Comparative Pharmacology
Head-to-head clinical analysis: COTRIM D S versus TRIMPEX.
Peer-Reviewed Evidence
Head-to-head clinical analysis: COTRIM D S versus TRIMPEX.
COTRIM D.S. vs TRIMPEX
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.
Inhibits dihydrofolate reductase, blocking the conversion of dihydrofolic acid to tetrahydrofolic acid, thereby inhibiting bacterial thymidine synthesis and DNA replication.
160 mg trimethoprim / 800 mg sulfamethoxazole (one double-strength tablet) orally every 12 hours.
5 mg/kg orally every 6 hours for acute infections; 5 mg/kg orally every 12 hours for chronic urinary tract infections.
None Documented
None Documented
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.
8-11 hours; prolonged in renal impairment (creatinine clearance <10 mL/min: 20-40 hours)
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: 40-70% as unchanged drug; biliary/fecal: minimal (10-15% as metabolites)
Category C
Category C
Antibiotic
Antibiotic