|
|
Trimethoprim
Pham P and Bartlett JG
06-17-2008
-
Available formulation in Zambia: Tablet: 100 mg; 200 mg.
- May be used for acute uncomplicated urinary tract infections (UTI) caused by susceptible organisms and prophylaxis of UTIs.
- UTI, uncomplicated: 100 mg PO twice a day or 200 mg PO once a day for 10 days.
- PCP treatment (mild to moderately severe): dapsone 100 mg qd + TMP 5mg/kg q8h.
Zambia Information Author: Paul A. Pham, Pharm. D.
-
Urinary tract infections (uncomplicated)
-
Pneumocystis jiroveci pneumonia (in combination with dapsone)
-
Campylobacter jejuni
brand
name
| generic
| Mfg
| brand
forms
| cost*
|
| Proloprim | Trimethoprim | ~Various generic manufacturer | PO
tab
100mg | $0.69 |
| Primsol | Trimethoprim | Taro | PO
sol
50mg/5mL (473mL) | $116.25 |
*Prices represent cost per unit specified and are representative of "Average Wholesale Price" (AWP).
AWP Prices were obtained and gathered by Lakshmi Vasist Pharm D using the Red Book, manufacturer's
information, and the McKesson database.
^Dosage is indicated in mg unless otherwise noted.
- Uncomplicated UTI: 200 mg PO daily in 1-2 doses (note: TMP/SMX preferred for this indication, but TMP alone used if sulfa intolerant)
- Mild-moderate PCP: TMP 5mg/kg PO q8h + dapsone 100mg PO once daily.
Usual dose.
UTI: 100mg q24h. PCP: 5mg/kg q8-12h.
Manufacturer recommends avoiding, but for PCP: 5-7.5mg/kg/day (1/2-1/3 standard dose).
5-7.5 mg/kg/d. On days of HD, dose 4-5 mg/kg post dialysis.
100-200 mg q48h.
No data. see TMP/SMX.
- Megaloblastic anemia
-
Neutropenia
-
Thrombocytopenia
- Reversible hyperkalemia (with high dose trimethoprim)
- Liver enzyme elevation
- Pancytopenia
- Rash and pruritis
- Erythema multiforme, Stevens-Johnson syndrome and TEN (unclear association)
- Methotrexate: plasma concentration of methotrexate may be increased due to decreased renal clearance. Monitor for pancytopenia with co-administration. Dose of methotrexate may need to be decreased.
- Dapsone: increased serum level of both dapsone (40%) and trimethoprim (48%).This interaction may be beneficial in the treatment of Pneumocystis carinii Pneumonia. No dose adjustment needed.
- Procainamide: elevated procainamide and N-acetylprocainamide (NAPA) serum level secondary to competitive inhibition of renal tubular secretion between trimethoprim and procainamide. Monitor serum level of procainamide and N-acetylprocainamide in addition to monitoring EKG for QTc prolongation and arrythmia.
- Phenytoin: phenytoin concentration may be increased due to trimethoprim Inhibition of hepatic metabolism Management recommendation / Monitor to phenytoin toxicity (drowsiness, nystagmus, dysarthria and tremor) and serum level. Dose may need to be adjusted.
E. coli
Generally used in combination with sulfamethoxazole. Only acceptable indication for monotherapy is acute uncomplicated UTI. TMP/dapsone is an alternative to TMP/SMX in the treatment of mild to moderately severe PCP, but should not be used with severe disease.
|
|
![Johns Hopkins POC-IT: Point of Care Information Technology [Home]](../../images/pocit_logo.gif){kind=logo}
Help
