Why is this medication prescribed?

Co-trimoxazole is a combination antibiotic that contains two active ingredients: sulfamethoxazole and trimethoprim. It is commonly prescribed for the treatment of various bacterial infections, including:

• Urinary tract infections (UTIs) caused by susceptible strains of bacteria.
• Respiratory tract infections, such as bronchitis and pneumonia.
• Ear infections (otitis media).
• Gastrointestinal infections, including traveler’s diarrhea caused by certain bacteria.
• Certain types of skin infections.

How should this medicine be used?

Co-trimoxazole is usually taken orally (by mouth) and comes in tablet or suspension (liquid) form. The dosage and duration of treatment depend on the specific infection being treated, the severity of the infection, and the patient’s age and medical condition. Here are general guidelines for its use:

• Dosage: The dosage will be prescribed by the healthcare provider based on factors like age, weight, and severity of the infection.
• Frequency: It is typically taken 1 to 2 times a day, as prescribed. It’s important to follow the prescribed schedule strictly.
• Duration: The duration of treatment can vary. It is important to complete the full course of medication even if symptoms improve, unless directed otherwise by your healthcare provider.
• Administration: Co-trimoxazole can be taken with or without food. If you are taking the liquid suspension form, shake the bottle well before measuring each dose.
• Special Instructions: Drink plenty of fluids while taking Co-trimoxazole to help prevent kidney stones. Avoid prolonged exposure to sunlight or tanning beds while taking this medication, as it can increase the risk of sunburn due to heightened sensitivity to sunlight.

Always follow your healthcare provider’s instructions regarding dosage, timing, and duration of Co-trimoxazole treatment. If you have any questions or concerns about your medication, it’s important to discuss them with your healthcare provider or pharmacist.

Other uses for this medicine

In addition to its primary uses for bacterial infections, Co-trimoxazole may also be used in certain circumstances for:

• Prevention of Pneumocystis jirovecii pneumonia (PJP) in individuals with weakened immune systems, such as those with HIV/AIDS.
• Treatment or prevention of certain types of malaria.
• Treatment of other infections caused by susceptible bacteria, as determined by your healthcare provider.

What special precautions should I follow?

When using Co-trimoxazole, it’s important to follow these precautions to ensure safe and effective treatment:

• Allergy: Inform your healthcare provider if you are allergic to sulfonamide antibiotics or any other medications. Co-trimoxazole should be used cautiously or avoided if you have a known allergy.
• Kidney function: Co-trimoxazole can affect kidney function, especially when used at higher doses or for prolonged periods. Your healthcare provider may monitor your kidney function while you are taking this medication.
• Sun sensitivity: Co-trimoxazole can make you more sensitive to sunlight. Avoid prolonged exposure to sunlight, tanning beds, and sunlamps. Use sunscreen and wear protective clothing when outdoors.
• Blood disorders: Co-trimoxazole may cause blood disorders such as low white blood cell count (neutropenia) or low platelet count (thrombocytopenia). Your healthcare provider may perform blood tests to monitor for these conditions.
• Pregnancy and breastfeeding: Inform your healthcare provider if you are pregnant, planning to become pregnant, or breastfeeding. Co-trimoxazole may not be recommended during pregnancy or breastfeeding, depending on the specific situation.
• Other medications: Inform your healthcare provider about all medications, vitamins, and supplements you are taking, as Co-trimoxazole may interact with certain drugs.

Always consult with your healthcare provider or pharmacist if you have any questions or concerns about using Co-trimoxazole, its potential side effects, or its interactions with other medications.

What special dietary instructions should I follow?

There are generally no specific dietary restrictions while taking Co-trimoxazole. However, it is important to maintain a balanced diet and drink plenty of fluids (especially water) to stay hydrated. This can help prevent potential side effects such as kidney stones.

What should I do if I forget a dose?

