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Package leaflet: Information for the user

Co-trimoxazole Tablets BP (400/80)
Sulfamethoxazole, Trimethoprim



Read all of this leaflet carefully before you start taking this

Keep this leaflet. You may need to read it again.
If you have any further questions, ask your doctor or pharmacist.
This medicine has been prescribed for you. Do not pass it on to others. It may
harm them, even if their symptoms of illness are the same as yours.
If any of the side effects get serious, or if you notice any side effects not
listed in this leaflet, please tell your doctor or pharmacist.
In this leaflet:
1. What this medicine is and what it is used for
2. Before you take
3. How to take
4. Possible side effects
5. How to store
6. Further information

1. What this medicine is and what it is used for
Co-trimoxazole tablets contain sulfamethoxazole and trimethoprim. These are
Together they work by stopping the growth of bacteria which cause infections
such as:
pneumonia, bronchitis, chest infections
urinary tract infections
ear infections
skin infections
brain infections
Co-trimoxazole tablets is used for adults and children from 6 years of age.
Co-trimoxazole tablets are not recommended for children under 6 years of age.

If you have any further questions on the use of this product, ask your doctor or

4. Possible side effects

2. Before you take
Do NOT take Co-trimoxazole tablets if you:
are allergic to sulfamethoxazole, trimethoprim, or any other sulfonamide, or
to any of the other ingredients (see Section 6)
have liver disease
have a blood disorder
have severe kidney problems.
Co-trimoxazole should not be given to infants during the first 6 weeks of life.
If any of the above apply to you, speak to your doctor or pharmacist.
Take special care with Co-trimoxazole tablets
Before taking the tablets, tell your doctor if you:
have lung problems (e.g. asthma)
have severe allergies (e.g. hayfever)
are over 65 years of age, as the elderly may get more side effects
have a folic acid deficiency
could be suffering from malnutrition (e.g. due to dieting or bowel problems)
have glucose-6-phosphate dehydrogenase (G6PD) deficiency
suffer from phenylketonuria (an enzyme deficiency) and are not on a
special diet
have porphyria (a metabolism disorder which causes abdominal pains and
mental disorder)
have HIV (Human Immunodeficiency Virus)
have a bacterial throat infection called streptococcal pharyngitis
have ever had high blood potassium levels
are taking pyrimethamine, a medicine for malaria.
Concomitant administration of Co-trimoxazole tablets with certain medicines,
potassium supplements and food rich in potassium may lead to severe
hyperkalaemia (increased potassium blood level). The symptoms of severe
hyperkalaemia might include muscle cramps, irregular heart rhythm, diarrhoea,
nausea, dizziness or headache.
Taking other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken
any other medicines, including medicines obtained without a prescription, and
herbal preparations.
Some medicines may be affected by Co-trimoxazole or they may affect how well
Co-trimoxazole will work. Tell your doctor or pharmacist if you are taking:
diuretics (water tablets)
digoxin, used to treat heart conditions
medicines likely to increase the amount of potassium in your blood (e.g.
ACE-inhibitors and spironolactone)
medicines for diabetes
medicines that thin the blood e.g. warfarin
methotrexate, a medicine used to treat arthritis or cancer
ciclosporin, a medicine used to suppress the immune system
phenytoin, a medicine used in the treatment of epilepsy
HIV medicines, such as zidovudine and lamivudine
procainamide, a medicine used to treat certain heart conditions
amantadine, a medicine used to treat the flu and also Parkinson's Disease
pyrimethamine, a medicine for malaria.
Pregnancy and breast-feeding
DO NOT take Co-trimoxazole if you are pregnant, especially in early or late
pregnancy, or while breast-feeding unless advised by your doctor.
Ask your doctor for advice before taking any medicine.
Driving and using machines
Co-trimoxazole may cause dizziness, head-spins and lack of co-ordination. If
this occurs do not drive, use machinery, or perform any tasks that may require
you to be alert.

3. How to take
Always take Co-trimoxazole tablets exactly as your doctor has told you and
always read the label. Your doctor will decide on the appropriate dose to suit
your condition. Ask your doctor or pharmacist if you are not sure.
Swallow the tablets with plenty of water, after a meal to prevent upset
stomach. It is important to drink plenty of fluids while you are taking
The schedules for children are according to the child’s age and body weight
provided in the table below:
Age and weight:

Children 6 to 12 years:
one tablet twice daily on each day of the week; or
one tablet twice daily three times a week on alternate days; or
one tablet twice daily three times a week on consecutive days; or
two tablets once a day three times a week on consecutive days.
Patients with kidney problems
If your kidneys are not working very well, your doctor may change the dose and
test your blood to see if the medicine is working properly.
Care should be taken as the elderly may get more side effects, which could be
serious if they have existing conditions or are taking other medicines.
Taking Co-trimoxazole tablets long term
If you are taking Co-trimoxazole for long periods, blood tests may be carried out.
The doctor may also prescribe an additional drug, folic acid, for you to take.
If you take more than you should
If you take more tablets than you should you may feel nauseous (sick) and
1. Tell your doctor, pharmacist or nearest hospital casualty department
2. Take the container and any remaining tablets with you so that people can
see what you have taken.
3. Do this even if you feel well.
If you forget to take
If you forget to take a dose take it as soon as you remember, but if it is almost
time for your next dose, skip the missed dose and continue as usual.
Do not take a double dose to make up for a missed dose.
If you stop taking
Do not stop just because you feel better. If you stop too soon, the infection may
come back. Keep taking the tablets until the prescribed course is finished.

