Berlocid

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Medically reviewed

Marina Burgos

Last updated on 10/01/2026

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Berlocid

What is Berlocid? Overview and Essential Facts

Property Description
Active Ingredients Sulphamethoxazole and Trimethoprim
Form Tablet, Suspension, Intravenous Solution
Pharmacological Class Antibiotic (Antimicrobial Agent)
Common Use Systemic treatment of bacterial infections
Origin Synthetic, Fixed-Dose Combination

Berlocid is a commercial name for the generic drug Co-trimoxazole, which is classified as a synthetic, systemic antibiotic and antimicrobial agent. This medicine is defined by its fixed combination of the two active components: Sulphamethoxazole and Trimethoprim. Co-trimoxazole is included on the World Health Organization's Model List of Essential Medicines (WHO), a designation reflecting its clinical use in managing infection.

The drug is structurally a fixed-dose combination product containing Sulphamethoxazole, which acts as a sulfonamide antibiotic, and Trimethoprim, which functions as a dihydrofolate reductase inhibitor. The combined agents achieve a synergistic therapeutic effect against susceptible pathogens, meaning they are more effective together than alone. This combination, known in some markets by names like Bactrim or Septra, is distinguished by its sequential mode of action. Co-trimoxazole is available in several formulations, including oral tablets, an oral suspension often used in pediatric settings, and a sterile solution for intravenous infusion.

The primary function of this medication is to provide systemic antibacterial therapy against a range of bacterial infections. The dual-compound nature ensures that the drug operates through the principle of sequential blockade. This mechanism provides the medicine with a bacteria-killing (bactericidal) property against target organisms, which is relevant in cases requiring elimination of the pathogen. The general benefit is the elimination of the pathogens responsible for initiating and propagating infections throughout the body.

Regulatory References

  1. World Health Organization's Model List of Essential Medicines (WHO)

What side effects are possible with Berlocid?

Possible Side Effects and Safety Information

The safety profile of Co-trimoxazole (Berlocid) is officially established by regulatory agencies like the FDA and EMA. Adverse reactions are classified by the frequency of their occurrence and the body system they affect, ensuring a neutral, fact-based description of potential risks.

Frequency and System-Organ Classifications

The medicine's safety profile includes effects on several physiological systems, notably the blood, skin, gastrointestinal tract, and nervous system. Side effects are categorized according to their estimated frequency:

  • Very Common: The most frequent documented reaction is hyperkalaemia (increased potassium in the blood).
  • Common: Reactions that may occur regularly include headache, nausea, diarrhoea, and fungal overgrowth.
  • Uncommon: Vomiting is classified within this frequency band.

Serious Adverse Reactions and Risk Context

Official labeling documents emphasize the risk of Very Rare but clinically significant adverse events, which have been associated with severe outcomes. These serious reactions include major blood dyscrasias such as agranulocytosis and aplastic anaemia, as well as severe cutaneous adverse reactions (SCARs), notably Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN).

Risk patterns related to treatment duration are documented; the highest risk period for severe skin reactions like SJS and TEN is generally within the first few weeks of treatment. Due to the potential for serious effects, the drug is subject to specific safety constraints, including contraindications for use in infants under two months of age, and in patients with severe hepatic or renal impairment. Older adults are also noted to be more susceptible to adverse reactions.

This structured regulatory profile defines the full spectrum of possible effects, from common metabolic shifts to very rare, critical events, guiding the formal constraints on the drug's use.

Overdose and Emergency Response

Overdose and when to seek help

The official regulatory profile for Berlocid (Co-trimoxazole) overdose focuses on specific systemic manifestations and mandatory emergency responses, as documented by authorities like the FDA and NIH.

Domain Official Regulatory Statements
Documented Overdose Presentations: Acute overdose may present with gastrointestinal symptoms like Nausea, Vomiting, Anorexia, or Colic, alongside neurological signs such as Dizziness, Confusion, Drowsiness, and in severe cases, Unconsciousness. Renal toxicity may lead to Hematuria or Crystalluria.
Serious Outcomes & Triggers: Delayed toxicity, particularly following chronic overdose, includes the risk of Bone marrow depression and Blood dyscrasias. Immediate emergency help is required when symptoms escalate to Seizure, Collapse, or Trouble breathing.
Mandated Emergency Action: If severe, life-threatening symptoms occur, such as loss of consciousness or a seizure, emergency services must be called immediately.

