Comparative Pharmacology
Head-to-head clinical analysis: SULFAMETHOXAZOLE versus SULFATRIM DS.
Peer-Reviewed Evidence
Head-to-head clinical analysis: SULFAMETHOXAZOLE versus SULFATRIM DS.
SULFAMETHOXAZOLE vs SULFATRIM-DS
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Displaces dihydropteroate synthetase from its substrate para-aminobenzoic acid (PABA), inhibiting bacterial folate synthesis. Bacteriostatic against susceptible organisms.
Sulfamethoxazole inhibits bacterial dihydropteroate synthase, blocking folate synthesis. Trimethoprim inhibits bacterial dihydrofolate reductase, inhibiting reduction of dihydrofolate to tetrahydrofolate. Sequential blockade of folate metabolism exerts bactericidal effect.
800 mg sulfamethoxazole with 160 mg trimethoprim (DS tablet) orally every 12 hours.
One double-strength tablet (160 mg trimethoprim/800 mg sulfamethoxazole) orally every 12 hours.
None Documented
None Documented
Clinical Note
moderateSulfamethoxazole + Gatifloxacin
"Sulfamethoxazole may increase the hypoglycemic activities of Gatifloxacin."
Clinical Note
moderateSulfamethoxazole + Rosoxacin
"Sulfamethoxazole may increase the hypoglycemic activities of Rosoxacin."
Clinical Note
moderateSulfamethoxazole + Trovafloxacin
"Sulfamethoxazole may increase the hypoglycemic activities of Trovafloxacin."
Clinical Note
moderateSulfamethoxazole + Nalidixic acid
9-11 hours in adults with normal renal function. Prolonged in renal impairment: up to 20-30 hours. In neonates, 6-12 hours.
SMX: 9-11 hours (terminal); TMP: 8-10 hours; prolonged in renal impairment (creatinine clearance <30 mL/min: up to 20-30 hours for both).
Primarily renal; ~80-90% excreted unchanged in urine, with 15-30% as acetylated metabolite. Biliary/fecal <5%.
Renal: 50-70% of total sulfamethoxazole (SMX) and 30% of trimethoprim (TMP) as unchanged drug via glomerular filtration and tubular secretion; 20-40% of SMX as N4-acetylated metabolite; biliary excretion accounts for <5%.
Category D/X
Category C
Sulfonamide Antibiotic
Sulfonamide Antibiotic
"Sulfamethoxazole may increase the hypoglycemic activities of Nalidixic acid."