Co-trimoxazole

(coe try mox' a zole)

PCI  : Contraindicated in pregnancy

LCI  : Contraindicated in lactation

Molecule Info

 | See TERMINOLOGY & ABBREVIATIONS |
Indication(s) & Dosage Susceptible infections
Adult: 960 mg bid, up to 2.88 g daily given in 2 divided doses in severe cases.
Child: 6 wk-5 mth: 120 mg bid; 6 mth-5 yr: 240 mg bid; 6-12 yr: 480 mg bid.

Urinary tract infections
Adult: 960 mg bid, up to 2.88 g daily given in 2 divided doses in severe cases.
Child: 6 wk-5 mth: 120 mg bid; 6 mth-5 yr: 240 mg bid; 6-12 yr: 480 mg bid.

Gastrointestinal infections
Adult: 960 mg bid, up to 2.88 g daily given in 2 divided doses in severe cases.
Child: 6 wk-5 mth: 120 mg bid; 6 mth-5 yr: 240 mg bid; 6-12 yr: 480 mg bid.

Respiratory tract infections
Adult: 960 mg bid, up to 2.88 g daily given in 2 divided doses in severe cases.
Child: 6 wk-5 mth: 120 mg bid; 6 mth-5 yr: 240 mg bid; 6-12 yr: 480 mg bid.

Pneumocystis (carinii) jiroveci pneumonia
Adult: Up to 120 mg/kg/day in 2-4 divided doses for 14-21 days.
Child: >4 wk: Up to 120 mg/kg daily given in 2-4 divided doses for 14-21 days. 


Prophylaxis of susceptible infections in AIDS patients
Adult: 960 mg daily.
Child: 450 mg/m2 (max: 960 mg) bid for 3 days in each wk, either consecutively or on alternate days.

Renal impairment: Dosage reduction for adults and children >12 yr:

CrCl (ml/min) Dosage Recommendation
15-30 Half the standard dose.
<15 Not recommended.
Hepatic impairment: Avoid in severe impairment.
Overdose Nausea, vomiting, diarrhoea, mental depression, confusion, facial swelling, headache, bone marrow depression and slight elevations of serum transaminases. Empty stomach immediately by inducing emesis or by lavage. Treatment is supportive and symptomatic with monitoring of blood counts and other appropriate laboratory studies (e.g. serum electrolyte concentrations). Haemodialysis may remove only moderate amounts of the drug while peritoneal dialysis is not useful in drug removal.
Contraindications Hypersensitivity; severe renal or hepatic insufficiency; infants <4 wk; megaloblastic anaemia; pregnancy and lactation.
Special Precautions G6PD deficiency; potential folate deficiency; hepatic and renal impairment; elderly; porphyria; thyroid dysfunction; maintain adequate hydration.
Adverse Drug Reaction(s) Renal failure, nausea, vomiting, diarrhoea, anorexia; skin rashes, urticaria.
Potentially Fatal: Stevens-Johnson syndrome, agranulocytosis, toxic epidermal necrolysis, hepatic necrosis.
Drug Interactions Reduced ciclosporin concentrations in blood when used concurrently. Increases toxicity of methotrexate. Inhibits phenytoin clearance. Potentiates warfarin and oral hypoglycaemics.
Potentially Fatal: Co-admin with pyrimethamine causes megaloblastic anaemia. Enhancement of renal damage by ciclosporin. Please consult manufacturer's PIL (Prescribing Information Leaflet) for detailed drug interactions.
Lab Interference May also interfere with serum methotrexate assay when using the competitive binding protein technique. May interfere with the Jaffe's reaction assay for creatinine.
Storage Oral: Store at 15-25°C.
Pharmacology Co-trimoxazole exhibits the synergistic actions of its components (sulfamethoxazole and trimethoprim) by 10-fold. Sulfamethoxazole inhibits dihydrofolic acid formation from PABA, thus interfering with synthesis and growth of bacterial folic acid. Trimethoprim inhibits enzymes folic acid pathway, preventing the reaction of the dihydrolic acid to tetrahydrofolate. Co-trimoxazole possesses bactericidal effects against E coliKlebsiella spp,Enterobacter spp, M morganiiP mirabilisP vulgarisH influenzaeStrep pneumoniaePneumocystis (carinii) jiroveciCyclospora spp.
Absorption: Oral: Almost complete (90-100%). Time to peak, serum: Within 1-4 hr.
Distribution: Protein binding: Sulfamethoxazole: 68%; Trimethoprim: 45%.
Metabolism: Sulfamethoxazole: N-acetylated and glucuronidated; Trimethoprim: Metabolised to oxide and hydroxylated metabolites.
Excretion: Both are removed in urine as metabolites and unchanged drug.
ATC Classification J01EA01 - trimethoprim; Belongs to the class of trimethoprim and derivatives. Used in the treatment of systemic infections. 
J01EC01 - sulfamethoxazole; Belongs to the class of intermediate-acting sulfonamides. Used in the treatment of systemic infections.