Official Supportive Statements

  • Specific Countermeasure: Folinic acid (Leucovorin) is specified for administration to counteract the hematological toxicity, particularly bone marrow depression.
  • Management: Symptomatic and supportive treatment is the primary approach, which may include procedures like Gastric lavage and monitoring for electrolyte imbalances or blood dyscrasias.
  • Population Note: Elderly patients are noted to have an increased risk of severe effects, including hematological disorders, due to potential underlying folate deficiencies.

Therapeutic Uses of Berlocid

Berlocid (Co-trimoxazole) is commonly used as a systemic antibiotic to help with pathogen elimination in infections, offering symptomatic relief that helps ease the overall symptom burden across various therapeutic domains.

This medication is generally used for managing conditions characterized by periods of heightened symptoms, including bacterial urinary tract infections (UTIs), acute exacerbations of chronic bronchitis (AECB), acute otitis media, and specific severe infections like Pneumocystis Pneumonia (PCP/PJP) and Shigellosis.

Acute Relief for Symptomatic Distress

The drug is applied in addressing symptom clusters that may become intense or disruptive. It plays a role in managing symptoms related to physical discomfort and systemic imbalance, such as dysuria (painful urination), persistent productive cough, and severe ear pain. When used appropriately, it provides supportive relief when symptoms interfere with routine activities.

“The primary benefit is addressing the infection responsible for symptoms that create noticeable physiological strain.”

Quick Fact: Relief for Symptomatic Discomfort The medicine is commonly used to help with the acute symptomatic episodes of UTIs, contributing to improved comfort and assisting with the maintenance of functional stability against urinary discomfort.

Regulatory References

  1. NIH MedlinePlus overview

Eligibility and Restrictions for Use

Official Eligibility Profile for Berlocid (Co-trimoxazole)

Official regulatory documents define specific population groups that are permitted to use this medicine and groups for whom use is strictly prohibited or restricted. This profile is based solely on documented requirements from global health authorities.

Scope Item Official Regulatory Statement
Populations for whom use is allowed Adults and children aged 2 months and older for most indications. Use is established in children, adolescents, and adults [Source 2.5, 3.4].
Populations for whom use is contraindicated Patients with known hypersensitivity to sulfonamides or trimethoprim. Individuals with severe liver damage or severe, unmonitored renal insufficiency [Source 1.4, 2.6, 3.3].
Age-related restrictions Contraindicated in infants younger than 6 weeks of age (or 2 months, by some labels) due to potential risks of kernicterus [Source 1.3, 2.6].
Condition-specific restrictions Contraindicated in patients with acute porphyria or megaloblastic anemia due to folate deficiency [Source 1.4, 3.3]. Use requires caution in patients with G6PD deficiency or those with a predisposition to folate deficiency [Source 1.5, 2.3].
Physiological status restrictions Contraindicated in pregnant patients at term and in nursing mothers (specifically when the infant is at risk of hyperbilirubinemia) [Source 1.3, 2.8, 3.6].

Connection to the overall eligibility profile

Regulatory documents define who can and cannot use the medicine by establishing clear contraindications based on age, physiological state, and inherent patient factors. For populations outside of these contraindications, use is established, though regulatory labeling mandates caution or dose restriction for certain conditions, such as moderate renal impairment or pre-existing folate deficiency.

What should I know about interactions with other medicines?

Interactions with other medicines and products

Berlocid (Co-trimoxazole) interacts with several medicines through officially documented pharmacokinetic and pharmacodynamic mechanisms, leading to specific regulatory restrictions.

Formal Restrictions and Contraindications

Classification Interacting Substance Official Regulatory Requirement
Contraindicated Dofetilide Must not be co-administered due to inhibition of the renal organic cation transporter (OCT2), significantly increasing Dofetilide plasma concentrations.

Documented Pharmacokinetic Interactions

The medicine is documented to interfere with the metabolism and elimination of several substances, potentially increasing their exposure:

  • Warfarin: Co-administration may potentiate the anticoagulant effect through stereo-selective inhibition of metabolism (CYP2C9 inhibition) and displacement from protein binding sites.
  • Phenytoin: Co-trimoxazole prolongs the half-life of Phenytoin, which can lead to excessive plasma levels.
  • Repaglinide: Exposure is increased due to inhibition of its metabolism (e.g., CYP2C8/CYP2C9), potentiating its effects.
  • Digoxin: Plasma concentrations may be increased, a caution noted as particularly relevant in elderly patients.

