cotrimoxazol (trimethoprim + sulfamethoxazol)

J - Antiinfectives For Systemic Use -> J01 - Antibacterials For Systemic Use -> J01E - Sulfonamides And Trimethoprim -> J01EE - Combinations Of Sulfonamides And Trimethoprim, Incl. Derivatives -> J01EE01 - Sulfamethoxazole And Trimethoprim
Administration category: Free Medicine group: antibacterial File parts: sulfamethoxazol trimethoprim Brand name: Bactrimel

Safety margins

≥ 18 years
WeightROADosage
ROA:
po
Dosage:
min. 400/80mg 1 dd to max. 1600/320mg 3 dd
ROA:
iv
Dosage:
min. 400/80mg 1 dd to max. 1600/320mg 3 dd

Kidney function

≥ 18 years
ROAGFRDosageIntervalComments
ROA: po
GFR:
10 - 30
Dosage:
50%
GFR:
<10
Dosage:
do not prescribe
ROA: iv
GFR:
10 - 30
Dosage:
50%
GFR:
<10
Dosage:
do not prescribe

Notes GFR general:

Volwassenen: bij PCP:
normale nierfunctie: 25/5 mg/kg 3 dd iv/po.
GFR 50-100 ml/min: 25/5 mg/kg 2-3 dd iv/po.
GFR 10-50 ml/min: 25/5 mg/kg 1-2 dd iv/po.
GFR < 10 ml/min: 12.5/2.5 mg/kg 1 dd iv/po.  

Renal elimination: 20%

Renal function-replacement therapy

CAPD: not dialized - Cotrimoxazol wordt niet of nauwelijks verwijderd door peritoneale dialyse. 800 mg sulfamethoxazol + 160 mg trimethoprim 1x per dag. PCP: 12.5/2.5 mg/kg 1 dd iv/po. Bij behandeling langer dan 1 week monitor de N4-acetylmetaboliet

Hemo dialysis: Intermitterende hemodialyse: 800 mg sulfamethoxazol + 160 mg trimethoprim 1x per dag, op dialysedagen toedienen na de dialyse. PCP: 12.5/2.5 mg/kg na elke dialyse iv/po. Monitor de N4-acetylmetaboliet.

CAV / VVHD: Continue hemodialyse: 1600 mg sulfamethoxazol + 320 mg trimethoprim 3x per dag gedurende de eerste 48h (72h bij PCP). Vervolgens 1600 mg SMX + 320 mg TMP 1x per dag (2x per dag bij PCP). Vanaf dag 4 op geleide van spiegels. Monitor de N4-acetylmetaboliet

Interactions

Interaction with (ATC): Expected effect:
Interaction with (ATC):
L04AD01 - Ciclosporin
Expected effect:
verlaging ciclosporineconcentratie in volbloed en verhoogde kans op nefrotoxiciteit
Interaction with (ATC):
N03AB02 - Phenytoin
Expected effect:
verhoging plasmaconcentratie fenytoine
Interaction with (ATC):
B03BB01 - Folic Acid
Expected effect:
vermindering werking foliumzuur
Interaction with (ATC):
L01BA01 - Methotrexate
Expected effect:
verhoging plasmaconcentratie methotrexaat
Interaction with (ATC):
B01AA - Vitamin K Antagonists
Expected effect:
versterking effect orale anticoagulantia

Pregnancy

Due to the expiration of the alphanumeric classification for use in pregnancy and lactation, reference is made to the current, online information of the Teratology Information Service (TIS) of LAREB:

For individual advice, consult an expert on site.
Metadata

Swab vid: M-1291.2
Updated: 06/16/2019 - 20:05
Status: Published

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