"Cotrimoxazole"( tablets): instructions for use, composition, prices, reviews

According to the instructions, "Cotrimoxazole" in tablets is an antibacterial medicament for a wide range of effects, and also has bactericidal and antiprotozoal properties.

Pharmacology of the drug

The drug is active against a number of Gram-positive and Gram-negative strains that are resistant to sulfonamides.

What is the composition of the Cotrimoxazole tablets? The main components of the drug are sulfamethoxazole( sulfamethoxazole) and trimethoprim( trimethoprim), which provide a bactericidal effect.

The mechanism of action is due to the presence of a double blocking effect on the metabolism of bacteria. The substance sulfamethoxazole is similar in structure to aminobeyzoic acid, which prevents the inclusion of this element in the molecule of the dihydrofolic component. Trimethoprim is able to reversibly inhibit the dihydrofolate reductase of certain bacteria, disrupting the process of synthesis of tetrahydrofolic acid from its dihydrofolic analogue, and also promotes the formation of pyrimidine and purine bases and nucleic substances, suppressing growth along with the multiplication of microorganisms. This is confirmed by the instruction attached to the tablets "Cotrimoxazole".

As there is an oppression of the vital activity of Escherichia coli, the synthesis of riboflavin, thiamine, nicotinic acid and other vitamins from complex "B" of the group in the digestive system is abolished.

Immediately after ingestion, these components are almost completely and, importantly, quickly absorbed in the gastrointestinal system. Antibacterial concentration in the blood on this background persists for seven hours, and a day after a single application in the plasma can be seen only small amounts. The equilibrium content in the blood plasma is recorded after two to three days. Forty-four percent of trimethoprim and seventy sulfamethoxazole are localized in a state combined with plasma proteins. All these components are biologically transformed in the liver, that is, acetylation occurs along with the formation of inactive metabolites. This is indicated by the instruction attached to the preparation "Cotrimoxazol"( Cotrimoxazol).

The following elements are distributed evenly in the body and pass through the histohematetic barriers, creating concentrations in urine and lungs that exceed the presence of such components in the plasma itself. To a lesser extent, there is accumulation in the area of ​​bronchial secretion, vaginal discharge, and also in the area of ​​prostate tissue, liquid consistency of the middle ear, spinal substances, bones and bile. The same applies to saliva, watery eyes, breast milk and interstitial fluid. Eliminations have the same speed. Description of the drug "Cotrimoxazole" does not end there.

In children

In children, the degree of assimilation is much smaller, and this directly depends on their age. For example, up to one year the process takes from seven to eight hours, and from two to ten years it will take a little less - from five to six. Among the elderly and patients with impaired renal function, the time for assimilation is also increasing. The kidneys are excreted in the form of metabolites, it occurs in unchanged form, namely, from fifty to seventy percent of trimethoprim and from ten to thirty sulfamethoxazole is eliminated. What else describes the instructions to the tablets "Cotrimoxazole" instruction?

Indications for use of the drug

As a rule, the described agent is prescribed by doctors against the background:

• Infections occurring in the urogenital system, for example, with epididymitis and gonorrhea, both with regard to male and female forms. In addition, the medicine will be relevant in case of soft chancre, venereal and inguinal lymphogranuloma.
• Pathology of the respiratory tract, for example, with acute or chronic bronchitis, croupous pneumonia.
• Otorhinolaryngological diseases, that is, with average otitis media, sinusitis, laryngitis, angina or scarlet fever.
• Diseases of the digestive system, namely, typhoid fever, salmonella, cholera, dysentery, cholecystitis, cholangitis, gastroenteritis, which is caused by enterotoxic strains.
• Skin infections: acne, pyoderma, furunculosis.
• Acute or chronic osteomyelitis.
• With brucellosis, South American blastomycosis, malaria, toxoplasmosis as part of complex therapy.

To tablets "Cotrimoxazole" instruction is very detailed.

Active substance and dosage form

The active ingredient of this drug is a similar substance, called "co-trimoxazole".This basic element of the composition has antimicrobial combined properties.

For the treatment with this medication, a concentrate solution for infusion along with syrup and a suspension for internal administration has been developed. Another form of medicine are tablets that are coated. The cost of the drug ranges from twenty to one hundred rubles, depending on the type of packaging.

Contraindications on the use of

Do not take oral tablets Cotrimoxazole in a number of the following cases:

• The presence of hypersensitivity, including sulfonamides.
• Development of hepatic and renal failure.
• Aplastic and B12 deficiency anemia, as well as agranulocytosis and leukopenia.
• Against the backdrop of deficiency of glucose-6-phosphate dehydrogenase.
• During pregnancy and lactation.
• In the case of pneumocystis pneumonia.
• At the age of up to six years and with the development of hyperbilirubinemia in children.
• C with extreme caution in the deficiency of folic acid, bronchial asthma, thyroid diseases.

This is confirmed by the instruction "Cotrimoxazole".Indications and contraindications should be strictly observed.

Dosage and administration of the drug

Adults and children over the age of twelve pills are taken orally at 960 milligrams once or twice a day twice a day. Against the backdrop of a severe course of infections, you should consume 480 milligrams three times a day, and with chronic infections, the same number is considered the supporting norm, but twice a day.

