J01EE01 - Sulfamethoxazole and Trimethoprim |
Porphyrinogenic |
P |
Rationale
The combination contains a notoriously porphyrinogenic sulfonamide component, inducer of CYP3A4. Several references warn against it. Trimetoprim is substrate for CYP2C9 and 3A4. Inhibits CYP2C8, 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 (150-200mg 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.
Personal communication
Andersson: Precipitates attacks (n=4).
IPNet drug reports
Uneventful use reported in 3 patients with acute porphyria.
Similar drugs
References
| # | Citation details | PubMed ID |
|---|---|---|
| 1. | Management of acute attacks in the porphyrias.
Kalman DR, Bonkovsky HL. Clin Dermatol. 1998; 16(2):299-306.
|
9554242 |
| Porphyria Drug Lists | ||
| 2. | Australian List
Australian Porphyria Association No longer maintained
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| 3. | French List
Centre Français des Porphyries
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| 4. | EPI List
European Porphyria Initiative No longer maintained
|
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| 5. | South African List
Porphyria South Africa No longer maintained
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Tradenames
Bactrimel · Co-trimoxazol · Co-trimoxazol forte 
Bactrim Forte · Eusaprim · Eusaprim Forte 
Bactrim · Bactrim Forte · Bactrim nr enf · Cotrimoxazole 
Septrin · Septrin Forte · Soltrim 
Cotripharm · Sumetrolim 
Bactrim · Bactrimel 
Bitrim · co-Trim · Cotrim · Dubluseptol · Epitrim · Sumetrolim · Tagremin · Trimesolphar 
Bactrim · Bactrim forte · Lagatrim · Lagatrim forte · Nopil · Nopil forte 
Co-trimoxazole · Septrin · Septrin Adult · Septrin for Infusion · Septrin Forte · Septrin Paediatric 
Sulfametoxazol Trimetoprim · Zomylac 
Bactrim · Cotrim · Eusaprim · Extempore J01EE01 Sulfametoxazol trimetoprim · Sulfametoxazol-Trimetoprim · Trimesolphar · Zomylac 
Bactrim · Bactrimel · Zomylac 
Bactrim · Bactrim Forte · Biseptol · Trimesolphar 
Bactisol · Bactrim · Decasulf Forte · Mediprim · Sultamiblas · Sultrifar · Supribac · Trimesulf · Trimetoprim · Trimetoprim + Sulfametoxazol · Trimetoprim - Sulfametoxazol · Trimetoprim Sulfa · Trimetoprim Sulfametoxazol · Trimetoprim Sulfametoxazol-f · Trimetoprima Sulfa · Trimetoprima Sulfametoxazol · Trimetoprin Sulfa · Trimetroprima Sulfametoxazol · Trisulfa 
Bactrim · Co-trimoxazole · Co-Trimoxazole - Calmic · Deprim · Microcetim · Septrin · Septrin Forte · Sulfamethoxazole · Sulfatrim · Trimel · Trisul 
b.s. · co-Trimexazole · Mortin · Mortin-ds · Primzole · Sulfamethoxazole · Sulfatrim · Suprim · Trimaxazole 
Septra · Sulfamethoxazole Trimethoprim · Sulfatrim 
Bactrim Forte · Cotrim Forte · Eusaprim · Eusaprim Forte 
Cotrim · Cotrim forte · Eusaprim 
Cotrim · Cotrim Forte · Zomylac 
Bactrim Forte · Berlocid · Biseptol · Bitrim · Co-Trimoxazol · Epitrim · Sumetrolim 
Bactrim · Biseptol 
Bactrim · Berlocid · Biseptol 
Bactrim · Bactrim-Eumedica · Esbesul 
Sulotrim · Sulotrim forte 
Bactrim · Biseptol · Cotrim-k · Cotrimoxazol · Eusaprim · Primotren · Septrin · Sulotrim · Sultrimix · Trimesolphar 
Biseptol · Cotrimoxazol Forte · Sumetrolim 
Cotrimoxazole · Septra