Comparative Pharmacology
Head-to-head clinical analysis: SULFATRIM DS versus SULFONAMIDES DUPLEX.
Peer-Reviewed Evidence
Head-to-head clinical analysis: SULFATRIM DS versus SULFONAMIDES DUPLEX.
SULFATRIM-DS vs SULFONAMIDES DUPLEX
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
Sulfonamides are competitive antagonists of para-aminobenzoic acid (PABA) and inhibit dihydropteroate synthase, blocking folate synthesis in susceptible bacteria.
One double-strength tablet (160 mg trimethoprim/800 mg sulfamethoxazole) orally every 12 hours.
Oral: 500-1000 mg twice daily; maximum 2000 mg/day.
None Documented
None Documented
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).
Terminal half-life: 7-12 hours in patients with normal renal function; prolonged to 24-50 hours in renal impairment (CrCl <30 mL/min) due to reduced elimination.
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%.
Renal: 70-100% unchanged drug via glomerular filtration and tubular secretion; fecal/biliary: <5%.
Category C
Category C
Sulfonamide Antibiotic
Sulfonamide Antibiotic