Comparative Pharmacology
Head-to-head clinical analysis: COTRIM D S versus NITROFURANTOIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: COTRIM D S versus NITROFURANTOIN.
COTRIM D.S. vs NITROFURANTOIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
COTRIM D.S. is a combination of sulfamethoxazole, a competitive inhibitor of dihydropteroate synthase, and trimethoprim, a reversible inhibitor of dihydrofolate reductase. This sequential blockade of folate synthesis leads to bactericidal activity.
Nitrofurantoin is reduced by bacterial flavoproteins to reactive intermediates that inactivate or inhibit bacterial ribosomal proteins, DNA, RNA, and metabolic enzymes, leading to bacterial cell death.
160 mg trimethoprim / 800 mg sulfamethoxazole (one double-strength tablet) orally every 12 hours.
100 mg orally twice daily for 5-7 days (uncomplicated UTI); 50-100 mg orally four times daily for 7 days (symptomatic uncomplicated UTI). Extended-release: 100 mg orally twice daily for 7 days.
None Documented
None Documented
Clinical Note
moderateNitrofurantoin + Norfloxacin
"The therapeutic efficacy of Norfloxacin can be decreased when used in combination with Nitrofurantoin."
Clinical Note
moderateNitrofurantoin + Teriflunomide
"The serum concentration of Teriflunomide can be increased when it is combined with Nitrofurantoin."
Clinical Note
moderateNitrofurantoin + Probenecid
"The serum concentration of Probenecid can be increased when it is combined with Nitrofurantoin."
Clinical Note
moderateNitrofurantoin + Rolapitant
Sulfamethoxazole: 9-12 hours (normal renal function). Trimethoprim: 8-11 hours. Both are prolonged in renal impairment (e.g., creatinine clearance <30 mL/min: >24 hours). Clinical context: dosing interval is typically 12 hours; dose adjustment required if CrCl <30 mL/min.
Normal renal function: 20-60 minutes; impaired function: prolonged up to 1-2 hours, clinically significant due to urinary concentration requirement
Sulfamethoxazole: ~20% unchanged in urine, remainder as acetylated and glucuronide metabolites. Trimethoprim: ~50-80% unchanged in urine, remainder as oxidative metabolites. Both undergo renal excretion via glomerular filtration and tubular secretion. Total renal elimination: 70-90% of dose combined. Biliary/fecal: <10%.
Renal: ~40% unchanged via glomerular filtration and tubular secretion, biliary/fecal: <1%
Category C
Category D/X
Antibiotic
Antibiotic
"The serum concentration of Rolapitant can be increased when it is combined with Nitrofurantoin."