Trimethoprim
Trimethoprim.JPG

CLINICAL USE

Antibacterial agent

DOSE IN NORMAL RENAL FUNCTION

Treatment: 200 mg every 12 hours Prophylaxis: 100 mg at night

PHARMACOKINETICS

  • Molecular weight                           : 290.3
  • %Protein binding                           : 45
  • %Excreted unchanged in urine     : 40–60
  • Volume of distribution (L/kg)       : 1–2.2
  • half-life – normal/ESRD (hrs)      : 8–10/20–49

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

    >25 Dose as in normal renal function 15–25 Dose as in normal renal function <15 Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                : Not dialysed. Dose as in normal renal function
  • HD                     : Dialysed. Dose as in normal renal function
  • HDF/high flux   : Dialysed. Dose as in normal renal function
  • CAV/VVHD      : Probably dialysed. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • Anti-arrhythmics: increased risk of ventricular arrhythmias with amiodarone – avoid concomitant use; concentration of procainamide increased
  • Anti-epileptics: antifolate effect and concentration of phenytoin increased
  • Antimalarials: increased risk of antifolate effect with pyrimethamine
  • Ciclosporin: increased risk of nephrotoxicity Cytotoxics: increased risk of haematological toxicity with azathioprine and mercaptopurine; antifolate effect of methotrexate increased

    ADMINISTRATION

    Reconstition

    Route

    Oral

    Rate of Administration

    Comments

    OTHER INFORMATION

    Serum creatinine may rise due to competition for renal secretion Hyperkalaemia is common in CKD 5 Short-term folic acid supplementation may be prescribed in patients with CKD 4-5 to cover antifolate effects of treatment dose .



    See how to identify renal failure stages according to GFR calculation

    See how to diagnose irreversible renal disease

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