Documented Pharmacodynamic Interactions

  • ACE Inhibitors and ARBs: Co-administration carries an officially noted risk of hyperkalaemia (high blood potassium) due to the Trimethoprim component reducing renal potassium excretion.
  • Methotrexate and high-dose Pyrimethamine: Increased risk of haematological toxicity results from combined anti-folate activity, a key regulatory caution.
  • Folinic Acid: Supplementation is noted to interfere with the antimicrobial efficacy of Berlocid during the treatment of specific infections.

Mechanism of Action

Dual and Sequential Enzyme Inhibition

Berlocid's mechanism of action relies on a precise, dual-compound interference with the bacterial metabolic pathway responsible for producing folic acid (tetrahydrofolate, or THF). The first active component, Sulphamethoxazole, acts as a competitive inhibitor to the bacterial enzyme Dihydropteroate synthase (DHPS). This molecular action restricts the creation of necessary folate precursors.


Synergistic Blockade and Microbial Elimination

The second active component, Trimethoprim, intervenes further along the same pathway by inhibiting the enzyme Dihydrofolate reductase (DHFR), which converts the intermediate form of folate into the vital THF cofactor. The sequential blockade results in a synergistic effect, meaning the combined enzymatic inhibition is more potent than the individual effects of the components. This action halts essential synthesis pathways by cutting off the supply of cofactors required for DNA and RNA. This comprehensive shutdown produces a bactericidal (bacteria-killing) physiological effect against susceptible pathogens. The mechanism's selective toxicity is achieved by targeting bacterial DHFR with an affinity significantly greater than for the corresponding human enzyme.

Dosage and Administration Information

How Berlocid is Used: Dosing and Administration

Berlocid (Co-trimoxazole) is administered systemically according to established guidelines to ensure correct dosage and delivery method. Dosing is dependent on the specific infection being treated and the patient's kidney function, and is standardized across its approved forms.

Approved Administration Routes and Schedules

Administration Type Dosing Frequency and Duration Pattern
Oral (Tablet or Suspension) Typically administered twice daily (every 12 hours). Treatment duration often continues for at least five days and until the patient is symptom-free for two days.
Intravenous (IV) Infusion Used for severe infections or if oral intake is not possible. Dosing frequency may increase to three or four times daily for high-dose protocols, such as for Pneumocystis Pneumonia.

Key Administration Instructions

Instruction Category Procedural Rule
Dosing Adjustment (Renal) The standard dose is reduced by half for adult patients with a Creatinine Clearance (CrCl) between 15 and 30 mL/minute. Use is generally not recommended below 15 mL/minute.
IV Preparation and Rate The intravenous concentrate must be diluted prior to use and administered only as a slow infusion over 60 to 90 minutes. Rapid injection or bolus infusion is strictly prohibited.
General Intake Oral tablets may be taken with food or drink. Patients are generally advised to maintain adequate fluid intake throughout the course of treatment.

These instructions establish the parameters for the drug's use: a standardized twice-daily frequency for oral forms, dose modification based on kidney function, and requirements for the slow preparation and administration of the intravenous solution.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Berlocid

Evidence for Use in Pneumocystis Pneumonia (PCP/PJP) Prophylaxis

Research has extensively examined Berlocid in the context of research examining its use for infection incidence against Pneumocystis Pneumonia (PCP/PJP). Studies were primarily conducted using Randomized Controlled Trials (RCTs) and Systematic Reviews, which represent primary research methodologies. Research examined outcomes such as all-cause mortality and the incidence of PCP/PJP infection over follow-up periods that often extended over multiple years in immunocompromised populations, including adults and children with HIV. Available evidence is consistent regarding the patterns observed in the HIV-positive population, but more heterogeneous in other immunocompromised groups.

