Manufacturer: Pacific Pharmaceuticals manufactures Trisul.
The uses of Trisul include:
TRISUL should only be used where, in the judgement of the physician, the benefits of treatment outweigh any possible risks; consideration should be given to the use of a single effective antibacterial agent.
Urinary tract infections
Respiratory tract infections
Treatment of acute exacerbations of chronic bronchitis.
Treatment and prevention of Pneumocystis Jirovecii.
Genital tract infections
Treatment of chancroid.
Treatment granuloma inguinale (venereum)
Gastrointestinal tract infections
Treatment of shigellosis
Treatment of travellers' diarrhoea (including gastroenteritis due to enterotoxigenic E. coli).
Treatment and prophylaxis of toxoplasmosis, treatment of nocardosis.
Dosage and Administration
It may be preferable to take TRISUL with some food or drink to minimise the possibility of gastrointestinal disturbances.
Adults and Children over 12 years
Standard dosage - 2 tablets every 12 hours.
This dosage approximates to 6 mg trimethoprim and 30 mg sulfamethoxazole per kilogram body weight per 24 hours.
Treatment should be continued until the patient has been symptom free for two days; the majority will require treatment for at least 5 days. If clinical improvement is not evident after 7 days' therapy, the patient should be reassessed.
As an alternative to STANDARD DOSAGE for acute uncomplicated lower urinary tract infections, short term therapy of 1 to 3 days' duration has been shown to be effective.
Use in the Elderly
Particular care is always advisable when treating elderly patients because, as a group, they are more susceptible to adverse reactions and more likely to suffer serious effects as a result particularly when complicating conditions exist, e.g. impaired kidney and/or liver function and/or concomitant use of other medications.
Special Dosage Recommendations
Unless otherwise specified STANDARD DOSAGE applies.
Where dosage is expressed as "tablets" this refers to the adult tablet, ie. 80 mg trimethoprim and 400 mg sulfamethoxazole. If other formulations are to be used appropriate adjustment should be made.
Impaired renal function
Adults and Children over 12 years: (No information is available for children under 12 years of age).
Creatinine Clearance (ml/min) Recommended Dosage
> 30 Standard dosage
15 - 30 Half the standard dosage
< 15 Not recommended
A higher dosage is recommended, using 20 mg trimethoprim and 100 mg sulfamethoxazole per kg body-weight per day in two or more divided doses for two weeks. The aim is to obtain peak plasma or serum levels of trimethoprim of greater than or equal to 5 micrograms/ml.
The following dose schedules may be used:
160 mg trimethoprim/800 mg sulfamethoxazole daily 7 days per week.
160 mg trimethoprim/800 mg sulfamethoxazole three times per week on alternate days.
320 mg trimethoprim/1600 mg sulfamethoxazole per day in two divided doses three times per week on alternate days.
The following dose schedules may be used for the duration of the period at risk:
Standard dosage taken in two divided doses, seven days per week
Standard dosage taken in two divided doses, three times per week on alternate days
Standard dosage taken in two divided doses, three times per week on consecutive days
Standard dosage taken as a single dose, three times per week on consecutive days
The daily dose given on a treatment day approximates to 150 mg trimethoprim/m2/day and 750 mg sulfamethoxazole/m2/day. The total daily dose should not exceed 320 mg trimethoprim and 1600 mg sulfamethoxazole.
In uncomplicated cases 4 tablets every 12 hours for two days; or
5 tablets followed by a further 5 tablets eight hours later; or
10 tablets once daily for 3 days.
If poor patient compliance is expected a single dose of 8 tablets taken under supervision may be employed.
Oro-pharyngeal gonococcal infection
2 tablets three times daily for seven days.
The standard dosage recommendations for gonorrhoea are applicable.
2 tablets twice daily for 7 days; if no evidence of healing is apparent after 7 days a further 7 days' treatment can be considered, however, physicians should be aware that failure to respond may indicate that the disease is caused by a resistant organism.
2 tablets twice daily for up to 2 weeks.
There is no consensus on the most appropriate dosage. Adult doses of 6 to 8 tablets daily for up to 3 months have been used.