Avlotrin Tablet, Oral Suspension

Cotrimoxazole is a mixture of the sulphonamides sulphamethoxazole with trimethoprim in the proportions of 5 to 1. The two components act synergistically to produce a bactericidal or bacteriostatic action against a wide range of gram-positive and gram-negative organism and some protozoa.

Cotrimoxazole is a mixture of the sulphonamides sulphamethoxazole with trimethoprim in the proportions of 5 to 1. The two components act synergistically to produce a bactericidal or bacteriostatic action against a wide range of gram-positive and gram-negative organisms and some protozoa. It is also active against pneumocystis carinii. Sulphamethoxazole inhibits the enzyme dihydropteroate reductase, which catalyzes the reduction of folic acid to dihydrofolic acid whilst trimethoprim prevents the reduction of dihydrofolic acid to tetrahydrofolic acid by competitive inhibition of dihydrofolate reductase, thereby interfering with cell replication.

Both drugs are rapidly and almost completely absorbed from the bowel reaching peak plasma concentrations 1-4 hours after ingestion. Sulphamethoxazole is 65% and trimethoprim is 40% protein bound.

Uses

Cotrimoxazole is used for-

  • Respiratory tract infections: Acute and chronic bronchitis, bronchiectasis, lobar and bronchopneumoniae, pneumocystis carinii pneumonitis, otitis media and sinusitis.
  • Genito-urinary tract infections: Urethritis, cystitis, prostatitis, pyelonephritis, gonorrhoea.
  • Skin infections: Pyoderma, abscess and wound infections.
  • Other bacterial infections: Acute and chronic osteomyelitis, acute brucellosis, septicaemias, nocardiosis and other infections caused by susceptible organisms.
Trade Name Avlotrin
Generic Cotrimoxazole (Sulphamethoxazole + Trimethoprim)
Weight 400mg+80mg, (200mg+40mg)/5ml
Type Tablet, Oral Suspension
Therapeutic Class Anti-diarrhoeal Antimicrobial drugs, Sulphonamides & Trimethoprim
Manufacturer ACI Limited
Available Country Bangladesh
Last Updated: June 23, 2021 at 11:19 am

Dosage

Avlotrin dosage

Cotrimoxazole double strength tablet: Over 12 years

  • For mild to moderate infections: 1 tablet twice daily.
  • For severe infections: 1.5 tablets twice daily.
  • Long term therapy (>14 days): 0.5 tablet twice daily.
  • Gonorrhoea: 2 tablets every 12 hours for two days or 2.5 tablets followed by a further dose of 2.5 tablets after 8 hours.

Cotrimoxazole tablet: over 12 years

  • For mild to moderate infections: 2 tablets twice daily.
  • For severe infections: 2 tablets thrice daily.
  • Long term therapy: (>14 days): 1 tablet twice daily.

Cotrimoxazole suspension: Under 12 years

  • 6-12 years: 2 teaspoonful twice daily.
  • 6 month-5 years: 1 teaspoonful twice daily.
  • 6 weeks-6 months: 0.5 teaspoonful twice daily.

Side Effects

At the recommended dose side effects are rare and mild. About 75% of the untoward effects involve the skin. Exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis (Lyell's syndrome) are rare. Nausea and vomiting constitute the bulk gastrointestinal reactions. Diarrhoea, glossitis, and stomatitis are uncommon. Hematological reactions include various types of anemia, granulocytopenia, purpura and agranulocytosis.

Precaution

Prolonged full dose treatment with sulfamethoxazole-trimethoprim combination is associated with the risk of macrocytic anaemia due to the drug’s interference in the conversion of Folic acid into Folinic acid. If this occurs, it can be reversed by giving Folinic acid. Care should be taken when giving this combination to diabetic patients receiving sulphonylurea drug for possible potentiation of action of sulphonylurea

Pregnancy & Breastfeeding use

Pregnancy category-D. Pregnancy and during the nursing period, because sulphonamides pass the placenta and are excreted in the breast milk and may cause kernicterus.

Contraindication

Hypersensitivity to trimethoprim or sulphonamides, Patients with documented megaloblastic anaemia due to folate deficiency, Patients showing marked liver parenchymal damage, blood dyscrasia, severe renal insufficiency, glucose 6-phosphate dehydrogenase deficiency.

Acute Overdose

Symptoms: Dizziness, nausea, vomiting, rashes, headache, ataxia, drowsiness, dysuria, facial swelling, weakness and confusion, bone marrow depression, slight elevations of serum aminotransferases. 

Management: Supportive and symptomatic treatment. Empty stomach immediately by inducing emesis or by lavage. Observe the patient for at least 4 hr and monitor urea and electrolytes with FBC. Give fluids to maintain a good urine output. May give Ca leucovirin 5-10 mg/day to counteract any adverse effects of trimethoprim on bone marrow or Ca folinate 3-6 mg for 5-7 days orally or by IM inj.

Avlotrin contains Cotrimoxazole (Sulphamethoxazole + Trimethoprim) see full prescribing information from innovator Monograph

FAQ

What is Avlotrin used to treat?

Avlotrin is used to treat certain bacterial infections, such as pneumonia (a lung infection), bronchitis (infection of the tubes leading to the lungs), and infections of the urinary tract, ears, and intestines. It also is used to treat 'travelers' diarrhea.