Brand/Product Info


Total Products : 106                                                                                                          
Brand Name Manufacturer/Marketer Composition Dosage Form Pack Size & Price
ACTRIM Globe Pharmaceuticals Ltd Co-trimoxazole 480mg Tablet 100's: 90.00 MRP
ACTRIM Suspension Globe Pharmaceuticals Ltd Co-trimoxazole 240mg/5ml Suspension 60ml: 22.00 MRP
ACTRIM-DS Globe Pharmaceuticals Ltd Co-trimoxazole 960mg Tablet 100's: 140.00 MRP
ALCOT Pacific Pharmaceuticals Ltd. Co-trimoxazole 480mg Tablet 100's: 100.00 MRP
ALCOT Suspension Pacific Pharmaceuticals Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 20.00 MRP
ALCOT-DS Pacific Pharmaceuticals Ltd. Co-trimoxazole 960mg (double strength) Tablet 100's: 200.00 MRP
APCETRIM APC Pharmaceuticals Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 20.00 MRP
APTRIM Apollo Pharmaceutical Laboratories Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 20.54 MRP
AVLOTRIN ACI Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 21.57 MRP
AVLOTRIN DS ACI Ltd. Co-trimoxazole 960mg (double strength) Tablet 100's: 201.00 MRP
BACTIPRONT Renata Limited Co-trimoxazole 480mg Tablet 100's: 148.00 MRP
BACTIPRONT P-120 Renata Limited Co-trimoxazole 120mg Tablet 100's: 48.00 MRP
BACTIPRONT Suspension Renata Limited Co-trimoxazole 240mg/5ml Suspension 60ml: 22.06 MRP
BACTIPRONT-DS Renata Limited Co-trimoxazole 960mg Tablet 100's: 202.00 MRP
BIOTRIM Biopharma Laboratories Ltd Co-trimoxazole 480mg Tablet 100's: 149.00 MRP
BIOTRIM Suspension Biopharma Laboratories Ltd Co-trimoxazole 240mg/5ml Suspension 60ml: 21.56 MRP
BIOTRIM-DS Biopharma Laboratories Ltd Co-trimoxazole 960mg (double strength) Tablet 100's: 201.00 MRP
CENTRIM Central Pharmaceuticals Ltd Co-trimoxazole 240mg/5ml Suspension 60ml: 20.00 MRP
CENTRIM-DS Central Pharmaceuticals Ltd Co-trimoxazole 960mg Tablet 100's: 200.00 MRP
CO-TRY Ad-din pharmaceuticals Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 21.50 MRP
CO-TRY-DS Ad-din pharmaceuticals Ltd. Co-trimoxazole 960mg (double strength) Tablet 100's: 186.00 MRP
COSAT Eskayef Bangladesh Ltd Trimethoprim BP 40mg + Sulphamethoxazole BP 200mg Suspension 60ml MRP: 22.00
COSAT DS Eskayef Bangladesh Ltd Trimethoprim BP 160mg + Sulphamethoxazole BP 800mg Tablet 100's MRP: 202.00
COTRAZEN Zenith Pharmaceuticals Ltd. Co-trimoxazole 480mg Tablet 100's: 130.00 MRP
COTRAZEN DS Zenith Pharmaceuticals Ltd. Co-trimoxazole 960mg (double strength) Tablet 100's: 200.00 MRP
COTRAZEN Suspension Zenith Pharmaceuticals Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 21.22 MRP
COTRIM Square Pharmaceuticals Ltd. Sulphamethoxazole + Trimethoprim (400mg + 80mg) Tablet 10x10's: 149.00 MRP
COTRIM DS Square Pharmaceuticals Ltd. Sulphamethoxazole + Trimethoprim (800mg + 160mg) Tablet 10x10's: 204.00 MRP
COTRIM SUSP Square Pharmaceuticals Ltd. Sulphamethoxazole + Trimethoprim (200mg + 40mg /5 ml) Suspension 60 ml: 21.64 MRP
COTRIMOX Indo-Bangla Pharmaceuticals Works Ltd. Co-trimoxazole 480mg Tablet 100's: 135.00 MRP
COTRIMOX Suspension Indo-Bangla Pharmaceuticals Works Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 21.00 MRP
COTRIMOX-DS Indo-Bangla Pharmaceuticals Works Ltd. Co-trimoxazole 960mg (double strength) Tablet 100's: 200.00 MRP
COTS Opsonin Pharma Limited Co-trimoxazole 240mg/5ml Suspension 60ml: 21.25 MRP
DECATRIM Decent Pharma Laboratories Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 21.83 MRP
