Properties:
Sutaprim D.S. has a unique mode of action:
► Trimethoprime represents a group of compounds which affect the nucleoprotein
    metabolism of the cell of the micro-organism by interference with the folic-folinic acid
    systems.
► Sulphamethoxazole acts on the same biological pathway at a different point.
► The effect of both agents is markedly synergistic. The preparation has a bactericidal effect
    against a wide range of gram positive and gram negative bacteria and the resistance is less
    likely than when either agent is used alone.

Indications:
► Urinary tract infections:
    • For the treatment of urinary tract infections due to susceptible following organisms: E.Coli, Klebsiella Sp., Enterobacter Sp.,
      Morganella morgani, Proteus mirabilis and Proteus vulgaris.

► For the treatment of acute otitis media:
    due to susceptible strains.

► For the treatment of enteritis acute exacerbation of chronic bronchitis in adults:
    due to susceptible strains.
► For the treatment of enteritis travelers diarrhea in adults:
    due to susceptible strains.
► For the treatment of enteritis:
    caused by susceptible strains.

► Pneumocysts carinii pneumonia:
    • For the treatment of documented Pneumocysts carinii pneumonia
    • For the prophylaxis against Pneumocysts carinii pneumonia in individuals who immunosupressed and considered to be at
      increased risk of developing Pneumocysts carinii pneumonia.

Contraindications:
► Sutaprim D.S. is contraindicated in severe renal insufficiency, marked liver damage and glucose 6-phosphate dehydrogenase
    deficiency.
► It should not be administrated during pregnancy or breast feeding mothers and babies less than 2 months of age.
► Hematological disorders and porphyria.
► Hypersensitivity to sulphonamides is a contraindication.

Precautions:
1-If exanthema develops during treatment with Sulphamethoxazole and Trimethoprime tablets, the drug should be discontinued.
2-Incases of renal impairment, the dosage should be reduced to avoid accumulation of the drug.
3-Patients should be monitored during treatment to discover the serious side effects such as skin inflammations, anemia, liver toxicity.
4-Special care should be exercised in treating elderly patients or suspected folate deficient patients.
5-It should be given with caution to patients with severe allergy or bronchial asthma.
6-Reular hematological examination should be done during prolonged courses of treatment.
7-It should be used only under medical supervision for children less than 3 years.

Drug Interactions:
► Anesthetics: effect of thiopentane enhanced.
► Antiarrhythmics: the drug increases the risk of ventricular arrhythmias with amiodarone (avoid concomitant use).
► Anticoagulants: effect of dicoumarol and warfarin is enhanced.
► Antidiabetic: effect of sulphonylureas enhanced.
► Antiepileptic: antifolate effect and plasma concentration of phenytoin increased by the drug.
► Antimalarial: with pyrimethamine in a dose exceeding 25 mg weekly may develop megaloblastic anemia.
► Cytotoxics: antifolate effect of methotrexate increased by the drug.
► Indomethacin may increase blood level of Sulphamethoxazole.
► Increased Digoxin blood level may occurs.

Adverse reactions:
Sutaprim D.S. is generally well tolerated. The majority of side effects observed were of mild or moderate severity and were normally tolerated with continued treatment.
Gastrointestinal, the most frequently observed side effect was diarrhea/loose stool. Nausea, vomiting, epigastric distress, and abdominal pain/cramps have been observed.
Hypersensitivity reactions: urticaria ,erythema multiform and exfoliate dermatitis.
It is expected that the adverse reactions associated with use of ampicillin may be occasionally observed.

Dosage and administration:
► Adults ................................................. Once tablets twice daily for at least 5 days.
► In severe infections ............................. 2.88g (3 tablets) daily in 2 divided doses may be given.

Side effects:
Nausea, Vomiting, Skin rash, Hematological changes are rarely reported.

Packing:
Box of 10 tablets.