Children under two years of age are given a drug in the amount of 120 milligrams twice a day. At the age from two to six years - 240 milligrams twice a day

The minimum duration of treatment is, as a rule, four days. Immediately after the elimination of symptoms, therapy should continue for another two days. Against the background of chronic infections, the course of therapy should become longer. For example, in acute brucellosis it will be between three and four weeks, and with typhoid fever or paratyphoid it will take from one to three months. To the preparation "Cotrimoxazole" instruction for use( annotation) is available in each package.

For the prevention of recurrence of urinary tract infections for adults and children, prescribe 480 mg once a day at night. Young children and adolescents under the age of twelve can take 11 milligrams per kilogram of weight. The duration of such treatment is from three months to one year.

When taking a course of treatment for acute cystitis in children who are between the ages of seven and sixteen, you must take inside at 480 milligrams per day for three days. In the case of gonorrhea, patients take 2,000 milligrams for three doses. With gonorrheal pharyngitis, if there is an increased sensitivity to penicillin, eat 4000 milligrams once a day for a week. To achieve maximum efficacy, a regular concentration of trimethoprim in plasma or serum should be kept at a certain level.

This is confirmed to the "Cotrimoxazole" instructions for use and reviews.

Adverse actions on the basis of the use of the drug

When treatment with the use of the drug "Cotrimoxazole" is likely the manifestation of certain side effects and undesirable symptoms.

From the nervous system side, headaches and dizziness may occur. In a number of cases, aseptic meningitis, depression, apathy, tremor, and peripheral neuritis appear.

A malfunction in the digestive system is usually accompanied by nausea, vomiting, decreased appetite, diarrhea, gastritis and abdominal pain. In addition, the body's reaction can be expressed glossitis, stomatitis, cholestasis, increased activity of hepatic transaminases, as well as hepatitis, hepatonecrosis, pseudomembranous enterocolitis.

On the part of the respiratory system, some patients develop bronchospasm and pulmonary infiltrates.

Hematopoiesis reacts with leukopenia, neutropenia, thrombocytopenia, agranulocytosis, megaloblastic anemia.

With regard to the urinary system, there are polyuria, interstitial nephritis, renal dysfunction, crystalluria, hematuria, increased urea concentration, hypercreatininaemia, toxic nephropathy along with oliguria and anuria. From the musculoskeletal system arthralgia and myalgia occur.

If any undesirable effects occur, consult a doctor.

Allergic reactions are observed in the form of pruritus, photosensitivity, rash, multiforme exudative erythema, including Stevens-Johnson syndrome, toxic epidermal necrolysis, that is, Lyell's disease, as well as in the form of exfoliative dermatitis, allergic myocarditis, fever, angioneurotic edema andhyperemia sclera. Local reactions are expressed in thrombophlebitis in the area of ​​venipuncture and general soreness.

In the case of a general overdose of this drug, the body's reaction is accompanied by nausea, vomiting, intestinal colic, dizziness, drowsiness, depression, fainting. In addition, the negative influence is expressed in the confusion of consciousness, visual impairment, fever, hematuria, crystalluria. Against the background of a prolonged overdose, the onset of thrombocytopenia, leukopenia, megaloblastic anemia and jaundice is likely. The main treatment in this case should be gastric lavage. This is indicated by the instruction on the application to "Cotrimoxazole", and the description of the drug.

Specific guidance for the use of

As part of the use of Cotrimoxazole, the concentration of sulfamethoxazole, which is contained in the plasma, should be determined every two to three days before the next use. In the event that the volume exceeds one hundred and fifty micrograms per milliliter, treatment should be discontinued until it decreases by thirty units.

With long-term treatment courses( more than three months), regular blood tests are required, as there is a possibility of forming hematologic changes, most often without significant symptoms. These changes can be reversed if folic acid is started, which does not particularly interfere with the antimicrobial activity of the Cotrimoxazole tablets. The instruction for use confirms this.

It is particularly important to exercise with therapy in elderly patients or patients with suspected initial shortage of folate. The use of folic acid will be advisable and against long-term treatment in high doses.

For prophylactic purposes, it is recommended to maintain the necessary amount of urine in crystalline crystals. The risk of the onset of allergic and toxic complications of sulfonamide significantly increases with a decrease in the filtration function of the kidneys.

Against the background of treatment it is also forbidden to eat foods that contain in large quantities special substances from green parts of plants found in cauliflower, spinach, beans, carrots and tomatoes.

It is also important to avoid excessive sun and ultraviolet radiation. The risk of side effects increases dramatically for patients with AIDS.It is forbidden to use this drug for tonsillitis and pharyngitis, which are caused by beta-hemolytic group A streptococcus due to the widespread resistance of its strains. The complete information on the preparation "Cotrimoxazole" is presented above.

Reviews

As for the opinions of patients and customers, it can be said that in general people are satisfied with the results of the positive effect of this drug on their body. Patients write about the special effectiveness of "Cotrimoxazole" in the fight against viruses, as well as in the treatment of various infectious ailments.

Some people write in their comments that they do not like the drug because of the large list of side effects, the negative impact of which is confirmed by the patient's stories, cited as an example, where they report having headaches while taking medication, as well as nausea andother undesirable effects.

In the article the instruction is considered for the tablets "Cotrimoxazole".

Price

The cost of the drug is 30-50 rubles per package.