According to the instructions, "Cotrimoxazole" in tablets is an antibacterial drug with a wide spectrum of effects, and also has bactericidal and antiprotozoal properties.
Pharmacology of the drug
The drug is active against a number of gram-positive and gram-negative strains that are resistant to sulfonamides.
What is the composition of the cotrimoxazole tablets? The main components of the drug are sulfamethoxazole (sulfamethoxazole) and trimethoprim (trimethoprim), which provide a bactericidal effect.
The mechanism of action is determined by the presence of a double blocking effect on the metabolism of bacteria. The substance sulfamethoxazole is similar in structure to aminobeyzoic acid, which prevents the inclusion of this element in the molecule of the dihydrofolium component. Trimethoprim is capable of reversibly inhibiting the dihydrofolate reductase of certain bacteria, disrupting the synthesis of tetrahydrofolic acid from its dihydrofolic analogue, and also promotes the formation of pyrimidine and purine bases and nucleic substances, inhibiting growth along with the multiplication of microorganisms. This is confirmed by the instructions attached to the tablets "Cotrimoxazole".
Since the activity of Escherichia coli is inhibited, the synthesis of riboflavin, thiamine, nicotinic acid and other vitamins from the complex “B” group in the digestive system is eliminated.
Immediately after ingestion, these components are almost completely and, importantly, quickly absorbed in the gastrointestinal system. The antibacterial concentration in the blood against this background persists for seven hours, and a day after a single application in plasma, you can notice only small amounts. The equilibrium content in the blood plasma is recorded after two to three days. Forty-four percent of trimethoprim and seventy sulfamethoxazole are localized in a state combined with plasma proteins. All these components are biologically transformed in the liver, that is, acetylation occurs along with the formation of inactive metabolites. This is indicated by the instructions attached to the drug "Cotrimoxazole" (Cotrimoxazol).
Further, the listed elements are distributed evenly in the body and pass through histohematological barriers, creating concentrations in the urine and lungs that exceed the presence of such components in the plasma itself. To a lesser extent, accumulation occurs in the area of bronchial secretion, vaginal discharge, as well as in the area of prostate tissue, fluid consistency of the middle ear, spinal substances, bones and bile. The same applies to saliva, aqueous humor of the eye, breast milk and interstitial fluid. Eliminations have the same speed. The description of Cotrimoxazole does not end there.
In children
In children, the degree of assimilation is significantly less, and this directly depends on their age. For example, up to one year, the process takes from seven to eight hours, and from two to ten years it will take a little less - from five to six. Among the elderly and patients with impaired renal function, the time for assimilation also increases. By the kidneys, the drug is excreted in the form of metabolites, this occurs in an unchanged form, namely, it eliminates from fifty to seventy percent of trimethoprim and from ten to thirty sulfamethoxazole. What else does the instruction describe for Cotrimoxazole tablets?
Indications for use of the drug
As a rule, the described tool is prescribed by doctors against the background of:
- Infections that occur in the genitourinary system, for example, with epididymitis and gonorrhea, both in relation to the male and female forms. In addition, the medicine will be relevant in case of soft chancre, venereal and inguinal lymphogranulomas.
- Pathology of the respiratory tract, for example, with acute or chronic bronchitis, croupous pneumonia.
- Otorhinolaryngological diseases, that is, with otitis media, sinusitis, laryngitis, tonsillitis or scarlet fever.
- Digestive system diseases, namely with typhoid fever, salmonella carriage, cholera, dysentery, cholecystitis, cholangitis, gastroenteritis, which is caused by enterotoxic strains.
- Skin infections: acne, pyoderma, furunculosis.
- Acute or chronic osteomyelitis.
- With brucellosis, South American blastomycosis, malaria, toxoplasmosis as part of complex therapy.
The tablets "Cotrimoxazole" instructions are very detailed.
Active ingredient and dosage form
The active component of this drug is a substance similar in its definition, which is called “co-trimoxazole”. This main element of the composition has antimicrobial combined properties.
For the purpose of treatment with the help of this medication, an infusion solution concentrate was developed along with syrup and a suspension for internal administration. Another form of medication is coated tablets. The cost of the drug ranges from twenty to one hundred rubles, depending on the type of packaging.
Contraindications
Oral tablets "Cotrimoxazole" can not be taken in a number of the following cases:
- The presence of hypersensitivity, including to sulfonamides.
- The development of hepatic and renal failure.
- The disease of aplastic and B12-deficient anemia, as well as agranulocytosis and leukopenia.
- Against a background of deficiency of glucose-6-phosphate dehydrogenase.
- During pregnancy and lactation.
- In case of pneumocystis pneumonia.
- At the age of six years and with the development of hyperbilirubinemia in children.
- With special care in case of folic acid deficiency, bronchial asthma, thyroid diseases.
This is confirmed by the instruction "Cotrimoxazole". Indications and contraindications should be clearly observed.
Dosage and administration of the dosage of the drug
Adults and children over twelve years of age, tablets are taken orally at 960 milligrams once or in half of this dose twice a day. Against the background of a severe course of infections, 480 milligrams should be taken three times a day, and in chronic infections, the same amount is considered a supporting norm, but twice a day.