DECATRIM DS Decent Pharma Laboratories Ltd. Co-trimoxazole 960mg (double strength) Tablet 100's: 150.00 MRP
DEOTRIM Desh Pharmaceuticals (Pvt) Ltd Co-trimoxazole 480mg Tablet 100's: 120.00 MRP
DEOTRIM Suspension Desh Pharmaceuticals (Pvt) Ltd Co-trimoxazole 240mg/5ml Suspension 60ml: 21.80 MRP
DEOTRIM-DS Desh Pharmaceuticals (Pvt) Ltd Co-trimoxazole 960mg (double strength) Tablet 100's: 200.00 MRP
DOCTRIM Doctors Chemical Works Ltd Co-trimoxazole 240mg/5ml Suspension 60ml: 21.00 MRP
EDITRIM Edruc Limited Co-trimoxazole 240mg/5ml Suspension 60ml: 21.50 MRP
EDITRIM-DS Edruc Limited Co-trimoxazole 960mg (double strength) Tablet 100's: 202.00 MRP
FISAT Sanofi Co-trimoxazole 480mg Tablet 100's: 151.00 MRP
FISAT-DS Sanofi Co-trimoxazole 960mg Tablet 100's: 264.00 MRP
G-COTRIMOXAZOLE Gonoshasthaya Pharmaceuticals Ltd Co-trimoxazole 480mg Tablet 100's, 500's pot: 121.00 & 605.00 MRP
G-COTRIMOXAZOLE DS Gonoshasthaya Pharmaceuticals Ltd Co-trimoxazole 960mg (double strength) Tablet 100's: 177.00 MRP
G-COTRIMOXAZOLE Suspension Gonoshasthaya Pharmaceuticals Ltd Co-trimoxazole 240mg/5ml Suspension 50ml, 100ml: 19.00 & 28.10 MRP
GENTRIM General Pharmaceuticals Ltd Co-trimoxazole 480mg Tablet 100's: 149.00 MRP
GENTRIM Suspension General Pharmaceuticals Ltd Co-trimoxazole 240mg/5ml Suspension 60ml: 22.13 MRP
JASOTRIM Jayson Pharmaceuticals Ltd. Co-trimoxazole 480mg Tablet 100's: 149.00 MRP
JASOTRIM Suspension Jayson Pharmaceuticals Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 21.61 MRP
K-TRIM Kemiko Pharmaceuticals Ltd Co-trimoxazole 240mg/5ml Suspension 60ml: 20.00 MRP
LITRIM Millat Pharmaceuticals Ltd Co-trimoxazole 240mg/5ml Suspension 60ml: 21.05 MRP
LITRIM-DS Millat Pharmaceuticals Ltd Co-trimoxazole 960mg (double strength) Tablet 100's: 202.00 MRP
M-TRIM Modern Pharmaceuticals Ltd Co-trimoxazole 480mg Tablet 100's: 146.00 MRP
M-TRIM DS Modern Pharmaceuticals Ltd Co-trimoxazole 960mg (double strength) Tablet 100's: 202.00 MRP
M-TRIM Suspension Modern Pharmaceuticals Ltd Co-trimoxazole 240mg/5ml Suspension 60ml: 21.24 MRP
MEDITRIM Medimet Pharmaceuticals Ltd Co-trimoxazole 480mg Tablet 100's: 148.00 MRP
MEDITRIM Suspension Medimet Pharmaceuticals Ltd Co-trimoxazole 240mg/5ml Suspension 60ml: 20.00 MRP
MEDITRIM-120 Medimet Pharmaceuticals Ltd Co-trimoxazole 120mg Tablet 100's: 130.00 MRP
MEDITRIM-DS Medimet Pharmaceuticals Ltd Co-trimoxazole 960mg (double strength) Tablet 50's: 130.00 MRP
MEGASET Alco Pharma Ltd Co-trimoxazole 960mg Tablet 100's: 202.00 MRP
MEGATRIM DS Beximco Pharmaceuticals Ltd Trimethoprim BP 160mg + Sulphamethoxazole BP 800mg Tablet 150's: 390.00 MRP
MEGATRIM SUSPENSION Beximco Pharmaceuticals Ltd Trimethoprim BP 40mg + Sulphamethoxazole BP 200mg Suspension 60ml: 22.10 MRP
NAVATRIM Navana Pharmaceuticals Limited Co-trimoxazole 240mg/5ml Suspension 60ml: 21.07 MRP
NAVATRIM DS Navana Pharmaceuticals Limited Co-trimoxazole 960mg (double strength) Tablet 100's: 201.00 MRP
NEOSET Alco Pharma Ltd Co-trimoxazole 480mg Tablet 100's: 142.00 MRP
NEOSET Suspension Alco Pharma Ltd Co-trimoxazole 240mg/5ml Suspension 60ml: 20.99 MRP
NEOTRIM Medicon Laboratories Ltd Co-trimoxazole 240mg/5ml Suspension 60ml: 22.00 MRP
OCTRIM Orion Pharma Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 21.08 MRP
PABA Belsen Pharmaceuticals Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 20.00 MRP
PHARMATRIM Pharmadesh Laboratories Limited Co-trimoxazole 480mg Tablet 100's: 130.00 MRP
