Brand and Other Names:Primsol, Proloprim, more...TMP
- Classes: Antibiotics, Other
Dosing & Uses
Dosage Forms & Strengths
100 mg PO q12hr
CrCl 15-30 mL/min: 50 mg q12hr
CrCl <15 mL/min: 100 mg q24hr or avoid use
See also combo with sulfamethoxazole (Cotrim/Bactrim/Septra/Sulfatrim)
Available also as a combo with sulfadiazine (Coptin) in Canada
Other Indications and Uses
UTI caused by E. coli, Enterobacter spp., K. pneumoniae, P. mirabilis, coagulase-neg Staphylococcus spp.
<12 years old: safety and efficacy not established
Serious - Use Alternative
Significant - Monitor Closely
Frequency Not Defined
Maculopapular rash (3-7% at 200 mg/day; incidence higher with larger daily doses)
Phototoxic skin eruptions
Toxic epidermal necrolysis
Liver enzyme elevation
BUN and creatinine increased
Megaloblastic anemia due to folate deficiency
Decreases urinary potassium excretion; may cause hyperkalemia, particularly with high doses, renal insufficiency, or when combined with other drugs that cause hyperkalemia
Large doses or long term therapy may interfere with hematopoiesis; monitor for signs/symptoms of hematologic disorders
Prolonged use may cause fungal or bacterial superinfection, including clostridium difficile-associated diarrhea and pseudomembranous colitis; may occur >2 months postantibiotic treatment
Hypersensitivity reactions reported
Use caution in patients with renal or hepatic impairment
Use caution in patients with potential for folate deficiency, including malnourished, chronic anticonvulsant therapy, or elderly; folates may be administered concomitantly without interfering with antibacterial action of trimethoprim
Some dosage forms may contain benzyl alcohol and derivatives; avoid in neonates
Not indicated for prophylactic or prolonged administration in otitis media at any age
Pregnancy & Lactation
Pregnancy Category: C
Lactation: enters breast milk
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Absorption: readily and extensive
Distribution: widely into body tissues and fluids (middle ear, prostate, bile, aqueous humor, CSF); crosses placenta; enters breast milk
Protein binding: 42-46%
Half-life elimination: 8-14 hr; prolonged in renal impairment
Time to peak, serum: 1-4 hr
Metabolism: partially hepatic
Excretion: urine (60-80%) as unchanged drug
Mechanism of Action
Inhibits dihydrofolate reductase, which in turn inhibits folic acid reduction to tetrahydrofolate, causing inhibition of microorganism growth
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