COXICURE 30% POWDER 100G

Indications

• Urinary tract infections
• Respiratory tract infections
• Gastrointestinal infections
• Certain bacterial infections in immunocompromised patients

Dosage

Children: Refer to the BNF for Children for appropriate paediatric dosing.

Adults: Refer to specific clinical guidelines or the BNF for appropriate adult dosing.

Mechanism of action

Sulphaclozine works by competitively inhibiting the enzyme dihydropteroate synthase in the bacterial folate synthesis pathway. This inhibition prevents the formation of dihydropteroic acid, a precursor in the synthesis of folate, thus ultimately leading to a reduction in bacterial DNA, RNA, and protein synthesis, effectively inhibiting bacterial growth and replication.

Pharmacodynamics

Sulphaclozine exhibits bactericidal activity against a wide range of Gram-positive and Gram-negative bacteria. The drug's efficacy is influenced by the concentration of the drug at the site of infection and the susceptibility of the bacteria involved. Resistance may develop through chromosomal mutations or plasmid-mediated mechanisms that alter the target enzyme or decrease drug permeability.

Pharmacokinetics

Sulphaclozine is typically administered orally and is absorbed from the gastrointestinal tract. The drug is distributed throughout body tissues and fluids, including the lungs and kidneys. Sulphaclozine is metabolized in the liver and excreted primarily through the kidneys, with both unchanged drug and metabolites being eliminated in the urine. The half-life of sulphaclozine varies but is generally around 6 to 12 hours.

Contra-indications

• Hypersensitivity to sulfonamides or any component of the formulation
• Severe renal impairment
• Blood dyscrasias such as aplastic anemia or agranulocytosis

Adverse effects

• Skin rashes
• Nausea and vomiting
• Diarrhea
• Headache
• Hematological disorders including thrombocytopenia and leukopenia
• Hepatotoxicity
• Renal toxicity

Interactions

• May enhance the effects of anticoagulants such as warfarin
• May interact with methotrexate leading to increased toxicity
• May decrease the effectiveness of certain antidiabetic agents

Precautions

• Use with caution in patients with a history of asthma or allergies
• Monitor renal function regularly during therapy
• Caution in the elderly or those with underlying health conditions

Pregnancy

Use during pregnancy only if clearly needed, as safety in pregnancy has not been established.

Breast-feeding

Caution is advised when administering to breastfeeding mothers due to potential effects on the infant.

Storage

Store at room temperature, away from moisture and heat.

Formulations

• Tablets
• Oral suspension