Sulfamethoxazole and Trimethoprim 800 mg; 160 mg Tablet, 6-count
Other active recalls for Sulfamethoxazole And Trimethoprim (different manufacturers) — 5 · tap to view
🆔 Identity & classification
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🏷️ RxNorm drug class
This medicine belongs to the Sulfonamide Antimicrobial class.
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🏭 Manufacturer & labeler
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🩺 Clinical
Co-trimoxazole (a combination of sulfamethoxazole and trimethoprim) is used to treat certain infections that are caused by bacteria. It also is used to treat 'travelers' diarrhea. Co-trimoxazole is in a class of medications called sulfonamides. It works by stopping the growth of bacteria. Antibiotics will not work to kill viruses.
Read the full MedlinePlus article ↗- The IV form is used when your infection is serious enough that you need the medication working quickly and reliably, or when you're not able to take pills by mouth right now. Once...
- Why am I getting this antibiotic through an IV instead of just taking a pill?
- The most common things people notice are nausea, vomiting, and skin rashes — those are uncomfortable but not usually dangerous on their own. What you want to report right away is a...
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💊 What it looks like
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🧪 Inactive Ingredients / Excipients
Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.
💡 Tap an ingredient (hover on desktop) to see what it is and why it’s used.
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UNII 70097M6I30
Magnesium stearate is a salt made from magnesium and stearic acid, a fatty substance. It's used in tablets and capsules as a lubricant and glidant to help ingredients flow smoothly during manufacturing and prevent sticking.
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UNII 5856J3G2A2
A starch-based powder made from potatoes and processed with sodium. It acts as a disintegrant, helping the tablet or capsule break apart quickly in the stomach so the medicine can be absorbed.
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UNII O8232NY3SJ
A plant-based carbohydrate derived from corn kernels. It acts as a filler to add bulk, a binder to hold ingredients together, and a disintegrant to help the tablet break apart in your stomach for absorption.
3 inactive ingredients listed in the exact product block matched to this NDC.
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ingredient classCode="IACT" elements from the exact product block matched by this NDC. Label-section narrative from DailyMed / the openFDA label index is shown separately when available.Inactive ingredient FAQ
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💲 Pricing
A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.
| Price system | Per each | Per package |
|---|---|---|
| Retail pharmacies payNADAC · weekly | Not in the retail survey — common for institutional, discontinued, or low-volume packs. | |
| Medicaid paysCMS SDUD · 12 mo | No recent Medicaid claims on file for this NDC — rare and low-volume NDCs are suppressed in the public data. | |
| Medicare drug plans payPart D · Q2 2026 | $0.1395 | $0.84 / 6 tablets |
Where does this data come from?
🔁 Therapeutic equivalents
| Product | Labeler | Pack | NADAC/unit | TE | Status | Price vs. this |
|---|---|---|---|---|---|---|
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 00904-2725-61 | Major | 100 tablets | $0.045 | AB | Availability likely | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 57237-0233-01 | Rising | 100 tablets | $0.045 | AB | Availability likely | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 60687-0614-01 | American | 100 tablets | $0.045 | AB | Availability likely | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 62135-0898-18 | Chartwell | 180 tablets | $0.045 | AB | Availability likely | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 65862-0420-01 | Aurobindo | 100 tablets | $0.045 | AB | Availability likely | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 53489-0146-01 | Sun | 100 tablets | $0.047 | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 53746-0272-01 | Amneal | 100 tablets | $0.062 | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 00615-8121-10 | NCS | 10 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 42291-0759-01 | AvKARE | 100 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 42708-0053-20 | QPharma, | 20 tablets | — | AB | FDA listed | — |
