Суметролим

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Medically reviewed

Rosario Oropesa

Last updated on 22/12/2025

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 Суметролим

Property Description
Active Ingredient Sulfamethoxazole, Trimethoprim (Co-trimoxazole)
Form Tablet, Oral Suspension, Solution for Intravenous Infusion
Pharmacological Class Antibacterial, Sulfonamide and Folate Antagonist Combination
General Purpose To stop the growth and survival of susceptible bacteria
Origin Synthetic, Fixed-dose combination product

Identity and Classification: The Fixed-Dose Antibacterial Combination

Суметролим is a synthetic antibacterial combination product used to combat infections caused by susceptible bacteria. This brand delivers the generic medicine known as Co-trimoxazole (or trimethoprim/sulfamethoxazole), placing it in the high-level antibiotic category. Co-trimoxazole is a prescription-only medication.

Unlike many single-agent medicines, Co-trimoxazole is officially classified as a fixed-dose combination product because it contains two distinct active ingredients working together. Its combination structure is recognized for providing an enhanced effect compared to its individual components. Its high-level pharmacological classification groups it as both a sulfonamide and a folate antagonist, defining it as a robust anti-infective agent for various clinical applications.


The Composition: Two Active Ingredients for a Single Purpose

Суметролим is composed of the two essential active ingredients: sulfamethoxazole (SMX) and trimethoprim (TMP). This pairing is intentionally designed to achieve a highly effective synergistic anti-bacterial effect. The medicine is manufactured in various physical dosage forms, including solid oral tablets (such as the DS or Double Strength form), liquid oral suspension, and a solution prepared for intravenous infusion.

Sulfamethoxazole is categorized as a sulfonamide antibiotic, while trimethoprim is a dihydrofolate reductase inhibitor. Their co-formulation is necessary to realize their enhanced anti-microbial potential across different patient groups, including children who may require the liquid suspension.


How Суметролим Works to Stop Bacterial Growth

The medicine works by inducing a sequential blockade of folic acid enzymes within the targeted bacteria. Folic acid is a vital nutrient that bacteria must synthesize to create the nucleic acids and proteins needed for growth and replication. Consequently, the medicine essentially starves the bacteria of the building blocks they need to survive and spread. By attacking this process at two separate steps, the drug effectively prevents bacterial growth. This dual-action mechanism results in a powerful anti-bacterial action that ultimately helps the body eliminate the underlying infectious process.

Regulatory References

  1. U.S. National Institutes of Health
  2. NIH MedlinePlus

What side effects are possible with Суметролим?

Possible Side Effects and Safety Information

The safety profile of Суметролим (Co-trimoxazole) is formally documented in government regulatory materials, classifying potential adverse reactions by both their extbffrequency and the extbfSystem-Organ Class they affect. This information is intended to communicate the full scope of risks and required monitoring.


Regulatory Classification of Adverse Reactions

Adverse effects are categorized based on their documented occurrence rates. extbfHyperkalemia (elevated potassium levels) is the only reaction classified as extbfVery Common according to some official regulatory documents. extbfCommon reactions include extbfnausea, extbfvomiting, and extbfskin rash. Uncommon effects documented include extbfdiarrhea and extbfhepatitis.

Reactions are grouped physiologically, involving the extbfBlood and Lymphatic System (e.g., leucopenia, agranulocytosis), extbfGastrointestinal Disorders (e.g., acute pancreatitis), and extbfHepatobiliary Disorders (e.g., jaundice). Reactions such as extbfrenal failure are also listed.


Serious Adverse Reactions and Safety Constraints

Official labeling highlights the potential for extbfserious adverse reactions, which, though rare, are clinically significant. These include severe cutaneous reactions like extbfStevens-Johnson Syndrome (SJS) and extbfToxic Epidermal Necrolysis (TEN), as well as severe blood abnormalities (dyscrasias) and extbfHepatic Necrosis.

