What is Cotrimoxazole?

• Cotrimoxazole is an antibiotic that treats different types of bacterial infections. It fights bacteria in your body.
• Cotrimoxazole is used to treat infections such as urinary tract infections, bronchitis, ear infections (otitis), traveler's diarrhea, and Pneumocystis carinii pneumonia.
• Cotrimoxazole may also be used for purposes other than those listed in this medication guide.

What should I discuss with my doctor before taking Cotrimoxazole?

• Before taking this medication, tell your doctor if you have
  • kidney or liver disease, or
  • a glucose-6-phosphate dehydrogenase deficiency (G6PD deficiency).
• You may not be able to take Cotrimoxazole, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.
• Cotrimoxazole is in the FDA pregnancy category C. This means that it is not known whether sulfamethoxazole and trimethoprim will harm an unborn baby. Do not take the medication without first talking to your doctor if you are pregnant.
• Cotrimoxazole passes into breast milk and may harm a nursing baby. Do not take it without first talking to your doctor if you are breast-feeding a baby.
• Cotrimoxazole is not approved for use in children younger than 2 months of age.

How should I take sulfamethoxazole and trimethoprim?

• Take this drug exactly as directed by your physician. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take each dose with a full glass of water.
• Take it with food or milk if it upsets your stomach.
• You may crush the tablets and put them in water or a soft food like applesauce or pudding if you cannot swallow them whole.
• Take all of the Cotrimoxazole that has been prescribed for you even if you begin to feel better. Your symptoms may start to improve before the infections is completely treated.
• Store the tablets at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the dose you missed and take only your next regularly scheduled dose. Do not take a double dose of this medication unless otherwise directed by your doctor.
• If you have only missed one dose, you can take the rest of your scheduled doses for that day at evenly spaced intervals.

What happens if I overdose?

• Seek emergency medical attention.
• Symptoms of a sulfamethoxazole and trimethoprim overdose include nausea, vomiting, decreased appetite, diarrhea, headache, yellowing of the skin or eyes, decreased urine production, bloody urine, and coma.

What should I avoid while taking sulfamethoxazole and trimethoprim?

• Avoid prolonged exposure to sunlight. Cotrimoxazole may increase the sensitivity of your skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.

What are the possible side effects of Cotrimoxazole?

• Stop taking the drug and seek emergency medical attention if you experience any of the following serious side effects:
  • an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
  • unusual bleeding or bruising; or
  • yellow skin or eyes.
• Other, less serious side effects may be more likely to occur. Continue to take your medication and talk to your doctor if you experience
  • headache, fatigue, or dizziness;
  • nausea, vomiting, decreased appetite, or diarrhea;
  • weakness; or
  • increased sensitivity to the sun.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What drug(s) may interact with cotrimoxazole?

• amiloride
• cyclosporine
• dapsone
• digoxin
• divalproex
• dofetilide
• doxercalciferol
• medicines for diabetes
• methenamine
• methotrexate
• metronidazole
• phenytoin
• potassium salts (potassium chloride, potassium phosphate)
• procainamide
• pyrimethamine
• rifampin
• some medicines used to treat blood pressure and/or heart failure (ACE inhibitors such as benazepril, enalapril, lisinopril, moexipril, quinapril, ramipril, and others)
• spironolactone
• sulfinpyrazone
• triamterene
• trimetrexate
• valproic acid
• warfarin

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

Other Useful Information:

Calcium: A mineral found mainly in the hard part of bones, where it is stored. Calcium is added to bones by cells called osteoblasts and is removed from bones by cells called osteoclasts. Calcium is essential for healthy bones. It is also important for muscle contraction, heart action, nervous system maintenance, and normal blood clotting. Food sources of calcium include dairy foods, some leafy green vegetables such as broccoli and collards, canned salmon, clams, oysters, calcium-fortified foods, and tofu. According to the National Academy of Sciences, adequate intake of calcium is 1,200 milligrams a day (four glasses of milk) for men and women 51 and older, 1,000 milligrams a day for adults 19 through 50, and 1,300 milligrams a day for children 9 through 18. The upper limit for calcium intake is 2.5 grams daily.

