Trimeseptol Hataphar medicine for urinary tract infections (25 blisters x 20 tablets)

Dosage form Box of 25 blisters x 20 tablets
Specifications Sulfametoxazol, trimethoprim

Ingredient

Composition informationContent
Sulfametoxazol400mg
Trimethoprim80mg

Uses

Indications

Trimeseptol 400/80 Ha Tay 25x20 is indicated in the following cases:

Infections caused by bacteria sensitive to sulfamethoxazol and trimethoprim:

  • Urinary tract infections
    • infection of the lower urinary tract bacteria.
  • Acute otitis media in children. Trimethoprim (1 part). Sulfamethoxazol is a sulfonamide, inhibiting the competition of bacterial folic acid synthesis. Trimethoprim is a derivative of pyrimidine, inhibiting the enzyme specific to the bacterium of bacteria. Combining trimethoprim and sulfamethoxazol so that inhibits two consecutive stages of folic acid metabolism, thus effectively inhibits the synthesis of purin, thymin and final DNA of bacteria.

    This serial inhibitor has a bactericidal effect. This bronze mechanism also resists the growth of anti -drug bacteria and makes the drug work even when bacteria resist each component of the drug. The optimal effect against most microorganisms is seen in the ratio of 1 part of trimethoprim with 20 sulfamethoxazol. Trimeseptol preparations are coordinated with a ratio of 1: 5, due to the pharmacokinetic difference of 2 drugs, so in the body, the peak concentration ratio reaches a stack of 1:20.

    However, it is unclear whether the drug can reach the optimal ratio in all positions, and if both drugs achieve the concentration of treatment, the contribution of synergies to the effect of Trimeseptol In Vivo is still unknown. The following microorganisms are often sensitive to drugs: E. Coli, Klebsiella Sp., Enterobacter sp. Pneumocystis carinii.

    Trimeseptol has a few effects on Plasmodium falciparum and toxoplasma gondii. The anti -drug microorganisms are: Enterococcus, Pseudomonas, Campylobacter, anaerobic bacteria, meningococcal brain, gonorrhea, Mycoplasma. Trimeseptol resistance is growing slowly in test tubes than each of the lonely ingredients of the drug. This resistance increases in both gram -positive and gram -negative microorganisms but mainly in Entobacter.

    In Vietnam, according to the report of the National Monitoring Program on drug resistance of pathogenic bacteria (ASTS), this resistance grows very fast, many bacteria in the years 70 - 80 are often sensitive to trimeseptol, now strong resistance (Haemophilus Influenzae, E. Coli, Klebsiella, Proteus SCP. The trimeseptol resistance of bacteria varies from each region (North, Central, South), rural or urban, so the physician has a consideration of choosing a thorough drug.

    pharmacokinetics

    After drinking, both trimethoprim and sulfamethoxazol are quickly absorbed and highly available. After 2 hours after taking the dose of 800mg Sulfamethoxazol and 160mg Trimethoprim, the average serum concentration of Trimethoprim is 2.5mg/liter and of sulfamethoxazol is 40 - 50mg/liter. The stable concentration of trimethoprim is 4 - 5mg/liter, of sulfamethoxazol is 100mg/liter after 2-3 days of treatment with 2 doses daily.

    Average intravenous injection has reached the approximate concentrations as above. The half -life of Trimethoprim is 9 - 10 hours, of sulfamethoxazol is 11 hours. So for 12 hours apart is appropriate. 1: 5 ratio between trimethoprim and sulfamethoxazol is most suitable for tablets. However, in serum, this ratio is 1: 20 because Trimethoprim diffuses better out of the blood vessels, entering the tissues. Trimethoprim goes into tissues and secretions better than sulfamethoxazol. The concentration of drugs in urine is 150 times higher than the serum concentration.

    • Before taking Trimeseptol Hataphar medicine for urinary tract infections (25 blisters x 20 tablets)

    How to use

    Take oral use.

    Dosage

    Urinary tract infections, lower urinary tract infections

    Adults

    Take 2 capsules/day, 12 hours apart, for 10 days.

    Children

    Take 8mg trimethoprim/kg + 40mg sulfamethoxazol/kg, for 2 times 12 hours apart, for 10 days.

    Chronic, re -sectarian infections in adult women

    Low dose 1-2 tablets, take 1 or 2 times per week to reduce the number of recurrence.

    respiratory infections, acute bronchitis

    Adults

    Take 2-3 capsules, 2 times daily, for 10 days.

    Acute otitis media, acute pneumonia in children

    Take 8mg trimethoprim/kg + 40mg sulfamethoxazol/kg for 24 hours, divided into 2 times, 12 hours apart, for 5-10 days.

    gastrointestinal infections, dysentery

    Adults

    Take 2 capsules/day, 12 hours apart, 8 days.

