1 DS tabs PO BID
May require 15-20mg/kg/day of TMP IV in 4 divided doses for some indications: CNS infection, Pneumocystis jirovecii infection
15-20mg/kg/day of TMP IV in 4 divided doses
Note Quick method to calculate IV Septra dose in normal renal function
IV solution is supplied as 16 mg/mL TMP solution.
To obtain 16 mg/kg/day , order 1 mL IV solution per kg of body weight and divide total amount into 2-4 doses per 24hr period
Example 80 kg patient = 80 mL of Septra IV per 24hrs = 20 mL IV q6h
eGFR 0 - 10eGFR 10 - 30eGFR > 30Not recommended.
Consult pharmacy if use is deemed essential.50% of usual dosingUsual dosing
POIV1 single strength tablet q12h OR one double strength tablet twice daily2.5 to 5 mg/kg of TMP component every 24 hours
Dose after hemodialysis on dialysis days
Peritoneal Dialysis5 mg/kg of TMP component IV q8h
Depends on indication and type of renal replacement therapy
Pharmacist consult recommendedUse is generally not recommended
If necessary some regimens include:
PO: 1 single strength tablet q12h
IV: 5-10 mg/kg of TMP component q24h
Urinary tract infections
Susceptible MRSA infections
Stenotrophomonas infections
Pneumocystis jirovecii pneumonia (Treatment or prophylaxis)
Follow creatinine and electrolytes in patients at increased risk renal failure, hyperkalemia.
Gastrointestinal upset common
Bone marrow suppression
Hyperkalemia
Renal failure
Hepatitis
Aseptic meningitis
Stevens Johnson syndrome/toxic epidermal necrolysis
Other rashes
ACEi - Increased serum potassium level
Increases amantadine levels
Decreases cyclosporine
Methotrexate - Marrow suppression
Increases phenytoin
Increases rifampin
Increases INR with warfarin
IV Administration Dilute each 5mL amp in 100-125 mL NS or D5W. Administer dose over 60-90 min.
May dilute each 5 mL amp in 50-75 mL if fluid restricted but stability may be markedly decreased
Each 5 mL ampoule contains:
80 mg Trimethoprim
400 mg Sulfamethoxazole
Each single strength (SS) tablet contains:
80 mg Trimethoprim
400 mg Sulfamethoxazole
Each double strength (DS) tablet contains:
160mg Trimethoprim
800 mg Sulfamethoxazole
EH prescribing restrictions None
Community IV Formulary (Metro Area) NO
Tablets may be crushed for NG administration; Liquid formulation is also available.
10mL Oral liquid = 1 single strength (SS) tablet
20mL Oral liquid = 1 double strength (DS) tablet
Antimicrobial class: Sulfonamide - Antifolate
Pregnancy category: C
Average serum half life: 10 hours
Biliary penetration: Moderate
CSF penetration: Therapeutic
Lung penetration: Therapeutic
Urine penetration: Therapeutic