| Bactrim DS 800 mg/1; 160 mg 49708-0146-01 | Sun | 100 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 50090-2198-00 | A-S | 10 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 50090-2199-00 | A-S | 40 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 50090-2200-00 | A-S | 20 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 50090-2201-00 | A-S | 6 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 50090-2479-02 | A-S | 60 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 50090-4847-00 | A-S | 10 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 50090-4848-02 | A-S | 60 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 50090-4850-00 | A-S | 40 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 50090-5679-00 | A-S | 10 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 50090-5680-02 | A-S | 60 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 50090-5682-00 | A-S | 40 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 50090-6901-00 | A-S | 10 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 50090-6902-02 | A-S | 60 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 50090-6904-00 | A-S | 40 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 50090-7008-00 | A-S | 100 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 50090-7393-01 | A-S | 14 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 50090-7399-00 | A-S | 6 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 51655-0188-20 | Northwind | 20 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 51655-0307-20 | Northwind | 20 tablets | — | AB | FDA listed | — |
| Sulfamethox-TMP DS 800 mg/1; 160 mg 54348-0625-06 | PharmPak, | 6 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 55154-2580-00 | Cardinal | 10 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 55154-7895-00 | Cardinal | 10 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 55700-0611-06 | Quality | 6 tablets | — | AB | Discontinued | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 60429-0259-01 | Golden | 100 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 60760-0541-14 | St. | 14 tablets | — | AB | FDA listed | — |
| Sulfameth/Trimeth-DS 800 mg/1; 160 mg 61919-0645-28 | Direct_Rx | 28 tablets | — | AB | Discontinued | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 61971-0120-01 | Vista | 100 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mgthis 63187-0008-06 | Proficient | 6 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 63187-0695-06 | Proficient | 6 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 63187-0782-06 | Proficient | 6 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 63629-1765-00 | Bryant | 21 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 65162-0272-01 | Amneal | 10 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 66267-0196-06 | NuCare | 6 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 66267-0816-02 | NuCare | 2 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 67046-0295-03 | Coupler | 30 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 68071-4710-01 | NuCare | 10 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 68071-4948-02 | NuCare | 2 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 68788-7622-01 | Preferred | 10 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 69043-0011-01 | Cronus | 100 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 70518-0863-02 | REMEDYREPACK | 100 tablets | — | AB | Discontinued | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 70518-2604-00 | REMEDYREPACK | 14 tablets | — | AB | Discontinued | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 70518-3432-00 | REMEDYREPACK | 10 tablets | — | AB | Discontinued | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 70934-0544-06 | Denton | 6 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 71205-0810-06 | Proficient | 6 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 71335-0762-00 | Bryant | 21 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 72789-0018-02 | PD-Rx | 2 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 72789-0064-06 | PD-Rx | 6 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 76420-0064-06 | Asclemed | 6 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim DS 160 mg/1; 800 mg 80425-0001-01 | Advanced | 14 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim DS 800 mg/1; 160 mg 80425-0002-01 | Advanced | 14 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim DS 160 mg/1; 800 mg 80425-0003-01 | Advanced | 14 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 82868-0092-28 | Northwind | 28 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 82982-0044-14 | Pharmasource | 14 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 83939-0023-01 | VERITYRX, | 1 tablet | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 85766-0015-01 | Sportpharm | 100 tablets | — | AB | FDA listed | — |
| Sulfamethoxazole and Trimethoprim 800 mg/1; 160 mg 87441-0078-01 | Unit | 30 tablets | — | AB | FDA listed | — |
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⏳ Availability & generic status
This product is an FDA-approved generic. Other versions of the same drug are listed under Therapeutic equivalents, least expensive first.
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🔬 Reported adverse events (FAERS)
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📦 Packaging — all sizes for this product
| Package NDC | Description | Marketing start | Status |
|---|---|---|---|
| 63187-0008-06 You're viewing this | 6 TABLET in 1 BOTTLE (63187-008-06) | 2018-11-01 | Active |
| 63187-0008-10 | 10 TABLET in 1 BOTTLE (63187-008-10) | 2018-11-01 | Active |
| 63187-0008-14 | 14 TABLET in 1 BOTTLE (63187-008-14) | 2018-11-01 | Active |
| 63187-0008-20 | 20 TABLET in 1 BOTTLE (63187-008-20) | 2018-11-01 | Active |
| 63187-0008-28 | 28 TABLET in 1 BOTTLE (63187-008-28) | 2018-11-01 | Active |
| 63187-0008-40 | 40 TABLET in 1 BOTTLE (63187-008-40) | 2018-11-01 | Active |
You're viewing the smallest of 6 pack sizes for this product.