Evidence for Use in Uncomplicated Bacterial Skin Infections

The medicine was studied for its use in research exploring uncomplicated bacterial skin infections, such as cellulitis. The research typically utilized Randomized, Double-Blind, Placebo-Controlled Trials (RCTs). Researchers focused on measured outcomes related to outcomes linked to inflammatory or irritative states, such as the measurement of changes in redness and swelling, and monitored the rate of needing hospitalization. Results apply only to the populations studied, which were primarily patients with uncomplicated infections not requiring inpatient care. Data for certain groups, such as those with cellulitis without an abscess, may have been limited due to the specific sample sizes used in some trials.

Evidence for Use in Urinary Tract Infections (UTIs)

The medicine was evaluated in research that explored conditions associated with acute or disruptive episodes, such as UTIs. Research examined outcomes related to outcomes linked to inflammatory or irritative states, such as the clearance of bacteria from the urine (bacteriological outcomes) and the rates of recurrence. The evidence is limited due to the variability of evidence quality across studies, as many trials are older or focus on comparing treatment schedules rather than the medicine against a placebo in contemporary populations.

What is Still Uncertain About Berlocid's Evidence

A primary limitation is the growing rate of antimicrobial resistance observed in bacterial strains across different regions, which creates uncertainty about the patterns of effect of the medicine against certain common infections. Limited information is available for long-term outcomes concerning the sustained response after preventive use is discontinued. Furthermore, comparative evidence with some of the newest antibiotic therapies remains sparse in the broader evidence landscape.

Key Studies & References

  1. WHO Model List of Essential Medicines (Co-trimoxazole listing)
  2. NIH MedlinePlus: Sulfamethoxazole and Trimethoprim (Co-trimoxazole) Overview
  3. Co-trimoxazole prophylaxis in reducing mortality and morbidity in HIV-infected children: A systematic review and meta-analysis (Cochrane Review/PubMed)

Frequently Asked Questions (FAQ)

Common questions about Berlocid (FAQ)

Q: When will I start feeling better after taking this medication?

Official pharmacokinetic information describes how the drug works in the body. The active components, sulfamethoxazole and trimethoprim, typically reach their highest concentration in the bloodstream approximately 1 to 4 hours after you take a dose. Pharmacokinetic data describing this absorption profile provides context regarding the medicine's general onset of action.

Q: How is this drug eliminated from the body and how long does it take?

Regulatory data indicates that both active components are primarily removed from the body by the kidneys. The time it takes for half the drug to be eliminated, known as the half-life, is about 9 to 12 hours for both trimethoprim and sulfamethoxazole. Because of this, the body's ability to clear the medicine is highly dependent on kidney function.

Q: Does this medication interact with alcohol?

Official documents note that concurrent use of this medication and alcohol has been reported to potentially cause a reaction similar to that caused by disulfiram. This reaction may involve signs such as rapid heart rate, flushing, nausea, or vomiting. This is noted as a specific regulatory caution.

Q: Are there any effects on laboratory test results I should know about?

Official product information describes that the trimethoprim component can interfere with specific laboratory tests for serum creatinine, which may lead to artificially elevated results. Additionally, sulfamethoxazole has been documented to interfere with certain tests used to measure methotrexate levels. Official guidance notes that medical professionals should be informed of all medicines being taken when laboratory tests are ordered.

Q: Does it cause dizziness, and if so, how often?

According to official sources, dizziness is listed as a potential undesirable effect, meaning it is a reported side effect of the medicine. The specific frequency classification (e.g., common, uncommon) for dizziness may vary slightly depending on the regulatory document consulted.

Q: What should I do if I miss a dose?

Official patient information typically provides a general guideline for managing missed doses. If a dose is forgotten, the advice is usually to take it as soon as it is remembered, unless the time for the next dose is near. In that circumstance, official guidance typically states that the dose should be skipped to avoid accidentally taking too much, and the regular schedule resumed.

Q: Are there any warnings about driving or operating machinery?

Official documents note that this medication has been associated with side effects that affect the central nervous system, such as dizziness, convulsions, and hallucinations. Official product information notes that patients who experience these effects may have an impaired ability to perform tasks requiring concentration, such as driving or operating machinery.

Q: Will there be any effects when I stop taking the medication?

Regulatory documents primarily focus on the clinical risk of stopping treatment prematurely, noting this may lead to the return of the infection being treated. The official product information does not include statements regarding dependence, withdrawal, or habit-forming effects.

Q: Can this medication cause mood swings or changes in behavior?

