Emtrim Tablet And Syrup Composition, Dose, Side Effect, Use

Emtrim is an antibiotic. It is used to treat many different types of infection. It is manufactured by Emzor pharmaceutical industries limited, Nigeria. It comes in various forms and strengths. They include tablet, dispersible tablet and suspension.

Emtrim

Composition Of Emtrim

Emtrim is a brand of co-trimoxazole BP, a mixture of one part of trimethoprim, (2, 4-diamino-5-trimethoxybenzyl) pyrimidine and 5 parts of sulphamethoxazole, (5-methyl-3-sulfanilamide-isoxazole).

Each tablet contains: Trimethoprim BP 80 mg and sulphamethoxazole BP 400 mg

Each dispersible tablet contains: Trimethoprim BP 20 mg and sulphamethoxazole BP 100 mg

Each double strength tablet contains: Trimethoprim BP 160 mg and sulphamethoxazole BP 800 mg

Each 5 ml suspension contain: Trimethoprim BP 40 mg and sulphamethoxazole BP 200 mg

Pharmacological Properties

The two antibiotics in emtrim act synergistically to produce a bactericidal or bacteriostatic action against a wide range of gram-negative and gram-positive organisms such as streptococci, staphylococci, pneumococci, haemophilus influenzae, Neisseria gonorrhoeae, e-coli, Proteus mirabilis, Proteus vulgaris, Bordetella, Salmonella, klebsiella Aerobacter, Shigella, vibrio cholerae, brucella, pseudomonas pseudo mallei, pseudomonas cepacian, pneumocystis carinii, Serratia marcescens, Yersinia nocardia.

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The active components interfere with the bacterial synthesis of tetrahydro folic acid, an essential stage in the production of thymidine, purines and subsequent nucleic acids. Sulfamethoxazole inhibits the synthesis of the di hydrofluoric acid from p-aminobenzoic acid while trimethoprim inhibits the action of dihydrofolate reductase and prevent the synthesis of tetrahydro folic acids.

Indication Of Emtrim

(I) Respiratory tract infections: acute and chronic bronchitis, pneumonia, pneumocystis carinii pneumonia, pneumocystis, pharyngitis, tonsillitis, tonsillitis, otitis media.

(ii) Urinary tract infection: acute and chronic cystitis, pyelonephritis, urethritis.

(iii) Gastrointestinal tract infections: these include thyroid and parathyroid fever, typhoid carrier state and bacillary dysentery and cholera.

(iv) Skin and soft tissue infections: pyoderma, furuncles, abscesses and infected wounds.

(v) Bacteria infections: acute and chronic osteomyelitis, acute brucellosis, septicemia due to sensitive organisms, nocardiosis, mycetoma (except when caused by fungi) South American blastomycosis.

Absorption And Excretion

The two components of emtrim, sulfamethoxazole and trimethoprim are readily absorbed from the gastro-intestinal tract and peak plasma concentrations are reached within 4 hours after a dose is taken.

Dosage And Administration Of Emtrim

6 weeks to 5 months: 1 dispersible tablet twice daily

6 months to 5 years: 1 teaspoonful twice daily

6 to 15 years: 2 teaspoonsful twice daily

Adults above 12 years: 2 tablets twice daily or 1 tablet (double strength) twice daily

Side Effect Of Emtrim

At the recommended dosage, emtrim is usually well tolerated. Of the reported adverse effects, most are nausea (with or without vomiting) and drug rashes. Pseudomembranous colitis has been reported rarely while diarrhoea and glossitis are uncommon and monilial overgrowth is very rare.

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Isolated cases of severe skin sensitivity reactions such as erythema multiforme and toxic epidermal necrolysis-Lyell's syndrome have been reported. Various haematological changes have been reported, the majority being mild and reversible when treatment is stopped. Although most changes clinically asymptomatic, they may become severe in isolated cases especially in the elderly, those with hepatic or renal dysfunction and those with poor folate status.

Emtrim may induce hemolysis in certain susceptible glucose-6-phosphate deficiency patients. A high incidence of adverse effects has been reported in AIDS patients; desensitization may sometimes be considered.

Precautions

In patients with impaired renal function, the dosage should be reduced or the interval between does prolong in order to prevent accumulation in the blood. Determination of plasma drug concentrations is recommended in such patients. Regular blood counts are advisable whenever emtrim is given for prolonged. Especially in the elderly, with the possibility of hematological changes indicative of folic acid deficiency; these are reversible by folic acid therapy. An adequate urine output should be maintained at all times. Treatment must be discontinued immediately when a skin rash appears.

Contraindications

Emtrim is contraindicated in patients with mark liver parenchyma damage. It is also contraindicated in patients with severe renal insufficiency when repeated determinations of the plasma concentrations cannot be made except in rare circumstances. Emtrim should not be given to patients with serious haematological disorders.

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The combination has occasionally been administered to patients receiving cytotoxic agents for the treatment of leukaemia without evidence of any adverse effects on the bone marrow. Emtrim should not be administered to patients with a history of hypersensitivity to sulfonamides or trimethoprim. For safety reasons, emtrim is contraindicated in pregnancy.

If pregnancy cannot be excluded, possible risk should be balanced against the expected traffic benefits. Emtrim should not be given to premature and newborn infants during the first few weeks of life.