Pack size FAQ
What quantity is in NDC 63187-0008-06?
What is the difference between NDC 63187-0008-06 and NDC 63187-0008-10?
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🧭 About this NDC listing & data coverage
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| NDC identity (package / product / labeler codes) | ✓ Available |
| Labeler | ✓ Available |
| Product & package description | ✓ Available |
| Marketing category & status | ✓ Available |
| Active ingredient / dosage form / route | ✓ Available |
| FDA label (SPL via DailyMed) | ✓ Available |
| Package photos | ✓ Available |
| Inactive ingredients (structured) | ✓ Available |
| NADAC pharmacy acquisition price (CMS) | — Not published for this NDC CMS publishes NADAC only for NDCs reported in its retail-pharmacy survey. |
| Orange Book / therapeutic-equivalence data | ✓ Available |
| HCPCS J-code billing crosswalk | — Not published for this NDC Most self-administered / retail products have no J-code — that is normal. |
| Medicaid utilization (CMS SDUD) | — Not published for this NDC CMS reports utilization only for NDCs with Medicaid claims above its privacy threshold. |
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📄 Full prescribing information FDA SPL
🎯 Indications and Usage ▾
INDICATIONS AND USAGE To reduce the development of drug-resistant bacteria and maintain the effectiveness of sulfamethoxazole and trimethoprim tablets and other antibacterial drugs, sulfamethoxazole and trimethoprim tablets should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
Urinary Tract Infections For the treatment of urinary tract infections due to susceptible strains of the following organisms: Escherichia coli, Klebsiella species , Enterobacter species, Morganella morganii, Proteus mirabilis and Proteus vulgaris . It is recommended that initial episodes of uncomplicated urinary tract infections be treated with a single effective antibacterial agent rather than the combination. Acute Otitis Media For the treatment of acute otitis media in pediatric patients due to susceptible strains of Streptococcus pneumoniae or Haemophilus influenzae when in the judgment of the physician sulfamethoxazole and trimethoprim offers some advantage over the use of other antimicrobial agents.
To date, there are limited data on the safety of repeated use of sulfamethoxazole and trimethoprim in pediatric patients under two years of age. Sulfamethoxazole and trimethoprim is not indicated for prophylactic or prolonged administration in otitis media at any age. Acute Exacerbations of Chronic Bronchitis in Adults For the treatment of acute exacerbations of chronic bronchitis due to susceptible strains of Streptococcus pneumoniae or Haemophilus influenzae when in the judgment of the physician sulfamethoxazole and trimethoprim offers some advantage over the use of a single antimicrobial agent.
Shigellosis For the treatment of enteritis caused by susceptible strains of Shigella flexneri and Shigella sonnei when antibacterial therapy is indicated. Pneumocystis Carinii Pneumonia For the treatment of documented Pneumocystis carinii pneumonia and for prophylaxis against Pneumocystis carinii pneumonia in individuals who are immunosuppressed and considered to be at an increased risk of developing Pneumocystis carinii pneumonia. Traveler’s Diarrhea in Adults For the treatment of traveler’s diarrhea due to susceptible strains of enterotoxigenic E. coli .
⏱️ Dosage and Administration ▾
DOSAGE AND ADMINISTRATION Not recommended for use in pediatric patients less than 2 months of age. Urinary Tract Infections and Shigellosis in Adults and Pediatric Patients, and Acute Otitis Media in Children Adults: The usual adult dosage in the treatment of urinary tract infections is 1 sulfamethoxazole and trimethoprim DS (double strength) tablet every 12 hours for 10 to 14 days. An identical daily dosage is used for 5 days in the treatment of shigellosis.
