Comparative Pharmacology
Head-to-head clinical analysis: SULFATRIM versus SULFISOXAZOLE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: SULFATRIM versus SULFISOXAZOLE.
SULFATRIM vs SULFISOXAZOLE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Sulfatrim is a combination of sulfamethoxazole, a dihydropteroate synthase inhibitor that blocks folate synthesis, and trimethoprim, a dihydrofolate reductase inhibitor that blocks reduction of dihydrofolate to tetrahydrofolate, resulting in sequential inhibition of bacterial folate metabolism.
Sulfisoxazole is a sulfonamide antibiotic that inhibits bacterial dihydropteroate synthase, blocking the synthesis of dihydrofolic acid and ultimately inhibiting bacterial folate synthesis and DNA replication.
160 mg trimethoprim / 800 mg sulfamethoxazole (1 DS tablet) orally every 12 hours for 10-14 days.
1-2 g orally once, then 500 mg-1 g orally every 4-6 hours; maximum 6 g/day.
None Documented
None Documented
Clinical Note
moderateSulfisoxazole + Gatifloxacin
"Sulfisoxazole may increase the hypoglycemic activities of Gatifloxacin."
Clinical Note
moderateSulfisoxazole + Rosoxacin
"Sulfisoxazole may increase the hypoglycemic activities of Rosoxacin."
Clinical Note
moderateSulfisoxazole + Trovafloxacin
"Sulfisoxazole may increase the hypoglycemic activities of Trovafloxacin."
Clinical Note
moderateSulfisoxazole + Nalidixic acid
Sulfamethoxazole: 9-11 hours (prolonged in renal impairment, e.g., up to 30 hours in severe renal failure). Trimethoprim: 8-10 hours (prolonged in hepatic impairment).
Terminal elimination half-life is 5-7 hours in adults with normal renal function; prolonged to 12-20 hours in renal impairment (CrCl <30 mL/min).
Renal (70-80% as unchanged sulfamethoxazole and N4-acetylated metabolite; 30-40% as unchanged trimethoprim), biliary/fecal (20-30% sulfamethoxazole; 10-20% trimethoprim)
Renal excretion accounts for 70-85% of elimination, predominantly as unchanged drug (30-50%) and the N4-acetyl metabolite (15-30%). Biliary/fecal excretion is minimal (<5%).
Category C
Category C
Sulfonamide Antibiotic
Sulfonamide Antibiotic
"Sulfisoxazole may increase the hypoglycemic activities of Nalidixic acid."