The use of the medicine is formally extbfcontraindicated in individuals with severe pre-existing extbfhepatic damage, extbfsevere renal impairment, and extbfmegaloblastic anemia due to folate deficiency. extbfPeriodic monitoring of complete blood counts is specified in official prescribing information for patients on extbfextended administration or those predisposed to folate deficiency.


Population-Specific Safety Notes

The risk of adverse reactions is documented to be extbfincreased in certain populations. extbfOlder adults carry a higher risk of serious reactions, and patients with extbfAIDS are noted to have a significantly higher incidence of effects like fever, rash, and blood abnormalities. extbfHyperkalemia is noted to potentially occur extbfrapidly after treatment initiation.

Overdose and Emergency Response

Overdose Manifestations

An acute overdose of Суметролим (Co-trimoxazole) may lead to officially documented manifestations such as vomiting, loss of appetite (anorexia), headache, dizziness, and confusion. More pronounced signs can include mental depression, blood in the urine (hematuria), and yellowing of the skin or eyes (jaundice). Chronic overdose, resulting from prolonged high exposure, is officially associated with serious hematologic outcomes, notably bone marrow depression. Severe toxicity may also present with metabolic abnormalities, including hyperkalemia (high blood potassium) or hyponatremia (low blood sodium).

When Immediate Medical Help is Required

Official guidance mandates that emergency medical attention must be sought immediately if an overdose is suspected. Urgent contact with emergency services is required if the individual has collapsed, is experiencing a seizure, has trouble breathing, or cannot be awakened. These actions are triggered by the official documentation of potentially life-threatening symptoms.

Supportive Management and Monitoring

Regulatory documents specify that overdose management is primarily symptomatic and supportive. Procedures may include gastric lavage or emesis and the administration of fluids to promote drug elimination. Monitoring requirements include regular blood counts and appropriate blood chemistries, such as electrolytes. Special consideration is given to patients with severely impaired renal function, who are noted to be at higher risk of drug accumulation and toxicity due to the increased half-lives of the components.

Therapeutic Uses of Суметролим

What Суметролим Treats: Main Uses and Benefits

Суметролим (Co-trimoxazole) plays a therapeutic role in providing symptomatic support in conditions associated with bacterial infection across several key domains. It is applied in contexts where a patient may require additional management of discomfort in conditions marked by heightened distress and acute manifestations. The medication may be relevant for easing symptoms in conditions such as infections of the urinary tract, acute exacerbations of chronic bronchitis, certain gastrointestinal illnesses, and acute otitis media. This application is commonly used when short-term symptomatic assistance is needed to help manage the intensity of symptoms.

Therapeutic Focus and Relief

The medication may be relevant in conditions characterized by periods of heightened symptoms presenting with systemic or localized discomfort. It is commonly used to help with infections involving the urinary tract, like acute cystitis and pyelonephritis; the respiratory tract, including Pneumocystis jirovecii Pneumonia (PJP); and specific cases of Shigellosis and skin/soft tissue infections. By supporting the management of the underlying infection, it helps ease the overall symptom burden on the patient, which may support general well-being during symptomatic phases. The therapeutic role of the medication is to support the patient during difficult episodes by easing distress and contributing to improved day-to-day comfort.

Quick Fact: Relief for Multiple Symptom Domains
Symptom Easing: Helps address symptoms like painful urination (dysuria), severe diarrhea, and localized swelling/redness associated with specific bacterial infections.
Context: Applied when symptoms become temporarily overwhelming and supportive relief is needed across urinary, respiratory, and skin/gut domains.

Eligibility and Restrictions for Use

Eligibility Scope

Category Official Regulatory Status
Populations for whom use is allowed Adults, adolescents, and children ge 2 months of age are approved for use in labeled indications.
Populations for whom use is contraindicated Patients with known hypersensitivity to trimethoprim or sulfonamides; those with marked hepatic damage or severe renal insufficiency ( CrCl < 15 mL/minute); and patients with megaloblastic anemia due to folate deficiency.