Children: The recommended dose for children with urinary tract infections or acute otitis media is 40 mg/kg sulfamethoxazole and 8 mg/kg trimethoprim per 24 hours, given in two divided doses every 12 hours for 10 days. An identical daily dosage is used for 5 days in the treatment of shigellosis. The following table is a guideline for the attainment of this dosage: Children 2 months of age and older: Weight Dose – every 12 hours lb kg Tablets 22 10 - 44 20 1 66 30 1 ½ 88 40 2 or 1 DS tablet For Patients with Impaired Renal Function When renal function is impaired, a reduced dosage should be employed using the following table: Creatinine Clearance (mL/min) Recommended Dosage Regimen Above 30 Usual standard regimen 15-30 1/2 the usual regimen Below 15 Use not recommended Acute Exacerbations of Chronic Bronchitis in Adults The usual adult dosage in the treatment of acute exacerbations of chronic bronchitis is 1 sulfamethoxazole and trimethoprim double strength tablet or 2 sulfamethoxazole and trimethoprim tablets every 12 hours for 14 days.
Pneumocystis Carinii Pneumonia Treatment: Adults and Children: The recommended dosage for patients with documented Pneumocystis carinii pneumonia is 75 to 100 mg/kg sulfamethoxazole and 15 to 20 mg/kg trimethoprim per 24 hours given in equally divided doses every 6 hours for 14 to 21 days11. The following table is a guideline for the upper limit of this dosage. Weight Dose – every 6 hours lb kg Tablets 18 8 - 35 16 1 53 24 1 ½ 70 32 2 or 1 DS tablet 88 40 2 ½ 106 48 3 or 1 ½ DS tablets 141 64 4 or 2 DS tablets 176 80 5 or 2 ½ DS tablets For the lower limit dose (75 mg/kg sulfamethoxazole and 15 mg/kg trimethoprim per 24 hours) administer 75% of the dose in the above table.
Prophylaxis Adults The recommended dosage for prophylaxis in adults is 1 sulfamethoxazole and trimethoprim DS (double strength) tablet daily 12 Children For children, the recommended dose is 750 mg/m2/day sulfamethoxazole with 150 mg/m 2 /day trimethoprim given orally in equally divided doses twice a day, on 3 consecutive days per week. The total daily dose should not exceed 1600 mg sulfamethoxazole and 320 mg trimethoprim 13 The following table is a guideline for the attainment of this dosage in children: Body Surface Area Dose – every 12 hours (m2) Tablets 0.26 - 0.53 ½ 1.06 1 Traveler’s Diarrhea in Adults For the treatment of traveler’s diarrhea, the usual adult dosage is 1 sulfamethoxazole and trimethoprim DS (double strength) tablet or 2 sulfamethoxazole and trimethoprim tablets every 12 hours for 5 days.
⛔ Contraindications ▾
CONTRAINDICATIONS Sulfamethoxazole and trimethoprim is contraindicated in patients with a known hypersensitivity to trimethoprim or sulfonamides and in patients with documented megaloblastic anemia due to folate deficiency. Sulfamethoxazole and trimethoprim is also contraindicated in pregnant patients and nursing mothers, because sulfonamides pass the placenta and are excreted in the milk and may cause kernicterus. Sulfamethoxazole and trimethoprim is contraindicated in pediatric patients less than 2 months of age.
Sulfamethoxazole and trimethoprim is also contraindicated in patients with marked hepatic damage or with severe renal insufficiency when renal function status cannot be monitored.