Official safety profiles indicate that psychiatric effects have been reported as adverse events. These include changes in behavior or mood, such as depression, anxiety, hallucinations, and psychosis. These are documented in the list of potential undesirable effects.

Q: Does this drug cause a metallic taste?

According to regulatory documents, taste disturbances, known as dysgeusia, are listed as a reported undesirable effect. Stomatitis, which is inflammation of the mouth, has also been documented. These effects may potentially lead to changes in the perception of taste.

Q: Is this a controlled substance or scheduled drug?

Official drug scheduling by major government authorities generally classifies this medication as a Prescription-Only Medicine. It is not typically designated as a controlled substance due to a lack of documented potential for abuse or dependence.

Q: Is there any public data available on the safety and tracking of adverse events?

Yes, regulatory agencies like the FDA and EMA operate systems to track and monitor adverse events reported for this medicine. Safety signals are continuously evaluated, and if a new risk is confirmed, official documents are updated to ensure the information is available to healthcare professionals and the public.

Q: Can I crush or chew the tablet if I have trouble swallowing?

Official product information sometimes notes that tablets are scored to assist in swallowing the whole unit, but this is not an instruction to divide the dose. For patients with difficulty swallowing, an oral suspension (liquid form) of the medicine is typically available as an alternative formulation.

Q: Does it interact with common over-the-counter pain relievers?

Regulatory documents state that this medicine can interact with the class of drugs known as non-steroidal anti-inflammatory drugs (NSAIDs), which include common pain relievers. This combination may increase the risk of certain adverse effects, such as kidney toxicity and high potassium levels (hyperkalemia).

Q: Does this medication cause sensitivity to the sun?

Official regulatory documents list photosensitivity as a potential undesirable effect. Photosensitivity means an increased sensitivity or reaction to sunlight. Due to this potential risk, regulatory information mentions that exposure to direct sunlight should be minimized.

Q: Does this medicine treat viral infections?

Official pharmacological data classifies this medicine as an antibiotic and states that it is effective against susceptible organisms. This typically includes a wide range of bacteria, as well as certain protozoa and fungi. It is not approved for the treatment of infections caused by viruses.

Q: How common is a rash side effect?

Rash is a commonly reported adverse event for this medication, according to regulatory classification. However, official safety information emphasizes that more severe skin reactions, such as Stevens-Johnson Syndrome, are considered rare but serious adverse events.

Q: Are there any special considerations for older adults?

Official warnings document that particular care is required when this medication is used by older adults. This population may have an increased susceptibility to adverse reactions, especially if there is existing impairment of kidney or liver function. This caution is noted in regulatory documents regarding geriatric use.

Q: What is the difference between short-term and long-term use?

The primary distinction noted in regulatory documents regarding duration of use relates to safety monitoring. When the medicine is administered for long periods, such as in preventive regimens, regular checks of blood counts may be necessary due to the potential for changes in blood indices.

Q: What kind of bacteria is this medicine effective against?

This medicine is defined as a broad-spectrum antibiotic. Official documents describe it as being effective against a wide range of susceptible bacteria, including both Gram-positive and Gram-negative types. It also shows activity against certain protozoa and fungi.

Q: Is there a reason people with heart conditions can't take this?

Official safety warnings caution about the risk of hyperkalaemia, or high potassium levels, which can be severe. This risk is a particular concern that is documented for patients with certain pre-existing heart conditions. The medicine is generally not listed as an absolute contraindication for all heart conditions.

Q: Does it work if I have G6PD deficiency?

Official warnings state that use in patients with Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency may lead to haemolysis, which is the destruction of red blood cells. This is noted as a specific risk factor in the official product information.

How should Berlocid be stored and disposed of?

How to Store and Dispose of Berlocid

Official regulatory documents define specific conditions for storing and disposing of Berlocid (Co-Trimoxazole) to maintain drug stability and safety. The primary storage requirements relate to temperature and light protection.

Storage Domain Requirement
Temperature Do not store above 25 C.
Protection Keep in the outer carton to protect from light.
Shelf Life 60 months when stored under the specified conditions.

Storage must ensure the medicine remains in its original, safe location and is not passed on to other individuals. Unused or expired Berlocid should not be discarded in household waste but must be disposed of according to local requirements, typically through a recognized pharmacy take-back scheme.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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