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п»їSulfamethoxazole and Trimethoprim tablet
What is this medicine?

SULFAMETHOXAZOLE; TRIMETHOPRIM or SMX-TMP is a combination of a sulfonamide antibiotic and a second antibiotic, trimethoprim. It is used to treat bacterial infections. It is also used to prevent infections in people who are at risk. It will not work for colds, flu, or other viral infections.
What should my health care professional know before I take this medicine?

They need to know if you have any of these conditions:
anemia
asthma
being treated with anticonvulsants
if you frequently drink alcohol containing drinks
kidney disease
liver disease
low level of folic acid or glucose-6-phosphate dehydrogenase
poor nutrition or malabsorption
porphyria
severe allergies
thyroid disorder
an unusual or allergic reaction to sulfamethoxazole, trimethoprim, sulfa drugs, other medicines, foods, dyes, or preservatives
pregnant or trying to get pregnant
breast-feeding
How should I take this medicine?

Take this medicine by mouth with a full glass of water. Take your medicine at regular intervals. Do not take it more often than directed. Do not skip doses or stop your medicine early.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed. This medicine has been used in children as young as 2 months of age.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.
What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.
What may interact with this medicine?

Do not take this medicine with any of the following:
aminobenzoate potassium
dofetilide
metronidazole

This medicine may also interact with the following:
ACE inhibitors like benazepril, enalapril, lisinopril, and ramipril
cyclosporine
digoxin
diuretics
indomethacin
medicines for diabetes
methenamine
methotrexate
phenytoin
potassium supplements
pyrimethamine
sulfinpyrazone
tricyclic antidepressants
warfarin

This list may not describe all possible interactions. Give your health care providers a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.
What should I watch for while using this medicine?

Tell your doctor or health care professional if your symptoms do not improve. Drink several glasses of water a day to reduce the risk of kidney problems.

Do not treat diarrhea with over the counter products. Contact your doctor if you have diarrhea that lasts more than 2 days or if it is severe and watery.

This medicine can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and use a sunscreen. Do not use sun lamps or tanning beds/booths.
What side effects may I notice from this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:
allergic reactions like skin rash or hives, swelling of the face, lips, or tongue
breathing problems
fever or chills, sore throat
irregular heartbeat, chest pain
joint or muscle pain
pain or difficulty passing urine
red pinpoint spots on skin
redness, blistering, peeling or loosening of the skin, including inside the mouth
unusual bleeding or bruising
unusually weak or tired
yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
diarrhea
dizziness
headache
loss of appetite
nausea, vomiting
nervousness

This list may not describe all possible side effects.
Where can I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 20 to 25 degrees C (68 to 77 degrees F). Protect from light. Throw away any unused medicine after the expiration date.
What is the shelf life of the pills?
The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.


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Generic Name: quinapril hydrochloride
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When used in pregnancy during the second and third trimesters, ACE inhibitors can cause injury and even death to the developing fetus. When pregnancy is detected, Accupril should be discontinued as soon as possible. See WARNINGS, Fetal/Neonatal Morbidity and Mortality.
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Accupril® (quinapril hydrochloride) is the hydrochloride salt of quinapril, the ethyl ester of a non-sulfhydryl, angiotensin-converting enzyme (ACE) inhibitor, quinaprilat.

Quinapril hydrochloride is chemically described as [3S-[2[R*(R*)], 3R*]] - 2 - [2 - [[1 - (ethoxycarbonyl) - 3 - phenylpropyl]amino] - 1 - oxopropyl] - 1,2,3,4 - tetrahydro - 3 - isoquinolinecarboxylic acid, monohydrochloride. Its empirical formula is C25H30N2O5•HCl and its structural formula is:


Quinapril hydrochloride is a white to off-white amorphous powder that is freely soluble in aqueous solvents.

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Quinapril is deesterified to the principal metabolite, quinaprilat, which is an inhibitor of ACE activity in human subjects and animals. ACE is a peptidyl dipeptidase that catalyzes the conversion of angiotensin I to the vasoconstrictor, angiotensin II. The effect of quinapril in hypertension and in congestive heart failure (CHF) appears to result primarily from the inhibition of circulating and tissue ACE activity, thereby reducing angiotensin II formation. Quinapril inhibits the elevation in blood pressure caused by intravenously administered angiotensin I, but has no effect on the pressor response to angiotensin II, norepinephrine or epinephrine. Angiotensin II also stimulates the secretion of aldosterone from the adrenal cortex, thereby facilitating renal sodium and fluid reabsorption. Reduced aldosterone secretion by quinapril may result in a small increase in serum potassium. In controlled hypertension trials, treatment with Accupril alone resulted in mean increases in potassium of 0.07 mmol/L (see PRECAUTIONS). Removal of angiotensin II negative feedback on renin secretion leads to increased plasma renin activity (PRA).

While the principal mechanism of antihypertensive effect is thought to be through the renin-angiotensin-aldosterone system, quinapril exerts antihypertensive actions even in patients with low renin hypertension. Accupril was an effective antihypertensive in all races studied, although it was somewhat less effective in blacks (usually a predominantly low renin group) than in nonblacks. ACE is identical to kininase II, an enzyme that degrades bradykinin, a potent peptide vasodilator; whether increased levels of bradykinin play a role in the therapeutic effect of quinapril remains to be elucidated.

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