    Children

    Use 8mg of trimethoprim/kg + 40mg sulfamethoxazol/kg for 24 hours, divided into 2 times 12 hours apart, for 5 days.

    pneumocystis carinii pneumonia

    Children and adults

    The recommended dose for patients with pneumocystis carinii pneumonia is 20mg trimethoprim/kg + 100mg sulfamethoxazol/kg for 24 hours, divided evenly 6 hours apart, for 14-21 days.

    Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

    What to do when overdose?

    Expression

    Anorexia, nausea, vomiting, headache, unconscious. Hematopoiia and jaundice are late for overdose. Inhibition of the marrow.

    Handling

    Causes vomiting, gastric lavage. Acidification of urine to increase trimethoprim elimination. If there are signs of marrow inhibition, patients need to use leucovorin (folinic acid) 5 - 15mg/day until hematoma recovery.

    What to do when forgetting 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

    Side Effects

    When using trimeseptol drugs, you may experience unwanted effects (ADR).

    Building in 10% of patients. The most unwanted effect occurs in the gastrointestinal tract (5%) and the skin reactions occur at least in 2% of patients taking drugs: foreign rash, acne. The ADR is usually mild but sometimes the skin poisoning syndrome is very severe, such as Lyell's syndrome. Trimeseptol is not used for patients who have identified huge red blood cell anemia or patients with severe liver disease, can be poisoned.

    Common, ADR> 1/100

  • Body: Fever.
    • digestive: Nausea, vomiting, diarrhea, tongue inflammation.

    Skin: itching, foreigner.

    Uncommon, 1/1000

  • Blood: Eosin leukemia, leukopenia, neutropenia, hemorrhage.
    • skin: urticaria.

    Rare, 1/1000

  • Body: Anaphylaxis, serum disease.
    • blood: huge red blood cell anemia, hemolytic anemia, thrombocytopenia, granulocytopenia and all bloody hemoglobin. nerve: Aseptic meningitis. Skin: Poisoned epidermal necrosis (Lyell syndrome), Stevens syndrome - Johnson form, angioedema, sensitivity.
  • Liver: jaundice, cholestasis in the liver, liver necrosis.
  • Metabolism: hyperkalemia, hypoglycemia.
  • Mental: Illusion.
    • genital - urinary: kidney failure, interstitial nephritis, kidney stones.

    ears: tinnitus.

    Instructions on how to handle ADR

    Use folic acid 5 - 10mg/day can avoid ADR due to lack of folic acid without reducing antibacterial effects. It should be noted that folic acid -deficient body is not fully reflected through serum folic acid levels. High doses Trimethoprim in the treatment of pneumocystis carinii pneumonia caused increased potassium but may return to normal.

    The risk of hyperkalemia also occurs in the common dose and should be considered, especially when used simultaneously other drugs that increase potassium or in the case of renal failure. Patients need to be instructed to drink enough water to avoid crystallized drugs into gravel. Do not expose to avoid light sensitivity.

    Warnings

    Before using the drug you need to read the instructions carefully and refer to the information below.

    Contraindicated

    Trimeseptol drugs are contraindicated in the following cases:

  • Severe kidney failure without monitoring the drug concentration in plasma, patients are determined to be huge red blood cell anemia due to folic acid deficiency, sensitive to sulfonamid or with trimethoprim, young children under 2 months old.

    • Precautions when using

    impaired renal function, prone to folic acid deficiency like elderly patients and when using high -dose trimeseptol, dehydration, malnutrition.

    trimeseptol can cause hemolytic anemia in people with a deficiency G-6PD.

    The ability to drive and operate machines

    can be used.

    Pregnancy

    Sulfonamid can cause jaundice in children during the period of birth due to pushing bilirubin from albumin. Because trimethoprim and sulfamethoxazol can hinder folic acid metabolism, the drug is only used during pregnancy when necessary. If you need to take the drug during pregnancy. It is important to use folic acid.

    Breastfeeding period

    Women during breastfeeding are not used trimeseptol. Babies are very sensitive to the toxic effect of the drug.

    Medicinal interaction

    Simultaneously used with diuretics, especially Thiazid, increases the risk of thrombocytopenia in the elderly. Sulfonamid may inhibit protein and excreted through the kidneys of methotrexat and thus reduces the excretion, increasing the effects of methotrexate. Trimeseptol simultaneously used with pyrimethamine 25mg/week increases the risk of huge red blood cell anemia. Trimeseptol inhibits phenytoin metabolism in the liver, capable of increasing the effect of phenytoin. Trimeseptol can extend prothrombin time in patients using warfarin.

    Storage

    In dry place, temperatures below 300C.

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