Clinical medicine profile
Co-trimoxazole
Therapeutic agent (verify pharmacological class)
- Route
- See product SmPC
- Schedule
- POM
- ATC
- Not assigned
- PPB status
- registered
This profile needs source confirmation
Some sections contain general class guidance rather than medicine-specific evidence. Confirm prescribing decisions against the current SmPC and Kenya STG/EML.
Safety essentials
The information most likely to change a prescribing or dispensing decision.
Contraindications
- Renal/hepatic failure, blood disorders, pregnancy and lactation, Vitamin B12 and folate deficiency, porphyria, premature/new born infants, concommitant use with anti-convulsant medicines.
Precautions
- Regular blood counts (on prolonged use), folate impairement, lactation, renal impairment, elderly, maintain adequate fluid output, allergic conditions, bronchial asthma, use of diuretics, concommitant use with coumarin anticoagulants, methotrexate, phenytoin.
Dosing matrix
Population and organ-function guidance, shown together for faster comparison.
By mouth, 960mg every 12 hours; child, every 12 hours, 6 weeks5 months, 120mg; 6 months5 years, 240 mg; 612 years, 480 mg By intravenous infusion, 960mg every 12 hours increased to 1.44g every 12 hours in severe infections; child 36 mg/kg daily in 2 divided doses increased to 54 mg/kg daily in severe infections. Treatment of Pneumocystis jirovecii [Pneumo- cystis carinii] infections[undertaken where facilities for appropriate monitoring available consult microbiologist and product literature], by mouth or by intravenous infusion, adult and child over 4 weeks, 120mg/kg daily in 24 divided doses for 14 days. Prophylaxis of Pneumocystis jirovecii [Pneumo- cystis carinii] infections], by mouth, 960mg once daily [may be reduced to 480mg once daily to improve tolerance] or 960mg on alternate days [3 times a week] or 960mg twice daily on alter- nate days [3 times a week]; child 6 weeks5 months, 120mg twice daily on 3 consecutive or alternate days per week or on 7 days per week; 6 months5 years, 240mg; 612 years, 480mg.
See label paediatric section if present; otherwise use paediatric formulary — do not extrapolate adult doses.
Review renal impairment dosing; many agents need CrCl/eGFR adjustment.
- CrCl 0–120: Confirm renal dosing in product SmPC / primary label.
Review hepatic impairment dosing; monitor LFTs if agent is hepatically cleared or hepatotoxic.
Use, effects & interactions
Indications
- URTI, LRTI, UTI, GI infections, skin infections.
- Clinical selection for Co-trimoxazole should follow culture results where relevant, Kenya STG/EML recommendations, and the current product SmPC.
- Class context: Therapeutic agent (verify pharmacological class).
- Confirm site-specific dose, duration and monitoring before prescribing.
Adverse effects
- Haematological changes, skin disorders, erythema multiforme, nausea and vomiting, toxic epidermal necrolysis, allergic vasculitis, glossitis, stomatitis, transient jaundice, acidosis, goitre, hypoglycaemic effect.
- High dose: tinnitus and peripheral neuritis.
Drug interactions
Open multi-drug checker ↗- Professional use: confirm indication, dose, duration, monitoring and patient counselling points against current Kenya STG / EML and the product SmPC.
- Document allergy status and key interactions.
Mechanism & disposition
Sulphonamides inhibit bacterial synthesis of dihydrofolic acid by competing with para-aminobenzoic acid Mechanism is agent-specific.
Read complete mechanism
Sulphonamides inhibit bacterial synthesis of dihydrofolic acid by competing with para-aminobenzoic acid Mechanism is agent-specific. At receptor, enzyme, ion channel, transporter or microbial target level, the drug alters a physiological or pathological pathway to produce its therapeutic effect. Confirm precise molecular mechanism in current SmPC / pharmacology reference for this INN before high-stakes decisions.
Product-specific
Product-specific
See product SmPC
are product-specific. Consider food effects, protein binding, hepatic CYP/UGT
when adjusting for organ impairment, age and drug interactions. Verify parameters in the current SmPC.
Pregnancy, lactation & diet
Use only if potential benefit justifies potential risk; prefer agents with better reproductive data when alternatives exist.
Assess infant risk vs benefit of maternal therapy; prefer agents with lactation data.
Brands & loaded prices
| Brand | Manufacturer | Pack | Observed price |
|---|---|---|---|
| COSATRIM DS TABS 10 * 10 | Not recorded | — | KES 462.25Daima Chemist price-list reference ↗ Source date not recorded · verify current price |
| SEPTRIN PAEDIATRIC SUSPENSION | Not recorded | 100ML | KES 219.04Daima Chemist price-list reference ↗ Source date not recorded · verify current price |
| UNITRIM DS TABS 10 * 10BLISTER new price | Not recorded | — | KES 130.07Daima Chemist price-list reference ↗ Source date not recorded · verify current price |
Sources & review state
Decision support only. Confirm patient-specific decisions against the current product SmPC, Kenya STG/EML, and professional judgement.