Age-Related and Specific Eligibility Rules

Age-Related Eligibility Rules

  • Infants ( < 2 months): Contraindicated due to the risk of hyperbilirubinemia and kernicterus.
  • Older Adults (Geriatric): Use is allowed but requires particular caution due to increased susceptibility to adverse reactions, including folate deficiency.

Condition-Specific Eligibility Rules

  • Pregnancy (Third Trimester): Contraindicated.
  • Lactation/Nursing: Not Recommended/Contraindicated for infants less than two months old, premature, or G6PD-deficient.
  • Co-administration: Contraindicated for patients concurrently receiving the antiarrhythmic drug dofetilide.
  • Conditional Use: Use requires caution in patients with G6PD deficiency (risk of hemolysis) and those with impaired renal function ( CrCl 15–30 mL/minute), which necessitates dosage reduction.

Connection to the overall eligibility profile Official regulatory documents define non-eligibility for Суметролим through specific criteria, primarily establishing absolute contraindications based on age, allergies, and severe organ function compromise. Use is either approved for healthy, eligible groups or subjected to restricted conditions where patient risk factors necessitate explicit regulatory caution and monitoring.

What should I know about interactions with other medicines?

Interactions with other medicines and products

Суметролим (Sulfamethoxazole/Trimethoprim) can interact with a variety of other medicines, potentially increasing the risk of serious side effects or reducing the effectiveness of the concomitant drug. The most significant concern involves Dofetilide, an antiarrhythmic medicine, whose combination with Суметролим is contraindicated due to the potential for fatal heart rhythm abnormalities.

Close monitoring and possible dose adjustment are required for concurrent use with the anticoagulant Warfarin, as the combination can amplify its blood-thinning effects, increasing the risk of bleeding. Similarly, co-administration with the anti-epileptic Phenytoin may raise its serum concentration, necessitating drug level monitoring to avoid toxicity.

Caution is advised with agents that affect potassium levels, such as ACE inhibitors and diuretics (especially thiazides in the elderly), due to the risk of hyperkalemia. The drug may also potentiate the effects of certain oral hypoglycemic agents (like sulfonylureas and repaglinide), requiring frequent blood glucose monitoring. Avoidance of concurrent use is also advised for Methotrexate and Cyclosporine due to increased toxicity and nephrotoxicity risk, respectively.

Mechanism of Action

Sequential Disruption of Bacterial Metabolism

Суметролим (Co-trimoxazole) utilizes a synergistic, dual-action mechanism that interferes with the ability of susceptible bacteria to grow and replicate by targeting a core metabolic pathway. The combination targets the required bacterial synthesis of tetrahydrofolate (THF), a vital cofactor.

The mechanism involves the two active ingredients blocking consecutive enzymatic steps. Sulfamethoxazole (SMX) acts as a structural analog to inhibit Dihydropteroate Synthase (DHPS). Simultaneously, Trimethoprim (TMP) directly inhibits Dihydrofolate Reductase (DHFR). . This sequential interference ensures a profound disruption of the microbial folate metabolism pathway.

This deficit in THF compromises the ability of bacteria to produce the essential precursors—purines and thymidine—required for new DNA and RNA synthesis. This molecular deprivation prevents the bacteria from dividing or growing, a mechanism that is often bactericidal (cell-killing) due to the combination's synergy, resulting in a profound loss of microbial viability.

Dosage and Administration Information

Administration Instructions (Co-trimoxazole)

Суметролим (Co-trimoxazole) is administered according to standard methods, dosages, and procedural steps defined for its use.