How many days should I take Avlotrin?

Avlotrin should be taken for at least five days. Make sure that you finish the course of Avlotrin which your doctor has prescribed.

How fast does Avlotrin work?

The recommended treatment lasts 21 days. It may be possible to switch to tablet form of Septrin if you respond well to the treatment. It may take five to seven days before you start to feel better. You may also be given a steroid, prednisone, to relieve your symptoms.

What bacteria does Avlotrin kill?

Avlotrin can be used to treat or prevent: Lung infections (pneumonia or PJP) caused by a bacteria called Pneumocystis jirovecii. Infections caused by a bacteria called Toxoplasma (toxoplasmosis).

Is Avlotrin a penicillin?

Avlotrin is a combination antibiotic. It can be taken by people who are allergic to penicillin, but it is not suitable for people who are allergic to sulfonamides.

Can Avlotrin cure UTI?

Treatment of uncomplicated urinary tract infections in an era of increasing antimicrobial resistance. Because of the high concentration of the drug in the urine and the favorable course of uncomplicated cystitis, a 3-day treatment of Avlotrin can be given to patients with this disease.

What happens if I use too much Avlotrin?

If you use too much Avlotrin cream, spray or solution or use it more often than you need to, it may make your skin red or irritated. If this happens, use less the next time.

Who can use Avlotrin?

Avlotrin cream, spray and solution can be used by most adults and children.

Who cannot use Avlotrin?

Avlotrin is not suitable for everyone. To make sure it's safe for you, tell a doctor if you have ever had an allergic reaction to Avlotrin or any other medicines in the past.

How to use Avlotrin?

Apply Avlotrin to the affected area 2 to 3 times a day. It will work better if you use it 3 times a day.

If the affected area is large or hairy, it's best to use either the spray or solution.

If you're using Avlotrin on your feet, make sure you wash and thoroughly dry your feet, especially between your toes, before applying Avlotrin.

How to use Avlotrin cream?

Apply Avlotrin cream to the affected area. Use the cream on your skin only. A strip of cream (0.5cm long) is enough to treat an area the size of your hand. Avoid putting it near your mouth, lips and eyes.

How to use Avlotrin spray?

If you're using the Avlotrin spray for the first time, prepare the spray by pressing the spray head down once or twice. Hold and spray about 15cm away from the affected area.

How to use Avlotrin solution?

Apply Avlotrin solution thinly and evenly to the affected areas.

A few drops of Avlotrin solution should be enough to cover an area the size of a hand.

If your ear is infected, put 2 to 3 drops of Avlotrin solution into your ear.

What if I forget to use Avlotrin?

If you forget to use Avlotrin, do not worry. Just apply it as soon as you remember and then keep following your usual routine.

What is the Side effects of Avlotrin?

Like all medicines, Avlotrin can cause side effects, although not everyone gets them. Side effects usually go away when you stop using it.

At the recommended dose side effects are rare and mild. About 75% of the untoward effects involve the skin. Exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis (Lyell's syndrome) are rare. Nausea and vomiting constitute the bulk gastrointestinal reactions. Diarrhoea, glossitis, and stomatitis are uncommon. Hematological reactions include various types of anemia, granulocytopenia, purpura and agranulocytosis.

Is Avlotrin safe in pregnancy?

Avlotrin is generally considered safe to use during pregnancy.

Is Avlotrin safe when breastfeeding?

Avlotrin is generally considered safe to use while you're breastfeeding.

If your baby is being treated for oral thrush you can carry on breastfeeding but you'll need to be treated at the same time. Apply Avlotrin cream on and around your nipples after each time you breastfeed your baby.

How does Avlotrin work?

Avlotrin works by killing the fungus (yeast) that is causing the infection.

Avlotrin kills fungus by causing holes to appear in its cell membrane and the contents leak out. This kills the fungus and treats the infection.

How long does Avlotrin take to work?

The symptoms of fungal infections, such as itching or soreness, should get better within a few days of treatment. Red and scaly skin may take longer to get better.

You may need treatment for 1 to 4 weeks.

Keep using Avlotrin for 2 weeks even if your symptoms have gone. This will stop the infection coming back.

Talk to a doctor if your symptoms do not get better within 7 days.

What if Avlotrin does not work?

Talk to a doctor if your symptoms do not get better within 7 days. You may need a longer course of treatment or a stronger medicine.

Is Avlotrin safe to use for a long time?

Do not use Avlotrin cream, spray or solution for more than 4 weeks, unless a doctor tells you to.

A fungal infection can become resistant to Avlotrin, which means it will no longer work properly.

Are there other similar medicines like as Avlotrin?

There are other antifungal medicines that are similar to Avlotrin, including:

These are all available to buy from a pharmacy.

Will Avlotrin affect my contraception?

Avlotrin will not affect the combined pill or emergency contraception.

Will Avlotrin affect my fertility?

Avlotrin treatments have no effect on the fertility of men or women.

Can lifestyle changes help fungal infections?

If you have a fungal skin infection, these tips may help:

  • do not scratch the area with the infection as this will damage the surface of the skin and the infection could spread.
  • keep the affected areas of skin clean.
  • keep the affected areas of skin dry where possible, but do not rub too much with a towel.
  • do not share towels with other people as you could spread the infection to them.
  • always wash your hands after treating the infection to stop it from spreading.