People with a hypersensitivity to trimethoprim or similar medications should not use trimethoprim prescription medication.
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Trimethoprim/sulfamethoxazole, also known as co-trimoxazole and can be abbreviated in the following ways: SXT, TMP-SMX, TMP-SMZ, or TMP-Sulfa. It is an antimicrobial used to treat and prevent many bacterial infections. This drug is very cost affordable and used for many types of illnesses. The FDA-Approved indications include acute infective exacerbation of chronic bronchitis, otitis media in pediatrics only, travelers diarrhea for treatment and prophylaxis, urinary tract infections, shigellosis, pneumocystis jirovecii, pneumonia/pneumocystis carinii pneumonia (PJP/PCP), and toxoplasmosis, both as prophylaxis and treatment. There are also non-FDA-approved indications. This activity outlines the indications, mechanism of action, methods of administration, important adverse effects, contraindications, toxicity, and monitoring, of TMP-SMX, so providers can direct patient therapy where necessary for infections as part of the interprofessional team.
Objectives:Identify the antimicrobial mechanism of action of trimethoprim/sulfamethoxazole, focusing on each component individually and the synergism of the combination.Summarize the approved indications for initiating antimicrobial therapy with trimethoprim/sulfamethoxazole.Outline the potential adverse events associated with trimethoprim/sulfamethoxazole.Explain interprofessional team strategies for improving care coordination and communication to properly use trimethoprim/sulfamethoxazole to improve patient outcomes in infectious disease.Access free multiple choice questions on this topic.
Trimethoprim/sulfamethoxazole, also known as co-trimoxazole and can be abbreviated in the following ways: SXT, TMP-SMX, TMP-SMZ, or TMP-sulfa. It is an antimicrobial used to treat and prevent many bacterial infections. In 1974, TMP/SMX healthcare professionals began prescribing the medication, and the drug is now on the list of the World Health Organization's (WHO) essential medicines. This drug is very cost affordable and used for many types of illnesses.
Sulfamethoxazole is a sulfonamide (antimicrobial drug class) that works directly on the synthesis of folate inside microbial organisms, e.g., bacteria. Sulfamethoxazole achieves this directly as a competitor of p-aminobenzoic acid (PABA) during the synthesis of dihydrofolate via inhibition of the enzyme dihydropteroate synthase. Trimethoprim is a direct competitor of the enzyme dihydrofolate reductase, resulting in its inhibition, which halts the production of tetrahydrofolate to its active form of folate. The combination of these two agents is meant to create a synergistic anti-folate effect; tetrahydrofolate is a necessary component for synthesizing purines required for DNA and protein production. When used alone, these drugs only act in a bacteriostatic manner. However, when used in the combination of sulfamethoxazole-trimethoprim, they block two steps in the bacterial biosynthesis of essential nucleic acids and proteins, thus can be bactericidal, e.g., urine.
Sulfamethoxazole/trimethoprim may be administered orally without regard to meals. However, it is best to take it with at least 8 ounces of water. It also has an intravenous formulation. The choice of oral or intravenously varies both on the type of infection/or type of prophylactic use. It should not be administered intramuscularly. Patients with impaired renal function must have calculated dosing regimens based on renal function, as listed below. Administration of the two drugs is in a 1 to 5 ratio (trimethoprim:sulfamethoxazole) as a tablet formulation; this is so when they enter the body, their concentration throughout the blood/tissues is 1 to 20, which is the peak synergistic desired effect ratio of the two drugs in combination. 59ce067264