Download SULFAMETHOXAZOLE/TRIMETHOPRIM `Co

Christchurch Hospital
SULFAMETHOXAZOLE/TRIMETHOPRIM
‘Co-trimoxazole’
Parent/Caregiver Information
Introduction
This fact sheet explains what co-trimoxazole is, how it is given and some of the possible side effects.
Some rare and long term side effects are explained as well as the more common ones. Each person
reacts differently to drugs, so your child will not necessarily suffer every side effect mentioned. If
you are concerned about any of these side effects, please ring one of the contact numbers listed and
ask for your doctor, nurse or pharmacist.
What is co-trimoxazole?
This is a combination antibiotic containing both trimethoprim and sulfamethoxazole. It is used to
prevent and treat a particular chest infection called Pneumocystis Jiroveci (Carinii) pneumonia. You
may hear the doctors and nurses referring to this pneumonia as ‘PCP’. This infection is due to an
organism (bug) which is probably present in most people’s lungs. Children who are receiving long
term drugs which interfere with the body’s ability to cope with infections may be more at risk from
this type of pneumonia.
Important Information you should know:
If your child is taking co-trimoxazole, this should be stopped before treatment with intravenous
methotrexate.
How is it given?
Co-trimoxazole is given by mouth in tablet or liquid form. When co-trimoxazole is given by mouth, it
is usually given to prevent PCP. It can be given in higher doses into a vein (intravenously) through a
cannula, Hickman line or implantable port to treat PCP.
What are the more common side effects?
Diarrhoea: Please contact CHOC if your child has diarrhoea which persists. It is important that your
child drinks lots of fluids.
What are the less common side effects?
Nausea and vomiting: This is uncommon. Anti-sickness drugs can be given to reduce or prevent
these symptoms if they do occur. Please contact CHOC if your child’s sickness persists.
Bone marrow suppression: Some children are sensitive to co-trimoxazole and this can show itself by
a reduction in how well your child’s bone marrow works. This means he or she may become
anaemic, bruise or bleed more easily than usual, and have a higher risk of infection. Please contact
CHOC if your child seems unusually tired, has bruising or bleeding, or any signs of infection,
especially a high temperature (>38oC).
Ref. 7293
Page |1
Issued By: Women’s and Children’s Health
Authorised By: Clinical Nurse Specialist, CHOC
September 2012
Christchurch Hospital
SULFAMETHOXAZOLE/TRIMETHOPRIM
‘Co-trimoxazole’
Parent/Caregiver Information
Children who are sensitive to co-trimoxazole may find that their bone marrow is more likely to be
suppressed when taking mercaptopurine or thioguanine as well as co-trimoxazole. Your child’s blood
count will be checked regularly and individual advice will be given by your hospital doctor.
Allergic reaction: Some children receiving co-trimoxazole have an allergic reaction to the drug. This
reaction may be mild to severe. Signs of a mild allergic reaction include skin rashes and itching, high
temperature, shivering, redness of the face, a feeling of dizziness or headache. If you see any of
these signs, please contact CHOC for advice.
Sensitivity to sunlight: While your child is having co-trimoxazole, their skin may be more sensitive to
sunlight. If your child does go out in the sun, always use a good sunblock of SPF30 or higher and
ensure they wear protective clothing and a sunhat.
Things you should know about cotrimoxazole tablets and liquid:
Tablets and liquid should be stored at room temperature.
If your child vomits after taking the dose, inform CHOC as your child may need another one.
Do not give them another dose without ringing CHOC first.
If you forget to give your child their dose, do not give them a double dose. Keep to your
child’s regular dose schedule.
Co-trimoxazole may need to be stopped before some courses of treatment. You will be told
if this is necessary.
Use of other medication:
Check with your doctor or pharmacist before giving your child other prescription or over-the-counter
medications that is not part of your child’s chemotherapy or supportive therapy protocol.
More Information:
If you have any other questions, please do not hesitate to ask. More information can be obtained
from the following:
CHOC
Phone (03) 364 1821
Clinical Outpatient Co-ordinator Phone (03) 364 1821
CHOC Pharmacist
Phone (03) 364 0640
Pager 8259
Shared Care Nurse
Phone (03) 364 1899
Ref. 7293
Page |2
Issued By: Women’s and Children’s Health
Authorised By: Clinical Nurse Specialist, CHOC
September 2012