⚠️ Warnings ▾
WARNINGS FATALITIES ASSOCIATED WITH THE ADMINISTRATION OF SULFONAMIDES, ALTHOUGH RARE, HAVE OCCURRED DUE TO SEVERE REACTIONS, INCLUDING STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, FULMINANT HEPATIC NECROSIS, AGRANULOCYTOSIS, APLASTIC ANEMIA AND OTHER BLOOD DYSCRASIAS. SULFONAMIDES, INCLUDING SULFONAMIDE-CONTAINING PRODUCTS SUCH AS SULFAMETHOXAZOLE/TRIMETHOPRIM, SHOULD BE DISCONTINUED AT THE FIRST APPEARANCE OF SKIN RASH OR ANY SIGN OF ADVERSE REACTION. In rare instances, a skin rash may be followed by a more severe reaction, such as Stevens-Johnson syndrome, toxic epidermal necrolysis, hepatic necrosis, and serious blood disorders (see PRECAUTIONS).
Clinical signs, such as rash, sore throat, fever, arthralgia, pallor, purpura or jaundice may be early indications of serious reactions. Cough, shortness of breath, and pulmonary infiltrates are hypersensitivity reactions of the respiratory tract that have been reported in association with sulfonamide treatment. Thrombocytopenia Sulfamethoxazole/Trimethoprim-induced thrombocytopenia may be an immune-mediated disorder.
Severe cases of thrombocytopenia that are fatal or life threatening have been reported. Thrombocytopenia usually resolves within a week upon discontinuation of sulfamethoxazole and trimethoprim. The sulfonamides should not be used for treatment of group alpha beta-hemolytic streptococcal infections.
In an established infection, they will not eradicate the streptococcus and, therefore, will not prevent sequelae such as rheumatic fever. Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including sulfamethoxazole and trimethoprim, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile .
C. difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use.
Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents. If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated.
🤒 Adverse Reactions ▾
ADVERSE REACTIONS The most common adverse effects are gastrointestinal disturbances (nausea, vomiting, anorexia) and allergic skin reactions (such as rash and urticaria). FATALITIES ASSOCIATED WITH THE ADMINISTRATION OF SULFONAMIDES, ALTHOUGH RARE, HAVE OCCURRED DUE TO SEVERE REACTIONS, INCLUDING STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, FULMINANT HEPATIC NECROSIS, AGRANULOCYTOSIS, APLASTIC ANEMIA AND OTHER BLOOD DYSCRASIAS (SEE WARNINGSSECTION). Hematologic : Agranulocytosis, aplastic anemia, thrombocytopenia, leukopenia, neutropenia, hemolytic anemia, megaloblastic anemia, hypoprothrombinemia, methemoglobinemia, eosinophilia.
Allergic Reactions : Stevens-Johnson syndrome, toxic epidermal necrolysis, anaphylaxis, allergic myocarditis, erythema multiforme, exfoliative dermatitis, angioedema, drug fever, chills, Henoch-Schoenlein purpura, serum sickness-like syndrome, generalized allergic reactions, generalized skin eruptions, photosensitivity, conjunctival and scleral injection, pruritus, urticaria and rash. In addition, periarteritis nodosa and systemic lupus erythematosus have been reported. Gastrointestinal: Hepatitis (including cholestatic jaundice and hepatic necrosis), elevation of serum transaminase and bilirubin, pseudomembranous enterocolitis, pancreatitis, stomatitis, glossitis, nausea, emesis, abdominal pain, diarrhea, anorexia.
Genitourinary : Renal failure, interstitial nephritis, BUN and serum creatinine elevation, toxic nephrosis with oliguria and anuria, crystalluria and nephrotoxicity in association with cyclosporine. Metabolic and Nutritional: Hyperkalemia (see PRECAUTIONS: Use in the Treatment of and Prophylaxis for Pneumocystis Carinii Pneumonia in Patients with Acquired Immunodeficiency Syndrome (AIDS). Neurologic : Aseptic meningitis, convulsions, peripheral neuritis, ataxia, vertigo, tinnitus, headache.
Psychiatric : Hallucinations, depression, apathy, nervousness. Endocrine : The sulfonamides bear certain chemical similarities to some goitrogens, diuretics (acetazolamide and the thiazides) and oral hypoglycemic agents. Cross-sensitivity may exist with these agents.