Administration Scope

Feature General Administration Guidelines
Route of Administration Oral (tablets, suspension) and Intravenous (IV) Infusion (solution concentrate). The IV route is administered over a 60 to 90 minute period.
Dosing Schedule Standard Dose: One Double Strength (DS) Tablet (800 mg SMX / 160 mg TMP) per dose, typically for acute infections. High Dose: Weight-based for conditions like PJP, using up to 15 to 20 mg/kg of the trimethoprim component per day.
Frequency and Timing Acute Treatment: Dosing is generally every 12 hours. Severe Infections: Dosing may be every 6 to 8 hours. Prophylaxis: Intermittent schedules, such as once daily or three times per week are used.
Course Duration Courses range from 5 days (e.g., Shigellosis, Traveler’s Diarrhea) to 14 to 21 days for more severe or complex treatments.
Special Administration Oral forms may be taken with or without food but should be consumed with a full glass of water. The oral suspension must be shaken well before use.

Procedural and Adjustment Rules

Specific adjustments are required for certain populations. Patients with moderate renal impairment (Creatinine Clearance between 15 and 30 mL/min) must receive half the usual dosage regimen. The drug is generally not recommended for infants under 2 months of age. The intravenous solution concentrate must be diluted prior to infusion and must not be mixed with other medicinal products in the same container. If a dose is missed, it should be taken as soon as possible, or the dose should be skipped and the regular schedule continued if it is almost time for the next dose; double doses should not be taken.

Recent Clinical Evidence

Research evidence / Overview of studies for Суметролим

The medicine Суметролим (Co-trimoxazole) was studied in clinical trials to evaluate outcomes in contexts associated with bacterial presence. These studies follow patterns set by regulators to observe changes in patient status during the study period and track long-term status where possible. The research focuses on specific populations and monitored measurements related to bacterial presence and symptom evolution.

Evidence for Use in Urinary Tract Infections (UTIs)

The research exploring the use of Co-trimoxazole for Urinary Tract Infections (UTIs) relies on Randomized Controlled Trials (RCTs) and Systematic Reviews. These studies research examined different patient groups, including non-pregnant adults and older adults in institutional settings. Researchers used in research exploring how symptoms change over time, focusing on two key measured endpoints: microbiological eradication rate, which monitors bacterial presence, and clinical cure rate, which tracks symptom evolution. Findings describe patterns observed in the studies where treatment courses were typically short-term. What remains uncertain is the extent of long-term findings, as long-term patterns are not fully established.

Evidence for Use in Pneumocystis Jirovecii Pneumonia (PJP)

The evidence supporting the study of Co-trimoxazole for Pneumocystis Jirovecii Pneumonia (PJP) was evaluated in specialized cohorts. The research base includes Systematic Reviews, Meta-analyses, and observational studies structured to evaluate outcomes in immunocompromised patients. Key outcomes research examined included measurements of survival and mortality rates, as well as composite outcomes that monitored physiological status. Data show patterns related to these critical outcomes in both acute and long-term preventive use. What is still uncertain relates to the optimal dose for prophylaxis, as findings were mixed when evaluating lower-dose regimens.

Evidence for Use in Other Acute Infections

Research studies explored the role of Суметролим in several other short-term infections, including Acute Otitis Media (AOM), Acute Exacerbations of Chronic Bronchitis, and certain Gastrointestinal Infections. Comparative trials was evaluated in the pediatric population for AOM. Short-term RCTs were conducted during periods of increased symptom activity for chronic bronchitis. Research focused on the clinical resolution of acute diarrheal symptoms for GI infections. Evidence contributes to the research landscape by observing symptom patterns within the first one to two weeks of the study period.

What is Still Uncertain About Суметролим Research

The research on Суметролим highlights several areas where data are still emerging or where certainty remains low. A primary focus is the impact of antibiotic resistance. As resistance patterns evolve, the historical research findings may not fully align with contemporary results, meaning comparative evidence is limited for many current research scenarios. Furthermore, studies often describe group patterns, and research does not determine whether an individual’s clinical pattern will evolve similarly. Data for certain special groups, including pregnant populations, remain insufficient.

Key Studies & References

  1. Trimethoprim Sulfamethoxazole: StatPearls - NCBI Bookshelf (NIH)
  2. Low-dose trimethoprim-sulfamethoxazole for prophylaxis of Pneumocystis jirovecii pneumonia in HIV-uninfected patients: a systematic review and meta-analysis - Frontiers

Frequently Asked Questions (FAQ)

Common questions about Суметролим (FAQ)


Q: Why is Суметролим prescribed for so many different infections?

