Comparative Pharmacology
Head-to-head clinical analysis: COTRIM versus NITROFURANTOIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: COTRIM versus NITROFURANTOIN.
COTRIM vs NITROFURANTOIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
COTRIM is a combination of trimethoprim and sulfamethoxazole; sulfamethoxazole inhibits dihydropteroate synthase, and trimethoprim inhibits dihydrofolate reductase, sequentially blocking bacterial folate synthesis.
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.
1 double-strength tablet (160 mg trimethoprim + 800 mg sulfamethoxazole) orally every 12 hours for 5-14 days; 15-20 mg/kg/day (based on trimethoprim) IV divided every 6-8 hours for severe infections.
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: 9-11 hours (normal renal function); trimethoprim: 8-10 hours. Extended in renal impairment (SMX up to 30h, TMP up to 24h).
Normal renal function: 20-60 minutes; impaired function: prolonged up to 1-2 hours, clinically significant due to urinary concentration requirement
Renal: 50-70% unchanged sulfamethoxazole, 15-30% N4-acetylated metabolite; trimethoprim: 50-60% unchanged, 10-20% metabolites. Biliary/fecal: minimal.
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."