Synastat Tab

Side Effects of Synastat Tab

Nausea, vomiting, glossitis, pruritus, skin rash, fever, hyponatremia, hyperkalaemia, photosensitivity, liver enzyme elevation, , raised serum creatinine and BUN, blood dyscrasias, cholestatic jaundice, anaphylaxis, aseptic meningitis. Potentially Fatal: Stevens-Johnson syndrome, toxic epidermal necrolysis.

Drug Interactions

Concurrent use increased risk of blood dyscrasias with azathioprine, methotrexate, pyrimethamine; increased risk of hyperkalaemia with ACE inhibitors; increased risk of hyponatraemia when used with both potassium-sparing diuretics and thiazides; increased risk of bleeding with warfarin; increased risk of lithium toxicity; increased digoxin, phenytoin, procainamide, lamivudine, stavudine, repaglinide, rosiglitazone, dofetilide serum levels; decreased ciclosporin levels. Concurrent use with dapsone increased serum levels of both and increased risk of dapsone toxicity.

Contraindications

Hypersensitivity, serious haematological disorders, severe renal impairment, megaloblastic anaemia secondary to folate depletion.

Mechanism of Action

Trimethoprim inhibits the conversion of bacterial dihydrofolic acid to tetrahydrofolic acid which is important for the synthesis of DNA. It may be bacteriostatic or bactericidal depending on growth conditions. It is active against a wide range of gm-ve and gm+ve aerobes, as well as some protozoa. Absorption: Almost completely absorbed from the GI tract Distribution: Widely distributed into body tissues and fluids. Apparent Vd ranges from 100-120 L. 45% bound to plasma proteins. Crosses placenta readily. Metabolism: 10-20% metabolised by liver to oxide and hydroxylated metabolites Excretion: 40-60% excreted by the kidneys as unchanged drug within 24 hr; small amounts excreted in faeces via the bile.

Special Precautions

Renal and hepatic impairment, porphyria, patients with potential folate deficiency, elderly, pregnancy, lactation, children with fragile X chromosome associated with mental retardation. Perform regular haematological examination.

How to Use

Take orally with food and water, as directed by your physician.

How to Store

Keep in a cool, dry place away from sunlight and moisture.

Safety Concerns

• Alcohol: Avoid during treatment.
• Breastfeeding: Not recommended.
• Pregnancy: Contraindicated.
• Liver/Kidney: Use with caution.

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This content is for educational purposes only. Please consult your doctor before use.