Diuresis and hypoglycemia have occurred rarely in patients receiving sulfonamides. Musculoskeletal: Arthralgia and myalgia. Isolated cases of rhabdomyolysis have been reported with sulfamethoxazole and trimethoprim, mainly in AIDS patients.
Respiratory : Cough, shortness of breath and pulmonary infiltrates (see WARNINGS). Miscellaneous : Weakness, fatigue, insomnia.
🆘 Overdosage ▾
OVERDOSAGE Acute The amount of a single dose of sulfamethoxazole and trimethoprim that is either associated with symptoms of overdosage or is likely to be life-threatening has not been reported. Signs and symptoms of overdosage reported with sulfonamides include anorexia, colic, nausea, vomiting, dizziness, headache, drowsiness and unconsciousness. Pyrexia, hematuria and crystalluria may be noted.
Blood dyscrasias and jaundice are potential late manifestations of overdosage. Signs of acute overdosage with trimethoprim include nausea, vomiting, dizziness, headache, mental depression, confusion and bone marrow depression. General principles of treatment include the institution of gastric lavage or emesis, forcing oral fluids, and the administration of intravenous fluids if urine output is low and renal function is normal.
Acidification of the urine will increase renal elimination of trimethoprim. The patient should be monitored with blood counts and appropriate blood chemistries, including electrolytes. If a significant blood dyscrasia or jaundice occurs, specific therapy should be instituted for these complications.
Peritoneal dialysis is not effective and hemodialysis is only moderately effective in eliminating sulfamethoxazole and trimethoprim. Chronic Use of sulfamethoxazole and trimethoprim at high doses and/or for extended periods of time may cause bone marrow depression manifested as thrombocytopenia, leukopenia and/or megaloblastic anemia. If signs of bone marrow depression occur, the patient should be given leucovorin 5 to 15 mg daily until normal hematopoiesis is restored.
🧬 Clinical Pharmacology ▾
CLINICAL PHARMACOLOGY Sulfamethoxazole and trimethoprim is rapidly absorbed following oral administration. Both sulfamethoxazole and trimethoprim exist in the blood as unbound, protein-bound and metabolized forms: sulfamethoxazole also exists as the conjugated form. The metabolism of sulfamethoxazole occurs predominately by N4-acetylation, although the glucuronide conjugate has been identified.
The principal metabolites of trimethoprim are the 1- and 3-oxides and the 3'- and 4'-hydroxy derivatives. The free forms of sulfamethoxazole and trimethoprim are considered to be the therapeutically active forms. Approximately 70% of sulfamethoxazole and 44% of trimethoprim are bound to plasma proteins.
The presence of 10 mg percent sulfamethoxazole in plasma decreases the protein binding of trimethoprim by an insignificant degree; trimethoprim does not influence the protein binding of sulfamethoxazole. Peak blood levels for the individual components occur 1 to 4 hours after oral administration. The mean serum half-lives of sulfamethoxazole and trimethoprim are 10 and 8 to 10 hours, respectively.
However, patients with severely impaired renal function exhibit an increase in the half-lives of both components, requiring dosage regimen adjustments (see DOSAGE AND ADMINISTRATION section). Detectable amounts of sulfamethoxazole and trimethoprim are present in the blood 24 hours after drug administration. During administration of 800 mg sulfamethoxazole and 160 mg trimethoprim bid, the mean steady-state plasma concentration of trimethoprim was 1.72 mg/mL.
The steady-state mean plasma levels for free and total sulfamethoxazole were 57.4 mg/mL and 68.0 mg/mL, respectively. These steady-state levels were achieved after three days of drug administration 1 . Excretion of sulfamethoxazole and trimethoprim is primarily by the kidneys through both glomerular filtration and tubular secretion.
Urine concentrations of both sulfamethoxazole and trimethoprim are considerably higher than are the concentrations in the blood. The average percentage of the dose recovered in urine from 0 to 72 hours after a single oral dose of sulfamethoxazole and trimethoprim is 84.5% for total sulfonamide and 66.8% for free trimethoprim. Thirty percent of the total sulfonamide is excreted as free sulfamethoxazole with the remaining as N4-acetylated metabolite.
