Agary Pharmaceutical Limited
Plot C39A, Amuwo Odofin Commercial Scheme, Along Alakoso Avenue, Amuwo Odofin, Lagos.
Tel: 0809-275-6424, 0809-275-6425, 0808-745-4848.

Brand Name



Agary Pharmaceutical Limited
Plot C39A Amuwo Odofin Comm. Scheme, Along Alakoso Avenue, Amuwo Odofin, Lagos.

Therapeutic Class

Antibacterial, Sulfonamides and trimethoprim

Dosage Form, Composition & NAFDAC Registration Number (NRN)

Tablet (NRN: A4-3580): Sulphamethoxazole 400 mg plus Trimethoprim 80 mg; white scored tablet marked “GARYTRIM/480 mg and AGARY on both sides respectively

Pack Size: 10 ×10’s (in blisters); 1000’s in Jars



Co-trimoxazole is a potent antibacterial agent.

Sulfamethoxazole inhibits bacterial synthesis of dihydrofolic acid from para-aminobenzoic acid (PABA).

Trimethoprim blocks the production of tetrahydrofolic acid from dihydrofolic acid by binding to and reversibly inhibiting the action of required enzyme dihydrofolate reductase.

Thus, Co-trimooxazole blocks two consecutive steps in the biosynthesis of nucleic acid and proteins essential for many bacteria.

Absorption by the oral route is rapid. Significant plasma levels are obtained within an hour. Peak levels are achieved between 2 to 4 hours and are maintained over a period of 12 hours.


Treatment of infections caused by susceptible organisms. Infections of the urinary tract, respiratory tract, gastro-intestinal tract, bone and joint infections, chronic bronchitis, bacillary dysentry, gonacoccal urethritis, gonorrhea in penicillin-allergic patients.


Hypersensitivity to sulphonamides or Trimethoprim. Pregnancy, breast feeding, Premature babies and infants under six weeks old.
Severe liver or kidney damage, predisposition to folate deficiency or hyperkalaemia, elderly; asthma; G6PD deficiency.


Complete blood count should be done frequently in patients receiving Sulfonamides.

Co-trimoxazole should not be used in the treatment of Streptococcal Pharyngitis.

Co-trimoxazole should be discontinued if skin rash appears.

In patients with renal impairment it should be taken under strict medical supervision. A folate supplement should be considered when treating potentially folate deficient patients or with prolonged high dosage of Co-trimoxazole.

If Co-trimoxazole treatment is prolonged, especially in patients with suspected impairment of folate metabolism, it is suggested that complete blood counts including thrombocytes be performed at monthly intervals.

Maintain adequate fluid intake (to avoid crystalluria); avoid in blood disorders (unless under specialist supervision

Co-trimoxazole is generally not recommended when creatinine clearance is less than 15 ml per minute, unless facilities for haemodialysis are available.


The actions of sulfonamides (SMZ) may be antagonized by p - aminobenzoic acid and compounds derived from it, particularly, potassium aminobenzoate.

Sulfamethoxazole may potentiate the effects of drugs like oral anticoagulants, methotrexate and phenytoin due to displacement of the drug from the protein binding site or inhibition of metabolism.

High doses of sulfonamides have hypoglycemic effects; the antidiabetic effect of the sulfonylurea compounds may be enhanced by sulfonamides.

Trimethoprim may increase the serum concentrations and potentiate the effects of a number of drugs including phenytoin, digoxin and procainamide. Trimethoprim may potentiate the effects of warfarin.

Trimethoprim has been reported to reduce the renal excretion and increase blood concentrations of zidovudine, zalcitabine and lamivudine. An increased risk of nephrotoxicity has been reported with the use of co-trimoxazole and ciclosporin.

Adverse Effects

Gastro-Intestinal disturbances such as nausea, vomiting and diarrhoea. Allergic skin reactions like rashes, urticaria purpura, erythema multiforme and allergic dermatitis headache, weakness.

Blood dyscrasias due to Trimethoprim component such as megaloblastic anemia agranulocytosis, leucopenia, eosinophilia.

There have been a few reports of subjective experiences e.g. headache, depression, dizziness and hallucinations but their relationship to therapy remains unproven.

Neurological reactions like convulsions, ataxia, peripheral neuritis, aseptic meningitis, vertigo, and tinnitus have been reported.

Dosage & Administration


2 tablets every 12 hours, can be increased to 4 tablets every 12 hours for severe infections.


6 week to 5 months: 120 mg;
6 months to 5 years, 240 mg;
6 - 12 years, 480 mg. In divided doses. 

Co-trimoxazole should not be given to infants below 6 weeks of age.


Acute: With single dose of co-trimoxazole tablets, symptoms of overdosage have not been reported. Signs and symptoms of overdosage reported with sulfonamides include anorexia, colic, nausea, vomiting, dizziness, headache, drowsiness and unconsciousness.

Chronic: If signs of bone marrow supression occurs, the patient should be given Leucovorin 5 to 15 mg daily until normal haematopoiesis is restored.

Storage/Handling Recommendations

Store below 25oC in a dry place.

Protect from light.

Keep all medicines out of the reach of children.

Review Date

2017-09-14 04:58:04