Daily Dose:

Children aged 6 to 12 years
(OR body weight > 27 kg)

One tablet every 12 hours

Children > 12 years
(OR body weight > 53 kg)

Two tablets every 12 hours

Like all medicines, Co-trimoxazole tablets can cause side effects, although not
everybody gets them. Do not be alarmed by this list of possible side effects.
You may not experience any of them.
STOP taking the tablets and seek medical help immediately if you have any
of the following allergic reactions:
difficulty breathing or swallowing, swelling of the face, lips, tongue or throat
severe itching of the skin, with a red rash or raised lumps
blistering of the mouth, eyes, or genital region, patchy areas of rash,
peeling skin.
Seek immediate medical attention if you have any of the following symptoms:
sudden headache, stiff neck, fever, sensitivity to bright light, drowsiness
and muscle pain, with or without a rash
pinpoint red spots on the skin, unusual purple bruise-like rash on the skin
or in the mouth, unusual or heavy bleeding
fever, sore throat, mouth ulcers, repeated infections or infections that will
not go away
cough, feeling breathless, chest pain
swollen legs or joints, feeling tired
pain behind the ribs radiating towards the back, often worse when lying
down, nausea, vomiting, fever
severe stomach cramps, watery and severe diarrhoea which may be
yellowing of the skin or eyes, pale faeces and dark urine, unexplained
persistent nausea, stomach problems, loss of appetite or unusual tiredness
seizures (fits).
Tell your doctor if you get any of the following side effects:
Very common side effects (in more than 1 in 10 people):
increased amount of potassium in the blood. You cannot feel or see this but
your doctor may test your blood for this.
Common side effects (in less than 1 in 10 people):
skin rashes
oral thrush (white, furry sore tongue and mouth)
vaginal thrush (sore, itchy vagina with vaginal discharge)
thrush affecting the penis.
Uncommon side effects (in less than 1 in 100 people):
Very rare side effects (in less than 1 in 10 000 people):
reactions to the sun. Skin may become red, painful and swollen - do not
sunbathe, use a sun-bed or expose your skin to UV light
allergic-like reaction (skin rash, hives, fever and joint pain) which may
happen after you stop taking Co-trimoxazole
depression or hallucinations
tingling or numbness in the hands and feet
feeling unsteady or dizzy, head-spins, lack of co-ordination
ringing in the ears
inflamed and sore tongue, sore mouth, difficulty chewing and eating
butterfly-shaped rash over the nose and cheeks, made worse by exposure
to the sun. Tiredness and joint pains
low sugar level (feeling hungry, nervous, sweating, trembling)
low sodium level (headache, nausea, vomiting, lethargy, muscle cramps).
Blood may be tested for this
lack of appetite, weight loss
muscle weakness or pain
joint pain
kidney changes. Blood and urine may be tested for this.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This
includes any possible side effects not listed in this leaflet. You can also report
side effects directly via the Yellow Card Scheme at:
By reporting side effects you can help provide more information on the safety of
this medicine.

5. How to store
Keep out of the reach and sight of children.
Do not take after the expiry date which is stated on the label and on the
carton. The expiry date refers to the last day of that month.
Store in a dry place, away from heat and light.
Do not throw it away with your household waste or in water. Return all the
unwanted medicine to your pharmacist. This will help to protect the

6. Further information

Doses to treat infections
Adults: the usual dose is two tablets twice a day (every 12 hours).
Children 6 to 12 years: one tablet twice a day (every 12 hours).
Children under 6 years: this medicine is NOT suitable for children under
6 years.
Treatment will normally be given for 1- 5 days. If no improvement is seen after 7
days the doctor will reassess you.
Doses to treat Pneumocystis infections jirovecii lung infection (PCP)
Your doctor may prescribe higher doses than usual for more than 7 days.
Doses to prevent Pneumocystis infections
two tablets once a day on each day of the week; or
two tablets three times a week taken on alternate days; or
two tablets twice daily three times a week taken on alternate days.

Continued over page

What Co-trimoxazole Tablets contain
The active ingredients are sulfamethoxazole (400 mg) and trimethoprim
(80 mg).
The other ingredients are: starch, magnesium stearate, sodium starch
glycollate and colloidal silica.
What Co-trimoxazole Tablets look like and contents of the pack
Co-trimoxazole Tablets are white bi-convex tablets with a breakline on one side.
They are available in packs of 28, 100, 500 or 1000 tablets. Not all pack sizes
may be marketed.
Marketing Authorisation Holder
Chemidex Pharma Ltd., trading as Essential Generics, 7 Egham Business
Village, Crabtree Road, Egham, Surrey TW20 8RB.
Dales Pharmaceuticals Ltd., Snaygill Industrial Estate, Keighley Road, Skipton,
Yorkshire BD23 2RW.
This leaflet was last revised in 08/2017.



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Further information

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