VOL: 101, ISSUE: 05, PAGE NO: 31
- Trimethoprim: Monotrim, Trimopan.
- Trimethoprim prevents bacterial production by blocking the enzyme reduction of dihydrofolic acid.
- Is used in combination with sulfamethoxazole in co-trimoxazole because of synergistic activity but in this form it is associated with rare yet serious side-effects.
- Folic acid inhibitor.
- Nurse prescriber: urinary tract infections in women.
- Other: acute and chronic respiratory tract infections, prostatitis, shigellosis and invasive salmonella infections.
- Blood disease or disorders.
- Severe renal insufficiency.
- Renal impairment.
- Folate deficiency.
- Older people.
- Pregnancy and breastfeeding.
- Nausea and vomiting/diarrhoea.
- Depression of haematopoiesis.
- Erythema multiforme.
- Toxic epidermal necrolysis.
- Aseptic meningitis.
- Allergic reactions.
- May increase action of antiepileptics, digoxin, antivirals, other antibacterials, anticoagulants and antiarrhythmic medications.
- An increased risk of haematological toxicity with some cytotoxic medication.
- An increased risk of nephrotoxicity with ciclosporin medication.
- Available in tablets or suspension.
- Usually given once or twice a day.
- Assess symptoms.
- Evaluate therapeutic response.
- Patients who are having long-term therapy need regular blood count assessment.
- In women of childbearing age enquire about last menstrual period.
- Take trimethoprim on an empty stomach, one hour before or two hours after meals. Some patients may experience nausea. They can be advised to take trimethoprim with food.
- Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture.
- Discard any medication that is outdated or no longer needed.
- Be sure to complete the entire course of medication.
- Report any suspected side-effects to the health care professional who prescribed the medication.
- During breastfeeding traces of trimethoprim may be found in milk, but in short-term use this is not thought to be harmful.
- Women of childbearing age must be cautioned against becoming pregnant while taking trimethoprim, as there are teratogenic risks due to the folate-antagonist effects.
- Nurses should refer to manufacturer’s summary of product characteristics and to appropriate local guidelines.