Cotrim

Generic Name: sulfamethoxazole and trimethoprim (sul fa meth OX a zole and trye METH oh prim)
Brand Names: Bactrim, Cotrim, Septra, Sulfatrim Pediatric

What is Cotrim?

Cotrim is an antibiotic combination containing sulfamethoxazole and trimethoprim and it works by killing sensitive bacteria. Both ingredients are antibiotics that treat different types of infection caused by bacteria.

Cotrim is used to treat ear infections, urinary tract infections, bronchitis, traveler's diarrhea, and Pneumocystis carinii pneumonia.

Cotrim may also be used for other purposes not listed in this medication guide.

Important information

You should not use Cotrim if you are allergic to sulfamethoxazole or trimethoprim, if you are pregnant or breast-feeding, or if you have anemia (lack of red blood cells) caused by folic acid deficiency.

Before using Cotrim, tell your doctor if you have kidney or liver disease, a folic acid deficiency, asthma or severe allergies, AIDS, a glucose-6-phosphate dehydrogenase deficiency (G6PD deficiency), or if you are malnourished.

Slideshow: 2014 Update: First Time Brand-to-Generic Switches

Take Cotrim for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Cotrim will not treat a viral infection such as the common cold or flu.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

Avoid exposure to sunlight, sunlamps, or tanning beds. Cotrim can make your skin more sensitive to sunlight, and a sunburn may result. Wear protective clothing and use sunscreen (SPF 15 or higher) when you are outdoors.

Before taking this medicine

You should not use Cotrim if you are allergic to sulfamethoxazole or trimethoprim, if you are pregnant or breast-feeding, or if you have anemia (lack of red blood cells) caused by folic acid deficiency.

If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Before using Cotrim, tell your doctor if you have:

  • kidney or liver disease;
  • a folic acid deficiency;

  • asthma or severe allergies;

  • AIDS;

  • a glucose-6-phosphate dehydrogenase deficiency (G6PD deficiency); or

  • if you are malnourished.

FDA pregnancy category C. It is not known whether this medicine is harmful to an unborn baby. Before taking Cotrim, tell your doctor if you are pregnant or plan to become pregnant during treatment. Sulfamethoxazole and trimethoprim can pass into breast milk and may harm a nursing baby. Do not use Cotrim without telling your doctor if you are breast-feeding a baby. Do not give Cotrim to a child younger than 2 months old. Older adults may be more likely to have side effects while taking this medication.

See also: Pregnancy and breastfeeding warnings (in more detail)

How should I take Cotrim?

Take Cotrim exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Take Cotrim for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Cotrim will not treat a viral infection such as the common cold or flu. Drink plenty of fluids to prevent kidney stones while you are taking trimethoprim and sulfamethoxazole. Store the tablets and liquid at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose can cause dizziness, drowsiness, nausea, vomiting, loss of appetite, stomach pain, headache, yellowing of your skin or eyes, blood in your urine, fever, confusion, or fainting.

What should I avoid?

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

Avoid exposure to sunlight, sunlamps, or tanning beds. Cotrim can make your skin more sensitive to sunlight, and a sunburn may result. Wear protective clothing and use sunscreen (SPF 15 or higher) when you are outdoors.

Cotrim side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:

  • fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;

  • the first sign of any skin rash, no matter how mild;

  • pale skin, easy bruising or bleeding;

  • cough, feeling short of breath;

  • diarrhea that is watery or bloody;

  • feeling restless or irritable, confusion, hallucinations, seizure;

  • slow heart rate, weak pulse, severe tingling, numbness, muscle pain or weakness;

  • nausea, stomach pain, loss of appetite, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • fever, chills, body aches, flu symptoms; or

  • urinating less than usual or not at all.

Less serious Cotrim side effects may include:

  • painful or swollen tongue;

  • dizziness, spinning sensation;

  • ringing in your ears;

  • joint pain; or

  • sleep problems (insomnia).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Cotrim?

Tell your doctor about all other medications you use, especially:

  • seizure medication such as phenytoin (Dilantin);

  • a diuretic (water pill);

  • a blood thinner such as warfarin (Coumadin);

  • methotrexate (Trexall, Rheumatrex); or

  • an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik).

This list is not complete and there may be other drugs that can interact with Cotrim. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about Cotrim.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Cotrim only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2014 Cerner Multum, Inc. Version: 5.01. Revision Date: 01/13/2009 10:29:26 AM.
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