Order Bromo TMPS Online

Warnings

Tell your doctor if you are pregnant. Trimethoprim can interfere with your body's ability to metabolize folic acid, a form of vitamin B important in the development of the unborn baby's brain and spinal cord.

Interactions

Angiotensin II Receptor Blockers: Trimethoprim may enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Monitor therapy

MiFEPRIStone: May increase the serum concentration of CYP2C9 Substrates (High risk with Inhibitors). Management: Use CYP2C9 substrates at the lowest recommended dose, and monitor closely for adverse effects, during and in the 2 weeks following mifepristone treatment. Consider therapy modification

CYP2C9 Inhibitors (Moderate): May decrease the metabolism of CYP2C9 Substrates (High risk with Inhibitors). Monitor therapy

Food interaction

Take on empty stomach: 1 hour before or 2 hours after meals.

Take with a full glass of water.

Do not take calcium, aluminium, magnesium or iron supplements within 2 hours of taking this medication.

Pregnancy

• FDA has reviewed possible risks of pain medicine use during pregnancy.
• If you are pregnant or breastfeeding, talk to your doctor.
• Missed abortion or as diagnostic test for pregnancy.

Overview

Farm action

An antibacterial agent, a folic acid antagonist, acts TMPS. It is active against gram-negative (Escherichia coli, Proteus spp., Klebsiella spp.) And some gram-positive microorganisms. The mechanism of action is associated with inhibition of the enzyme dihydrofolate reductase in the synthesis of tetrahydrofolate acid. This leads to the depletion of folate, the main cofactor for the synthesis of nucleic acids, as a result, the production of nucleic acids and bacterial protein is disrupted. Bacteria dihydrofolate reductase is approximately 50,000-60000 times more strongly bound by trimethoprim than the corresponding mammalian enzyme. The effect is manifested Bromo the stage of folate synthesis, immediately following that at which sulfonamides act. With simultaneous use with sulfonamides, a synergistic effect is noted open link relation to the suppression of the production of tetrahydrofolate acid.

Pharmacokinetics

Absorption from the gastrointestinal tract is fast, almost complete (90-100%). Communication with plasma proteins - 45%. TCmax - 1-4 hours (after a single dose is approximately 1 μg / ml). It TMPS quickly and widely distributed in various tissues and body fluids, including the kidneys, liver, spleen, sputum, saliva and semen, and is also found in bile, bone marrow, and the spongy, but not compact layer of bones. Concentration in CSF - 30-50% concentration in blood serum. The concentration in the tissue and secretion of the prostate TMPS is 2-3 times higher than the concentration in the blood serum. Passes through the placenta and passes into breast milk. Distribution volume - adults: 1.3-1.8 l / kg, children: newborns - 2.7 l / kg, 1-10 years old - 1 l / kg. Metabolized in the liver, 10-20% to inactive metabolites. T1 / 2 - adults: with normal renal function - 8-10 hours, in patients with anuria - 20-50 hours, children: newborns - 19 hours, 1-10 years - 3-5.5 hours. Kidney excreted 50-60% in for 24 hours, mainly by glomerular filtration and tubular secretion, with 80-90% unchanged, the rest TMPS the form of inactive metabolites. A small amount - with bile (4%). Excretion is enhanced by an acid reaction of urine and weakens by alkaline. With hemodialysis, a moderate amount is removed, peritoneal dialysis is ineffective.

Indications

Infections of the kidneys and urinary tract (including pyelonephritis, cystitis, urethritis).

Contraindications

Hypersensitivity, renal failure, megaloblastic anemia due to folic acid deficiency, folic acid deficiency, pregnancy, lactation.
Carefully. Hepatic failure, bronchial asthma, thyroid dysfunction, early childhood.
Category of action on the fetus. C

Dosage

It is not used independently. It is used in combination with sulfanilamides (including with sulfamethoxazole - co-trimoxazole).

Side effects

Aseptic meningitis, methemoglobinemia, inhibition of bone marrow Bromo (agranulocytosis, leukopenia, thrombocytopenia, anemia), malignant exudative erythema (Stevens-Johnson syndrome), diarrhea, decreased appetite, nausea or vomiting, nephropathy, peptic ulcer, gastral.
Overdose. Symptoms: folic acid deficiency, bone marrow depression.
Treatment: gastric lavage, acidification of urine to enhance excretion of the drug by the kidneys, hemodialysis, calcium folinate - 3-6 mg / day / m for 5-7 days or longer (until the normalization of hematopoiesis).

Interaction

Suppresses hepatic metabolism Bromo phenytoin, increasing its T1 / 2 by 50% and reducing its clearance by 30%.
It reduces the renal clearance of procainamide and its metabolite N-acetyl-p-aminophenol, increasing their concentration in plasma. Enhances excretion and shortens T1 / 2 rifampicin. Enhances the anticoagulant effect of warfarin by inhibiting its metabolism.
The combination with sulfamethoxazole mutually enhances the antimicrobial effect Bromo effect).
Myelotoxic drugs - increased risk of inhibition of bone marrow hematopoiesis.
Cyclosporin - the frequency of nephrotoxicity increases. With simultaneous use with dapsone, concentrations of dapsone may increase (the frequency and severity of side effects, especially methemoglobinemia, may increase), and trimethoprim, which may be associated with a suppression of dapsone metabolism and / or competition of 2 drugs for excretion by the kidneys.
Dr. folic acid antagonists (methotrexate, pyrimethamine) increase the risk of megaloblastic anemia.

special instructions

With prolonged treatment, studies of peripheral blood, the functional state of the liver and kidneys should be systematically carried out. Elderly patients are shown the additional appointment of folic acid.

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