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Trisul ( Bactrim, Bethaprim, Cotrim, Septra, Generic Trimethoprim/Sulphamethoxazole ) - Product Origin: New Zealand	IndicationsTRISUL should only be used where, in the judgement of the physician, the benefits of treatment outweigh any possible risks; consideration should be given to the use of a single effective antibacterial agent.Urinary tract infectionsRespiratory tract infectionsTreatment of acute exacerbations of chronic bronchitis.Treatment and prevention of Pneumocystis Jirovecii. Genital tract infectionsTreatment of chancroid. Treatment granuloma inguinale (venereum) Gastrointestinal tract infectionsTreatment of shigellosisTreatment of travellers' diarrhoea (including gastroenteritis due to enterotoxigenic E. coli).Treatment and prophylaxis of toxoplasmosis, treatment of nocardosis.Dosage and AdministrationIt may be preferable to take TRISUL with some food or drink to minimise the possibility of gastrointestinal disturbances.Acute InfectionsAdults and Children over 12 yearsStandard dosage - 2 tablets every 12 hours.This dosage approximates to 6 mg trimethoprim and 30 mg sulfamethoxazole per kilogram body weight per 24 hours.Treatment should be continued until the patient has been symptom free for two days; the majority will require treatment for at least 5 days. If clinical improvement is not evident after 7 days' therapy, the patient should be reassessed.As an alternative to STANDARD DOSAGE for acute uncomplicated lower urinary tract infections, short term therapy of 1 to 3 days' duration has been shown to be effective.Use in the ElderlyParticular care is always advisable when treating elderly patients because, as a group, they are more susceptible to adverse reactions and more likely to suffer serious effects as a result particularly when complicating conditions exist, e.g. impaired kidney and/or liver function and/or concomitant use of other medications.Special Dosage RecommendationsUnless otherwise specified STANDARD DOSAGE applies.Where dosage is expressed as "tablets" this refers to the adult tablet, ie. 80 mg trimethoprim and 400 mg sulfamethoxazole. If other formulations are to be used appropriate adjustment should be made.Impaired renal functionAdults and Children over 12 years: (No information is available for children under 12 years of age).Creatinine Clearance (ml/min) Recommended Dosage > 30 Standard dosage 15 - 30 Half the standard dosage < 15 Not recommended Pneumocystis JiroveciiTreatmentA higher dosage is recommended, using 20 mg trimethoprim and 100 mg sulfamethoxazole per kg body-weight per day in two or more divided doses for two weeks. The aim is to obtain peak plasma or serum levels of trimethoprim of greater than or equal to 5 micrograms/ml.PreventionAdultsThe following dose schedules may be used:160 mg trimethoprim/800 mg sulfamethoxazole daily 7 days per week.160 mg trimethoprim/800 mg sulfamethoxazole three times per week on alternate days.320 mg trimethoprim/1600 mg sulfamethoxazole per day in two divided doses three times per week on alternate days.ChildrenThe following dose schedules may be used for the duration of the period at risk:Standard dosage taken in two divided doses, seven days per weekStandard dosage taken in two divided doses, three times per week on alternate daysStandard dosage taken in two divided doses, three times per week on consecutive daysStandard dosage taken as a single dose, three times per week on consecutive daysThe daily dose given on a treatment day approximates to 150 mg trimethoprim/m2/day and 750 mg sulfamethoxazole/m2/day. The total daily dose should not exceed 320 mg trimethoprim and 1600 mg sulfamethoxazole.GonorrhoeaIn uncomplicated cases 4 tablets every 12 hours for two days; or5 tablets followed by a further 5 tablets eight hours later; or10 tablets once daily for 3 days.If poor patient compliance is expected a single dose of 8 tablets taken under supervision may be employed.Oro-pharyngeal gonococcal infection2 tablets three times daily for seven days.Ano-rectal gonorrhoeaThe standard dosage recommendations for gonorrhoea are applicable.Chancroid2 tablets twice daily for 7 days; if no evidence of healing is apparent after 7 days a further 7 days' treatment can be considered, however, physicians should be aware that failure to respond may indicate that the disease is caused by a resistant organism.Granuloma Inguinale2 tablets twice daily for up to 2 weeks.NocardiosisThere is no consensus on the most appropriate dosage. Adult doses of 6 to 8 tablets daily for up to 3 months have been used.
Trisul Paediatric Sugar Free ( Septra, Generic Co-trimoxazole (Trimethoprim/Sulfamethoxazole) ) - Product Origin: New Zealand	TRISUL should only be used where, in the judgement of the physician, the benefits of treatment outweigh any possible risks; consideration should be given to the use of a single effective antibacterial agent. The in vitro susceptibility of bacteria to antibiotics varies geographically and with time; the local situation should always be considered when selecting antibiotic therapy.Urinary tract infectionsTreatment of acute uncomplicated urinary tract infections. It is recommended that initial episodes of uncomplicated urinary tract infections be treated with a single effective antibacterial agent rather than the combination.Respiratory tract infectionsTreatment of otitis media. TRISUL is not indicated for prophylactic or prolonged administration in otitis media.Treatment of acute exacerbations of chronic bronchitis.Treatment and prevention of Pneumocystis Jirovecii. (See Dosage and Administration and Adverse Effects).Other bacterial infections caused by sensitive organismsThere are a number of other bacterial infections caused by sensitive organisms for which treatment with TRISUL may be appropriate; the use of TRISUL in such conditions should be based on clinical experience and local in vitro data.Treatment and prophylaxis of toxoplasmosis, treatment of nocardiosis.Dosage and AdministrationIt may be preferable to take TRISUL with some food or drink to minimise the possibility of gastrointestinal disturbances.Acute InfectionsChildren aged 12 years and underAge Paediatric Suspension 6 to 12 years 10 ml every 12 hours 6 months to 5 years 5 ml every 12 hours 6 weeks to 5 months 2.5 ml every 12 hours This dosage approximates to 6 mg trimethoprim and 30 mg sulfamethoxazole per kilogram body weight per 24 hours.Treatment should be continued until the patient has been symptom free for two days; the majority will require treatment for at least 5 days. If clinical improvement is not evident after 7 days' therapy, the patient should be reassessed.As an alternative to STANDARD DOSAGE for acute uncomplicated lower urinary tract infections, short term therapy of 1 to 3 days' duration has been shown to be effective.

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