Monograph

J01EE01 - Sulfamethoxazole and Trimethoprim

Porphyrinogenic

Rationale

The combination contains a notoriously porphyrinogenic sulfonamide component, inducer of CYP 3A4. Several references warn against it. Trimetoprim is substrate for CYP 2C9 and 3A4. Inhibits CYP 2C8, 2C19, 2D6,3A4. Warned against in three references.

Chemical description

sulfamethoxazol: Sulfonamide excreted in urine in unchanged form (20%), in acetylated form (60%) and in glucuronidated form (15%). trimethoprim: Bacteriostatic antibiotic perorally used (150-200 mg x 2) in urinary tract infections. About 10-20 % is metabolized in the liver.About 50 % is excreted by the kidneys in unchanged form within 24 hours. Sulfonamides: Australian list: unsafe/attacks. EPI-list: unsafe. French list: avoid. South African list: avoid /use with extreme caution only. Steim,Tchudy 1970: unsafe. Moore, Hift 1997: unsafe. Kalman, Bonkowsky: known to exacerbate disease. Andersson: Precipitates attacks (N=4) Trimethoprim: Martindale: unsafe/acute attacks. Australian list: unsafe. South African list: use with extreme caution only.

IPNet drug reports

Uneventful use reported in 3 patients with acute porphyria.

Similar drugs

Explore alternative drugs in similar therapeutic classes J01E / J01EE or go back.

Tradenames and packages

From some sources, we get a list of packages (United Kingdom, Ireland, Estonia). Other sources contain more or less "clean" versions of the trade name (Denmark, Finland, Iceland, Lithuania, Norway). What you see here is the raw data we get from each country, so there will appear to be duplicates. The bold names are the searchable terms. The gray names that follow are all mapped to the bolded term.

Note: The cleaning is done automatically by a proprietary algorithm, and it may produce errors. We strive to improve it continuously.

Netherlands

Bactrimel · Bactrimel, concentraat voor oplossing voor intraveneuze infusie 96 mg/ml · Co-trimoxazol · Co-trimoxazol CF 480 mg, tabletten · Co-trimoxazol Teva 200/40 mg/5 ml, suspensie voor oraal gebruik · Co-trimoxazol forte · Co-trimoxazol forte CF 960 mg, tabletten

Belgium

Bactrim Forte · Bactrim Forte 800 mg - 160 mg comp. · Eusaprim · Eusaprim 40 mg - 200 mg/5 ml susp. buv. · Eusaprim 80 mg - 400 mg comp. · Eusaprim 80 mg - 400 mg/5 ml sol. perf. (à diluer) i.v. amp. · Eusaprim Forte · Eusaprim Forte 160 mg - 800 mg comp.

United Kingdom

Co-trimoxazole · Co-trimoxazole 160mg/800mg tablets · Co-trimoxazole 160mg/800mg/10ml solution for infusion ampoules · Co-trimoxazole 40mg/200mg/5ml oral suspension sugar free · Co-trimoxazole 80mg/400mg tablets · Co-trimoxazole 80mg/400mg/5ml oral suspension · Co-trimoxazole 80mg/400mg/5ml solution for infusion ampoules · Septrin · Septrin tablets · Septrin Adult · Septrin Adult 80mg/400mg/5ml oral suspension · Septrin for Infusion · Septrin for Infusion 80mg/400mg/5ml solution for infusion ampoules · Septrin Forte · Septrin Forte 160mg/800mg tablets · Septrin Paediatric · Septrin Paediatric 40mg/200mg/5ml oral suspension

Denmark

Sulfametoxazol Trimetoprim · Sulfametoxazol med Trimetoprim "SAD" · Zomylac

Norway

Bactrim · Bactrimel · Eusaprim · Zomylac

Poland

Bactrim · Bactrim Forte · Biseptol · Biseptol 120 · Biseptol 480 · Biseptol 960 · Trimesolphar

Luxembourg

BACTRIM FORTE · COTRIM FORTE · COTRIM FORTE RATIOPHARM · EUSAPRIM · EUSAPRIM FORTE

Iceland

Cotrim · Cotrim forte · Eusaprim

Finland

Cotrim · Cotrim Forte · Zomylac

Latvia

Bactrim · Biseptol

Serbia

Bactrim · Bactrim® · Bactrim-Eumedica · Bactrim-Eumedica™ · ESBESUL · ESBESUL®

Acute Porphyria Drug Database

Monograph