Clinical medicine profile
Co-trimoxazole/Bromhexine/Tolu Balsam/Sodium benzoate
Therapeutic agent (verify pharmacological class)
- Route
- See product SmPC
- Schedule
- POM
- ATC
- Not assigned
- PPB status
- registered
This profile needs source confirmation
Some sections contain general class guidance rather than medicine-specific evidence. Confirm prescribing decisions against the current SmPC and Kenya STG/EML.
Safety essentials
The information most likely to change a prescribing or dispensing decision.
Contraindications
- [From component Co-trimoxazole] Renal/hepatic failure, blood disorders, pregnancy and lactation, Vitamin B12 and folate deficiency, porphyria, premature/new born infants, concommitant use with anti-convulsant medicines.
Precautions
- [From component Co-trimoxazole] Regular blood counts (on prolonged use), folate impairement, lactation, renal impairment, elderly, maintain adequate fluid output, allergic conditions, bronchial asthma, use of diuretics, concommitant use with coumarin anticoagulants, methotrexate, phenytoin.
Dosing matrix
Population and organ-function guidance, shown together for faster comparison.
Adults, 7.5mL TID. In children over two years, 2.5mL TID
See label paediatric section if present; otherwise use paediatric formulary — do not extrapolate adult doses.
Review renal impairment dosing; many agents need CrCl/eGFR adjustment.
- CrCl 0–120: Confirm renal dosing in product SmPC / primary label.
Review hepatic impairment dosing; monitor LFTs if agent is hepatically cleared or hepatotoxic.
Use, effects & interactions
Indications
- Therapeutic use is agent- and indication-specific within the class (Therapeutic agent (verify pharmacological class)).
- Use according to culture results, national guidelines (Kenya STG/EML where applicable) and the current product SmPC.
- URTI, LRTI requiring expectoration.
Adverse effects
- [From component Co-trimoxazole] Haematological changes, skin disorders, erythema multiforme, nausea and vomiting, toxic epidermal necrolysis, allergic vasculitis, glossitis, stomatitis, transient jaundice, acidosis, goitre, hypoglycaemic effect.
- High dose: tinnitus and peripheral neuritis.
Drug interactions
Open multi-drug checker ↗- Professional use: confirm indication, dose, duration, monitoring and patient counselling points against current Kenya STG / EML and the product SmPC.
- Document allergy status and key interactions.
Mechanism & disposition
Combination product.
Read complete mechanism
Combination product. Component mechanism (Co-trimoxazole): Sulphonamides inhibit bacterial synthesis of dihydrofolic acid by competing with para-aminobenzoic acid
Product-specific
Product-specific
See product SmPC
are product-specific. Consider food effects, protein binding, hepatic CYP/UGT
when adjusting for organ impairment, age and drug interactions. Verify parameters in the current SmPC.
Pregnancy, lactation & diet
[Co-trimoxazole] Use only if potential benefit justifies potential risk; prefer agents with better reproductive data when alternatives exist. [Bromhexine] Use only if potential benefit justifies potential risk; prefer agents with better reproductive data when alternatives exist.
[Co-trimoxazole] Assess infant risk vs benefit of maternal therapy; prefer agents with lactation data. [Bromhexine] Assess infant risk vs benefit of maternal therapy; prefer agents with lactation data.
Brands & loaded prices
| Brand | Manufacturer | Pack | Observed price |
|---|---|---|---|
| No reviewed brand listings are linked yet. | |||
Sources & review state
Decision support only. Confirm patient-specific decisions against the current product SmPC, Kenya STG/EML, and professional judgement.