Суметролим is a combination of two active medicines that work together to fight bacteria. Official product information describes this dual-action mechanism as blocking two necessary steps in the bacterial production of folic acid. This results in a potent action against many different kinds of susceptible bacteria, which contributes to its wide range of uses for various conditions.


Q: Is Суметролим considered a broad-spectrum antibiotic?

Regulatory documents indicate that this medicine is active against a wide variety of bacteria. It is used for infections caused by several strains, including specific types of E. coli, Klebsiella, Proteus, and Shigella. This range of activity makes it generally classified as an anti-infective agent used for diverse bacterial conditions.


Q: How quickly should I expect to see an improvement after starting Суметролим?

While individual response can vary, the medicine is often prescribed for short-term courses, such as five days for some acute infections. This duration suggests that the expected clinical response and symptom improvement are generally anticipated to occur over a short period. It is standard practice for conditions to be monitored by a healthcare professional to assess the drug's effect.


Q: Can Суметролим cause sensitivity to sunlight?

Yes, official adverse reaction reports list an increased sensitivity of the skin to sunlight (photosensitivity) as a potential effect of this medicine. Regulatory documents advise that patients are advised to discuss appropriate sun exposure precautions with their healthcare provider, as this reaction has been reported.


Q: Are there any common foods or drinks that should be avoided while taking Суметролим?

The trimethoprim component of this medicine can cause an increase in potassium levels (hyperkalemia). Because of this, official warnings advise caution when certain high-potassium agents are used at the same time. Patients should consult their healthcare provider about whether dietary changes, particularly concerning high-potassium foods or salt substitutes, are necessary during treatment.


Q: Does Суметролим interact with common pain relievers like ibuprofen?

Regulatory information advises caution with medicines that affect the kidneys. This includes certain non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. Taking this combination may potentially increase the risk of adverse renal effects or hyperkalemia (high potassium levels).


Q: Does Суметролим affect birth control pills?

Official drug interaction information indicates that the sulfamethoxazole component of this medicine may reduce the effectiveness of certain oral contraceptives that contain ethinyl estradiol. This potential interaction may be associated with an increased risk of breakthrough bleeding or reduced contraceptive reliability.


Q: Can Суметролим cause changes in mood or sleep?

Adverse effects related to the nervous system have been reported in regulatory documents. These have included conditions like headache, depression, hallucinations, and aseptic meningitis. These reported adverse reactions are documented as affecting the nervous system.


Q: How long does Суметролим typically stay in the body?

The mean serum half-life for the sulfamethoxazole component is approximately 9 to 12 hours, according to official clinical pharmacology data. The trimethoprim component remains slightly shorter, with a half-life of approximately 6 to 11 hours in adults with normal kidney function.


Q: Is there a known interaction between Суметролим and alcohol?

Regulatory information states that patients with a history of alcohol abuse or liver disease may have an increased risk of serious side effects. Such patients are identified as a population where caution is warranted when the drug is used. Some sources note the potential for alcohol to cause a disulfiram-like reaction.


Q: Does the use of Суметролим increase the risk of antibiotic resistance?

Regulatory labeling indicates that all antibiotics are intended for use only to treat or prevent infections strongly suspected to be caused by bacteria. This general principle is applied to reduce the development of drug-resistant bacteria.


Q: What are the signs of a severe skin reaction related to Суметролим?

Severe skin reactions, such as Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), are documented as serious potential adverse effects. Regulatory documents describe warning signs that may present with symptoms such as skin rash, blistering, peeling, fever, red or irritated eyes, or sores in the mouth or on the lips.


Q: What are the long-term effects of taking Суметролим?