2 When administered together as sulfamethoxazole and trimethoprim, neither sulfamethoxazole nor trimethoprim affects the urinary excretion pattern of the other Both sulfamethoxazole and trimethoprim distribute to sputum, vaginal fluid and middle ear fluid; trimethoprim also distributes to bronchial secretion, and both pass the palcental barrier and are excreted in human milk. Geriatric Pharmacokinetics: The pharmacokinetics of sulfamethoxazole 800 mg and trimethoprim 160 mg were studied in 6 geriatric subjects (mean age: 78.6 years) and 6 young healthy subjects (mean age: 29.3 years) using a non-US approved formulation.
Pharmacokinetic values for sulfamethoxazole in geriatric subjects were similar to those observed in young adult subjects. The mean renal clearance of trimethoprim was significantly lower in geriatric subjects compared with young adult subjects (19 mL/h/kg vs. 55 mL/h/kg).
However, after normalizing by body weight, the apparent total body clearance of trimethoprim was on average 19% lower in geriatric subjects compared with young adult subjects. 3 Microbiology: Sulfamethoxazole inhibits bacterial synthesis of dihydrofolic acid by competing with para-aminobenzoic acid (PABA). Trimethoprim blocks the production of tetrahydrofolic acid from dihydrofolic acid by binding to and reversibly inhibiting the required enzyme, dihydrofolate reductase.
Thus, sulfamethoxazole and trimethoprim blocks two consecutive steps in the bio-synthesis of nucleic acids and proteins essential to many bacteria. In vitro studies have shown that bacterial resistance develops more slowly with both sulfamethoxazole and trimethoprim in…
📦 How Supplied / Storage and Handling ▾
HOW SUPPLIED Sulfamethoxazole and trimethoprim Double Strength tablets (white, scored, oblong), containing 800 mg sulfamethoxazole and 160 mg trimethoprim-bottles of 40 (NDC 63187-008-40). Imprint on tablets: VP 120. • Simvastatin tablets USP 10 mg are brick red coloured, oval shaped, biconvex, film-coated tablets, debossed "S 4" on one side and plain on other side. Bottles of 06 Tablets (NDC 63187-008-06) Bottles of 10 Tablets (NDC 63187-008-10) Bottles of 14 Tablets (NDC 63187-008-14) Bottles of 20 Tablets (NDC 63187-008-20) Bottles of 28 Tablets (NDC 63187-008-28) Bottles of 40 Tablets (NDC 63187-008-40) TABLETS SHOULD BE STORED AT 20° TO 25° C (68° to 77°F) ) [see USP Controlled Room Temperature].
DISPENSE IN TIGHT, LIGHT-RESISTANT CONTAINER.
📋 Description ▾
DESCRIPTION Sulfamethoxazole and Trimethoprim is a synthetic antibacterial combination product available in 800 mg sulfamethoxazole and 160 mg trimethoprim Double Strength tablets and 400 mg sulfamethoxazole and 80 mg trimethoprim tablets for oral administration. Each Double Strength tablet contains 800 mg sulfamethoxazole and 160 mg trimethoprim plus magnesium stearate, pregelatinized starch and sodium starch glycolate. Each tablet contains 400 mg sulfamethoxazole and 80 mg trimethoprim plus magnesium stearate, pregelatinized starch, and sodium starch glycolate.
Trimethoprim is 2, 4-diamino-5-(3,4,5 trimethoxybenzyl) pyrimidine: the molecular formula is C 14 H 18 N 4 O 3 . It is a white to light yellow, odorless, bitter compound with a molecular weight of 290.3 and the following structural formula: Sulfamethoxazole is N1-(5-methyl-3-isoxazolyl) sulfanilamide; the molecular formula is C10H11N3O3S. It is almost white, odorless, tasteless compound with a molecular weight of 253.28 and the following structural formula: chemical structure chemical structure