Trimethoprim-Sulfamethoxazole

Oral Bioavailability

Excellent

Approximate Cost

Dosing

Renal adjustments required when CrCl < 30 mL/min

General Information

Acceptable Uses

Bactrim, Septra

Adverse Effects

  • Rash

  • GI upset

  • Nausea

  • Renal dysfunction (worse with IV)

  • Hyperkalemia (worse with IV)

Rare

  • Stevens-Johnson syndrome

  • Bone marrow suppression (worse with IV)

Major Interactions

Inhibitor of CYP450 system

Oral Liquids

200mg/5mL - 40mg/5mL suspension

Tablet/Capsule Strengths

  • 400mg - 80mg (SS)

  • 800mg - 160mg (DS)

Additional Information

  • IV solution requires large fluid volumes.

  • Drug of choice for Pneumocystis jirovecii pneumonia

Pharmacology

Pharmacology: Inhibits folic acid synthesis

Antimicrobial class: Sulfonamide - DHFR inhibitor

Pregnancy category: C

Average serum half life: 10 hours

Route of Elimination: Renal

Metabolism: Partial hepatic