The potential for adverse effects is greater with extended use of the medicine. Regulatory documents highlight that long-term administration may increase the risk of certain blood disorders, such as aplastic anemia, or liver problems. Because of this, periodic monitoring of complete blood counts is required for patients on prolonged treatment.


Q: Can Суметролим affect liver function test results?

Adverse effects on the liver, including hepatitis and jaundice, have been reported in official documents. Because of this risk, regulatory warnings describe the necessity for monitoring of liver function tests in specific patient populations, such as those with existing liver dysfunction.


Q: How can I tell the difference between a side effect and an allergic reaction to Суметролим?

Common side effects listed in official information typically include nausea or a minor rash. In contrast, signs of a severe allergic reaction are more immediate and serious. These serious signs may include trouble breathing, swelling of the face, lips, tongue, or throat, or a severe, widespread, or blistering rash.


Q: Does Суметролим interact with supplements or vitamins?

Official patient instructions describe the importance of disclosing all prescription and non-prescription items, including vitamins and herbal supplements, to the prescribing healthcare provider. This ensures that any potential interactions can be assessed prior to treatment.


Q: Can Суметролим cause dizziness or lightheadedness?

Yes, dizziness is listed as a potential adverse reaction of this medicine in official regulatory documentation. This is one of the potential effects that may be experienced during treatment.


Q: Does Суметролим lose its effectiveness over time?

Official microbiological information notes that the combination of the two active components helps resistance develop more slowly than if each drug was used alone. The regulatory documents emphasize that the drug should be used only for susceptible bacteria.


Q: Is the onset of action of Суметролим quick or slow?

The onset is relatively quick after oral administration. Regulatory clinical pharmacology data indicates that the peak blood levels for the active ingredients occur within 1 to 4 hours. This means the medicine is rapidly absorbed into the bloodstream.


Q: Can Суметролим cause headache?

Yes, headache is listed as a common adverse reaction in the official regulatory documents for this medicine. This is one of the effects that is often monitored during treatment.


Q: Is it safe to drive or operate machinery while taking Суметролим?

Regulatory documents state that adverse effects such as dizziness or convulsions have been reported, which may affect an individual's ability to drive or operate machinery. Patients should be aware of these potential effects.


Q: Does Суметролим cause fatigue?

Yes, fatigue (a general feeling of unusual tiredness or weakness) is listed as a potential adverse reaction in the official product information for this medicine.


Q: Why is it important to stay hydrated while taking Суметролим?

The necessity for adequate fluid intake is described as important for preventing a condition called crystalluria (the formation of crystals in the urine). This condition is associated with the sulfamethoxazole component of the medicine.


Q: Are there specific symptoms that mean I should stop taking Суметролим right away?

Regulatory documents describe certain severe and potentially serious reactions that warrant immediate medical evaluation. These symptoms include a severe skin rash, blisters, trouble breathing, or severe abdominal pain with bloody diarrhea.


Q: Can Суметролим cause thrush or yeast infections?

Official patient information notes that using this medication for prolonged or repeated periods may result in a secondary fungal infection. This includes conditions such as oral thrush or a new yeast infection in other areas of the body.

How should Суметролим be stored and disposed of?

How to Store and Dispose of Sulfamethoxazole and Trimethoprim (Sumetrolim)

Official regulatory guidelines define specific conditions for storing and disposing of this medication to maintain its stability and ensure safety.


Storage Requirements

Condition Requirement
Temperature Store tablets and oral suspension at controlled room temperature, specifically between 68 F to 77 F (20 C to 25 C).
Protection The oral suspension must be protected from light. All forms must be kept away from excessive heat and moisture, and kept from freezing.
Container Keep the medicine in its original container, tightly closed. Do not use the product if the original seal is broken.
Child Safety Store the medication out of the sight and reach of children.

Disposal Instructions

Unused or expired medicine must be disposed of properly. The recommended method is to use a community drug take-back program. If no program is available, follow the specific procedure of mixing the drug with an undesirable substance and sealing it in a container before placing it in household trash. Do not flush the medication down the toilet.

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

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