Children under two years of age are given a drug in the amount of 120 milligrams twice a day. At the age of two to six years - 240 milligrams twice a day
The minimum duration of treatment is usually four days. Immediately after the elimination of symptoms, therapy should be continued for another two days. Against the background of chronic infections, the course of therapy should become longer. For example, in acute brucellosis it will be from three to four weeks, and in typhoid or paratyphoid it will take from one to three months. The preparation “Cotrimoxazole” contains instructions for use (abstract) in each package.
In order to prevent relapse in relation to urinary tract infections for adults and children, 480 milligrams are prescribed once a day at night. Small children and adolescents up to twelve years old can take 11 milligrams per one kilogram of weight. The duration of such treatment is from three months to one year.
When conducting a course of treatment for acute cystitis in children who are between the ages of seven and sixteen, it is required to take 480 milligrams per day for three days inside. In the case of gonorrhea, patients take 2000 milligrams in three divided doses. With gonorrheal pharyngitis, if there is an increased sensitivity to penicillin, they consume 4000 milligrams once a day for a week. To achieve maximum efficiency, the regular concentration of trimethoprim in plasma or serum should be kept at a certain level.
This is confirmed by the instructions for use and reviews for Cotrimoxazole.
Side effects due to the use of the drug
During treatment using the drug “Cotrimoxazole”, the manifestation of certain side effects and undesirable symptoms is likely.
From the nervous system, headaches and dizziness may occur. In some cases, aseptic meningitis, depression, apathy, tremor, as well as peripheral neuritis appear.
A malfunction of the digestive system is usually accompanied by nausea, vomiting, loss of appetite, diarrhea, gastritis and abdominal pain. In addition, the reaction of the body can be expressed by glossitis, stomatitis, cholestasis, increased activity of hepatic transaminases, as well as hepatitis, hepatonecrosis, pseudomembranous enterocolitis.
On the part of the respiratory system, some patients develop bronchospasm and pulmonary infiltrates.
Hematopoietic organs react with leukopenia, neutropenia, thrombocytopenia, agranulocytosis, megaloblastic anemia.
As for the urinary system, polyuria, interstitial nephritis, impaired renal function, crystalluria, hematuria, increased urea concentration, hypercreatininemia, toxic nephropathy along with oliguria and anuria are noted here. From the musculoskeletal system arthralgia and myalgia occur.
If any unwanted effects occur, consult a doctor.
Allergic reactions are observed in the form of pruritus, photosensitization, rash, erythema multiforme, including Stevens-Johnson syndrome, toxic epidermal necrolysis, i.e. Lyell's disease, as well as in the form of exfoliative dermatitis, allergic myocarditis, fever, angioneurotic edema and sclera. Local reactions are expressed in thrombophlebitis in the area of venipuncture and general pain.
In the case of a general overdose of this drug, the reaction of the body is accompanied by nausea, vomiting, intestinal colic, dizziness, drowsiness, depression, fainting. In addition, a negative effect is expressed in confusion, impaired vision, fever, hematuria, crystalluria. Against the background of a prolonged overdose, the onset of thrombocytopenia, leukopenia, megaloblastic anemia and jaundice is likely. The main treatment in this case should be gastric lavage. This is evidenced by the instructions for use with Cotrimoxazole and the description of the drug.
Special instructions for use
As part of the use of Cotrimoxazole, the concentration of sulfamethoxazole contained in plasma should be determined every two to three days before the next use. In the event that the volume exceeds one hundred and fifty micrograms per milliliter, treatment should be interrupted until it decreases by thirty units.
With long courses of treatment (over three months), regular blood tests are required, since there is a possibility of the formation of hematological changes, most often without severe symptoms. These changes can be reversed if you start taking folic acid, which does not particularly violate the antimicrobial activity of Cotrimoxazole tablets. The instructions for use confirm this.
Particular care should be taken during therapy in elderly patients or patients with a suspicion of an initial lack of folate. The use of folic acid will be advisable against the background of long-term treatment in high doses.
For preventive purposes, with crystalluria, it is recommended to maintain the necessary amount of urine excreted. The risk of allergic and toxic complications of sulfonamides increases significantly with a decrease in the filtration function of the kidneys.
The treatment also prohibits the use of foods that contain large quantities of special substances from the green parts of plants found in cauliflower, spinach, legumes, carrots and tomatoes.
It is also important to avoid excessive sunlight and ultraviolet radiation. The risk of side effects is greatly increased for AIDS patients. The use of this medication is prohibited for tonsillitis and pharyngitis, which are caused by beta-hemolytic group A streptococcus due to the widespread resistance of its strains. The above provides complete information about the drug "Cotrimoxazole".
Reviews
As for the opinions of patients and customers, it can be said that in general, people are satisfied with the results of the positive effect of this drug on their body. Patients write about the special effectiveness of Cotrimoxazole in the fight against viruses, as well as in the treatment of various infectious ailments.
Some in their comments write that they do not like the drug because of the large list of side effects, the negative effect of which is confirmed by the stories of patients, cited as an example, where they report the appearance of headaches in them while taking the medicine, as well as nausea and other unwanted effects.
The article describes the instructions for the tablets "Cotrimoxazole".
Price
The cost of the drug is 30-50 rubles per package.