Monograph

J01EE01 - Sulfamethoxazole and Trimethoprim

Porphyrinogenic

Rationale

The combination contains a notoriously porphyrinogenic sulfonamide component, inducer of CYP 3A4. Several references warn against it. Trimetoprim is substrate for CYP 2C9 and 3A4. Inhibits CYP 2C8, 2C19, 2D6,3A4. Warned against in three references.

Chemical description

sulfamethoxazol: Sulfonamide excreted in urine in unchanged form (20%), in acetylated form (60%) and in glucuronidated form (15%). trimethoprim: Bacteriostatic antibiotic perorally used (150-200 mg x 2) in urinary tract infections. About 10-20 % is metabolized in the liver.About 50 % is excreted by the kidneys in unchanged form within 24 hours. Sulfonamides: Australian list: unsafe/attacks. EPI-list: unsafe. French list: avoid. South African list: avoid /use with extreme caution only. Steim,Tchudy 1970: unsafe. Moore, Hift 1997: unsafe. Kalman, Bonkowsky: known to exacerbate disease. Andersson: Precipitates attacks (N=4) Trimethoprim: Martindale: unsafe/acute attacks. Australian list: unsafe. South African list: use with extreme caution only.

IPNet drug reports

Uneventful use reported in 3 patients with acute porphyria.

Similar drugs

Explore alternative drugs in similar therapeutic classes J01E / J01EE or go back.

Tradenames

This list comprises raw data collected from different countries. In some cases, a more comprehensive list of available drug packages is included. Consequently, very similar terms may therefore appear multiple times. Bold names are the searchable terms, while the gray names that follow are all mapped to the bolded term.

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Show more details and information about the listed tradenames

Bactrimel, concentraat voor oplossing voor intraveneuze infusie 96 mg/ml · Co-trimoxazol CF 480 mg, tabletten · Co-trimoxazol forte CF 960 mg, tabletten · Co-trimoxazol Teva 200/40 mg/5 ml, suspensie voor oraal gebruik

Bactrim Forte 800 mg - 160 mg comp. · Eusaprim · Eusaprim 40 mg - 200 mg/5 ml susp. buv. · Eusaprim 80 mg - 400 mg/5 ml sol. perf. (? diluer) i.v. amp. · Eusaprim Forte 160 mg - 800 mg comp.

SEPTRIN 80 mg/400 mg COMPRIMIDOS · SEPTRIN FORTE 160 mg/800 mg COMPRIMIDOS · SEPTRIN PEDIATRICO 20 mg/100 mg COMPRIMIDOS · SEPTRIN PEDIATRICO 8 mg/40 mg/ml SUSPENSION ORAL · Soltrim 160mg/ 800mg Polvo y Solucion Para Solucion Inyectable

Bactrim

BITRIM 400mg/80mg · co-Trim Arena · COTRIM-RATIOPHARM 400 mg/80 mg · EPITRIM 200 mg/40 mg/5 ml · SUMETROLIM 25mg/ml+5mg/ml · SUMETROLIM 400 mg/80 mg · Tagremin