If you forget to take a dose of Co-trimoxazole, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Co-trimoxazole, like any medication, can cause side effects. Not everyone experiences these side effects, and their severity can vary from person to person. Common side effects of Co-trimoxazole include:

• Nausea and vomiting: These are relatively common side effects and can often be managed by taking the medication with food.
• Diarrhea: Co-trimoxazole can disrupt the normal balance of bacteria in the gut, leading to diarrhea. It’s important to stay hydrated if you experience diarrhea while taking this medication.
• Skin reactions: Some people may develop rash or itching while taking Co-trimoxazole. Serious skin reactions such as Stevens-Johnson syndrome or toxic epidermal necrolysis are rare but can occur.
• Allergic reactions: Co-trimoxazole can cause allergic reactions in some individuals, ranging from mild itching or rash to severe reactions like anaphylaxis (a life-threatening allergic reaction).
• Blood disorders: Co-trimoxazole can affect blood cell counts, leading to conditions like neutropenia (low white blood cell count) or thrombocytopenia (low platelet count). Symptoms may include easy bruising, bleeding, or signs of infection.
• Kidney problems: Co-trimoxazole can sometimes cause kidney damage or kidney stones, particularly if not enough fluids are consumed while taking the medication.
• Liver problems: In rare cases, Co-trimoxazole may cause liver damage or liver dysfunction. Symptoms can include jaundice (yellowing of the skin or eyes), abdominal pain, or dark urine.
• Central nervous system effects: Some people may experience headache, dizziness, or confusion while taking Co-trimoxazole.
• Electrolyte abnormalities: Co-trimoxazole may affect electrolyte levels in the body, leading to symptoms such as muscle cramps or weakness.

If you experience any severe or persistent side effects while taking Co-trimoxazole, it’s important to seek medical attention immediately. Your healthcare provider may need to adjust your dosage or switch you to a different medication if side effects become problematic. Always inform your healthcare provider of any new symptoms or changes in your health while taking Co-trimoxazole.

What should I know about storage and disposal of this medication?

Storage and disposal of Co-trimoxazole:

• Storage: Store Co-trimoxazole tablets or suspension at room temperature away from moisture and heat. Keep the medication in its original container with the lid tightly closed. Avoid storing it in the bathroom, where moisture can affect its stability.
• Disposal: Dispose of any unused or expired Co-trimoxazole tablets or suspension properly. Do not flush them down the toilet or pour them into a drain unless instructed to do so. Check with your pharmacist or local waste disposal company for proper disposal methods in your area.

In case of emergency/overdose

• Emergency: If you suspect an overdose or experience severe symptoms such as severe dizziness, fainting, rapid or difficult breathing, or seizures, seek immediate medical attention (call emergency services or go to the nearest emergency room).
• Overdose: Overdosing on Co-trimoxazole can lead to symptoms such as nausea, vomiting, dizziness, headache, and confusion. It’s important to take the medication exactly as prescribed to avoid overdose. If you accidentally take more than the prescribed dose, contact your healthcare provider or a poison control center for advice.

What other information should I know?

• Effectiveness: Co-trimoxazole should be taken for the full prescribed length of time, even if symptoms improve before completing the course. Stopping the medication too early can allow bacteria to continue to grow, which may result in a relapse of the infection.
• Follow-up: Follow up with your healthcare provider as directed to monitor your response to Co-trimoxazole and to check for any potential side effects or complications.
• Interactions: Inform your healthcare provider about all other medications, vitamins, and supplements you are taking, as Co-trimoxazole can interact with certain drugs. This includes prescription and over-the-counter medicines, herbal products, and dietary supplements.
• Allergies: If you have a known allergy to sulfonamide antibiotics or any other medications, inform your healthcare provider before starting Co-trimoxazole.
• Pregnancy and breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the risks and benefits of Co-trimoxazole with your healthcare provider. They will help determine if the medication is safe for you and your baby.
• Sun sensitivity: Avoid prolonged exposure to sunlight, tanning beds, and sunlamps while taking Co-trimoxazole, as it can increase sensitivity to sunlight.

By following these guidelines and communicating openly with your healthcare provider, you can safely and effectively use Co-trimoxazole to treat bacterial infections while minimizing the risk of side effects and complications.