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sulfamethoxazole [SMX] (Gantanol, Aposulfatrim, Bactoreduct)

Tradename: Gantanol. Alias SMX. Dosage: 1) 1 g PO BID 2) 1 g IV every 8 hours Tabs: 500 mg. Syrup: 500 mg/5 mL. Dosage adjustment in renal failure: creatinine clearance dosage > 50-90 mL/min 12 hour dosing 10-50 mL/min* 18 hour dosing < 10 mL/min# 24 hour dosing * same dose for continuous arteriovenous hemofiltration # 1 g after hemodialysis Pharmacokinetics: - 1/2life 10 hours (20-50 hours ESRD) Laboratory: Therapeutic range: - Peak: 100-150 ug/mL - Trough: 75-120 ug/mL. Adverse effects: - crystals, insoluble in urine [3] - may lead to acute renal failure, reversible with discontinuation of drug - 2-fold increased risk of miscarriage - thromobocytopenia [5]

Interactions

drug interactions drug adverse effects (more general classes) monitor with carbonic anhydrase inhibitors

General

antibacterial agent oxazole; 1,3 oxazole sulfanilamide

Properties

MISC-INFO: elimination route KIDNEY pregnancy-category C safety in lactation -

Database Correlations

PUBCHEM correlations

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Sanford Guide to antimicrobial therapy 2001
  3. Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
  4. Muanda FT, Sheehy O, Berard A Use of antibiotics during pregnancy and risk of spontaneous abortion. CMAJ 2017 May 1;189:E625-33 PMID: 28461374 http://www.cmaj.ca/content/189/17/E625.full.pdf+html
  5. Curtis BR, McFarland JG, Wu GG Antibodies in sulfonamide-induced immune thrombocytopenia recognize calcium-dependent epitopes on the glycoprotein IIb/IIIa complex. Blood. 1994 Jul 1;84(1):176-83. PMID: 7517207 Free article.

Component-of

phenazopyridine/sulfamethoxazole/trimethoprim trimethoprim/sulfamethoxazole; cotrimoxazole (Bactrim, Septra, Cotrim, Sulfatrim, Sulfoxatrim, Trisulfam, Uroplus)