Cavities: Holes in the two outer layers of a tooth called the enamel and the dentin. The enamel is the outermost white hard surface and the dentin is the yellow layer just beneath enamel. Both layers serve to protect the inner living tooth tissue called the pulp, where blood vessels and nerves reside. Small cavities may not cause pain, and may be unnoticed by the patient. Larger cavities can collect food, and the inner pulp of the affected tooth can become irritated by bacterial toxins, foods that are cold, hot, sour, or sweet - causing toothache.

Naturopathy: A system of therapy based on preventative care, and on the use of heat, water, light, air, and massage as primary therapies for disease. Some naturopaths use no medications, either pharmaceutical or herbal. Some recommend herbal remedies only. A few who are licensed to prescribe may recommend pharmaceuticals in those cases where they feel their use is warranted.

Naturopathy is an American healthcare profession. It was founded in the US as a formal healthcare system at the turn of the 20th century by medical practitioners from various natural therapeutic disciplines. By the early 1900s, more than 20 naturopathic medical schools existed, and naturopathic physicians were licensed in most States. Today there are more than 1,000 licensed naturopathic doctors in the US.

As practiced today, naturopathic medicine integrates traditional natural therapeutics -- including botanical medicine, clinical nutrition, homeopathy, acupuncture, traditional oriental medicine, hydrotherapy, and naturopathic manipulative therapy -- with modern scientific medical diagnostic science and standards of care. The medical research base of naturopathic practice consists of empirical documentation of treatments using case history observations, medical records, and summaries of practitioners' clinical experiences.

At present, the two accredited naturopathic medical schools in the US have active research departments. Naturopathic researchers have investigated the pharmacology and physiological effects of nutritional and natural therapeutic agents, and naturopathic physicians have been active in the investigation of new homeopathic remedies and in the natural treatment of women's health problems. The most recently completed naturopathic study in women's health tested the clinical and endocrine effects of a botanical formula as an alternative to estrogen replacement therapy.

Blood: The familiar red fluid in the body that contains white and red blood cells, platelets, proteins, and other elements. The blood is transported throughout the body by the circulatory system. Blood functions in two directions: arterial and venous. Arterial blood is the means by which oxygen and nutrients are transported to tissues while venous blood is the means by which carbon dioxide and metabolic by-products are transported to the lungs and kidneys, respectively, for removal from the body.

Blood pressure: The blood pressure is the pressure of the blood within the arteries. It is produced primarily by the contraction of the heart muscle. It's measurement is recorded by two numbers. The first (systolic pressure) is measured after the heart contracts and is highest. The second (diastolic pressure) is measured before the heart contracts and lowest. A blood pressure cuff is used to measure the pressure. Elevation of blood pressure is called "hypertension".

Brain: That part of the central nervous system that is located within the cranium (skull). The brain functions as the primary receiver, organizer and distributor of information for the body. It has two (right and left) halves called "hemispheres."

Disease: Illness or sickness often characterized by typical patient problems (symptoms) and physical findings (signs). Disruption sequence: The events that occur when a fetus that is developing normally is subjected to a destructive agent such as the rubella (German measles) virus.

Doctor: In a medical context, any medical professional with an MD, a PhD, or any other doctoral degree. The term doctor is quite nonspecific. A doctor may, for example, be a physician, psychologist, biomedical scientist, dentist, or veterinarian. In a nonmedical context, a professor of history might be addressed as doctor, an eminent theologian might be named a doctor of a church, and a person awarded an honorary doctorate by a college or university might also be called a doctor.

The word "doctor" comes from the Latin "docere" meaning to teach. A doctor was a teacher, especially a learned or authoritative one.