PHARMATRIM Suspension Pharmadesh Laboratories Limited Co-trimoxazole 240mg/5ml Suspension 60ml: 21.58 MRP
PHARMATRIM-DS Pharmadesh Laboratories Limited Co-trimoxazole 960mg (double strength) Tablet 100's: 219.00 MRP
POLITRIM The Acme Laboratories Ltd. Co-trimoxazole 480mg Tablet 100's: 142.00 MRP
POLITRIM Suspension The Acme Laboratories Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 21.58 MRP
POLITRIM-DS The Acme Laboratories Ltd. Co-trimoxazole 960mg (double strength) Tablet 100's: 264.00 MRP
SALTRIM Salton Pharmaceuticals Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 21.08 MRP
SALTRIM DS Salton Pharmaceuticals Ltd. Co-trimoxazole 960mg (double strength) Tablet 50's: 100.50 MRP
SEEMATRIN Seema Pharmaceuticals Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 24.00 MRP
SEFTRIM Hudson Pharmaceuticals Ltd Co-trimoxazole 240mg/5ml Suspension 60ml: 17.00 MRP
SEFTRIM-DS Hudson Pharmaceuticals Ltd Co-trimoxazole 960mg (double strength) Tablet 100's: 150.00 MRP
SEMOTRIM Reliance Pharmaceuticals Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 22.00 MRP
SEMOTRIM DS Reliance Pharmaceuticals Ltd. Co-trimoxazole 960mg (double strength) Tablet 100's: 206.00 MRP
SEPTRA Asiatic Laboratories Ltd. Co-trimoxazole 480mg Tablet 100's: 149.00 MRP
SEPTRA Suspension Asiatic Laboratories Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 21.57 MRP
SEPTRA-DS Asiatic Laboratories Ltd. Co-trimoxazole 960mg (double strength) Tablet 100's: 203.00 MRP
SINATRIM IBN SINA Pharmaceutical Industry Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 22.00 MRP
SINATRIM-DS IBN SINA Pharmaceutical Industry Ltd. Co-trimoxazole 960mg (double strength) Tablet 100's: 210.00 MRP
SITRIM Silva Pharmaceuticals Limited Co-trimoxazole 240mg/5ml Suspension 60ml: 20.07 MRP
SITRIM DS Silva Pharmaceuticals Limited Co-trimoxazole 960mg (double strength) Tablet 100's: 200.75 MRP
SOMA-DS Ambee Pharmaceuticals Ltd. Co-trimoxazole 960mg (double strength) Tablet 100's: 203.00 MRP
SULPHATRIM Amico Laboratories Ltd. Co-trimoxazole 480mg Tablet 100's: 149.00 MRP
SULPHATRIM Suspension Amico Laboratories Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 22.10 MRP
SULPHATRIM-DS Amico Laboratories Ltd. Co-trimoxazole 960mg (double strength) Tablet 100's: 250.00 MRP
SULPRIM Somatec Pharmaceuticals Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 21.07 MRP
SULPRIM DS Somatec Pharmaceuticals Ltd. Co-trimoxazole 960mg (double strength) Tablet 100's: 201.00 MRP
SUMETROLIM Ambee Pharmaceuticals Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 21.61 MRP
SUPRIM Nipa Pharmaceuticals Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 20.00 MRP
SUPRIM-DS Nipa Pharmaceuticals Ltd. Co-trimoxazole 960mg (double strength) Tablet 50's: 101.00 MRP
SYTRIM Syntho Laboratories Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 21.25 MRP
SYTRIM DS Syntho Laboratories Ltd. Co-trimoxazole 960mg (double strength) Tablet 50's: 100.00 MRP
TRICOT Reman Drug Laboratories Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 21.50 MRP
TRICOT-DS Reman Drug Laboratories Ltd. Co-trimoxazole 960mg (double strength) Tablet 100's: 210.00 MRP
TRIMETRIN Aexim Pharmaceutical Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 21.00 MRP
TRIPRIM Supreme Pharmaceuticals Ltd. Co-trimoxazole 240mg/5ml Suspension 60ml: 21.00 MRP
TRIPRIM-DS Supreme Pharmaceuticals Ltd. Co-trimoxazole 960mg (double strength) Tablet 100's: 200.00 MRP