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Trimethoprim-Sulfamethoxazole

PrescriptionCDSCO approved
Potentiated sulfonamide antibiotic
Last reviewed 19 Apr 2026 · PetCare.AI Editorial Team
Species
Dog, Cat
Brands
3 available
Interactions
1 documented
Formulations
4

Mechanism of action

Sequential blockade of folate synthesis — sulfamethoxazole inhibits dihydropteroate synthase, trimethoprim inhibits dihydrofolate reductase

At a glance

Class
Potentiated sulfonamide antibiotic
Schedule
Prescription
Storage
Store below 25°C, protect from light
CDSCO (India)
Vet-approved — 1975-01

Dosing

🐕

Dog

Urinary tract infections
Dose
15–30 mg/kg
Route
PO
Frequency
BID
Max dose
960 mg/dose; 1920 mg/day
Duration: 10-14 days
Skin infections (Staphylococcal)
Dose
15–30 mg/kg
Route
PO
Frequency
BID
Max dose
960 mg/dose; 1920 mg/day
Duration: 21-30 days
Protozoal infections (Coccidiosis)
Dose
15–30 mg/kg
Route
PO
Frequency
BID
Max dose
960 mg/dose; 1920 mg/day
Duration: 5-7 days
🐈

Cat

Urinary and respiratory infections
Dose
15–30 mg/kg
Route
PO
Frequency
BID
Max dose
480 mg/dose; 960 mg/day
Duration: 7-14 days
Educational reference only
This information is provided for educational purposes and is not a substitute for professional veterinary advice, diagnosis, or treatment. Always consult a qualified veterinarian before administering any medication to your pet. Find a vet near you →

Formulations

💊

Tablet — 2

Strength
480mg (80+400mg)
Available in India
Strength
960mg (160+800mg)
Available in India
🧴

Suspension — 1

Strength
240mg/5mL
Available in India
💉

Injectable — 1

Strength
480mg/5mL
Available in India

Storage

Store below 25°C, protect from light

Safety

Absolute contraindications — do not use

  • Known sulfonamide hypersensitivity
    Dobermans have increased risk of idiosyncratic polyarthritis/hepatopathy
    Doberman Pinscher
  • Severe hepatic disease
    Hepatically metabolised — risk of hepatotoxicity

Use with caution

  • Keratoconjunctivitis sicca (KCS) history
    Sulfonamides can cause or worsen KCS
  • Dehydration
    Risk of crystalluria — maintain hydration

Adverse effects

Common
Vomiting
Diarrhoea
Anorexia
Serious
Keratoconjunctivitis sicca (KCS)
Hepatotoxicity
Blood dyscrasias (thrombocytopenia, anaemia)
Drug eruption
Polyarthritis (Dobermans)

Monitoring parameters

Schirmer tear test (baseline and during treatment)CBCLiver enzymesUrinalysisHydration status
Educational reference only
This information is provided for educational purposes and is not a substitute for professional veterinary advice, diagnosis, or treatment. Always consult a qualified veterinarian before administering any medication to your pet. Find a vet near you →

Interactions

Contraindicated — 1

Methotrexate
contraindicated
Both are folate antagonists; combined use causes severe bone marrow suppression
Management: Do not combine. If antibiotic needed during methotrexate therapy, use non-folate antagonist.
Educational reference only
This information is provided for educational purposes and is not a substitute for professional veterinary advice, diagnosis, or treatment. Always consult a qualified veterinarian before administering any medication to your pet. Find a vet near you →

Brands

International

Bactrim
Roche

India

Septran
GSK
TMP-SMX Vet
Virbac

FAQs

Frequently asked questions

What is Trimethoprim-Sulfamethoxazole?
Trimethoprim-Sulfamethoxazole is a potentiated sulfonamide antibiotic used in pets. Sequential blockade of folate synthesis — sulfamethoxazole inhibits dihydropteroate synthase, trimethoprim inhibits dihydrofolate reductase
What is Trimethoprim-Sulfamethoxazole used for in pets?
Trimethoprim-Sulfamethoxazole is used in veterinary medicine for: Urinary tract infections; Skin infections (Staphylococcal); Protozoal infections (Coccidiosis); Urinary and respiratory infections.
What is the Trimethoprim-Sulfamethoxazole dose for dogs?
For dogs, Trimethoprim-Sulfamethoxazole is typically dosed as follows — Urinary tract infections: 15–30 mg/kg PO BID; Skin infections (Staphylococcal): 15–30 mg/kg PO BID; Protozoal infections (Coccidiosis): 15–30 mg/kg PO BID. Always consult your veterinarian for a dose tailored to your pet's weight, age, and condition.
What is the Trimethoprim-Sulfamethoxazole dose for cats?
For cats, Trimethoprim-Sulfamethoxazole is typically dosed as follows — Urinary and respiratory infections: 15–30 mg/kg PO BID. Always consult your veterinarian for a dose tailored to your pet's weight, age, and condition.
What are the side effects of Trimethoprim-Sulfamethoxazole?
Common: Vomiting, Diarrhoea, Anorexia. Serious (call your vet immediately): Keratoconjunctivitis sicca (KCS), Hepatotoxicity, Blood dyscrasias (thrombocytopenia, anaemia), Drug eruption, Polyarthritis (Dobermans).
Does Trimethoprim-Sulfamethoxazole need a prescription?
Yes. Trimethoprim-Sulfamethoxazole is a prescription medication and should only be administered under veterinary supervision.
When should Trimethoprim-Sulfamethoxazole not be used?
Do not use Trimethoprim-Sulfamethoxazole if: Known sulfonamide hypersensitivity; Severe hepatic disease.
Educational reference only
This information is provided for educational purposes and is not a substitute for professional veterinary advice, diagnosis, or treatment. Always consult a qualified veterinarian before administering any medication to your pet. Find a vet near you →

References

CDSCO approvals (India) — 3

Trimethoprim +Sulphadoxine
M/s Hoechst · Approved 1973- September
Trimethoprim+sulphadoxime
M/s Burroghs wellcare Co., Bombay · Approved 1974-July
Cosumix Plus Alpha Chloropyridazine Sodium 10gm + trimethoprim 2gm per 100 gm po
M/s Hindusan Ciba geigy · Approved 01.05.1990
Each 100 gm cosumix plus powder contains; alpha chloropyridazine sodium-10g, methoprin-2gm
Source: CDSCO Veterinary Drug Approval Registry (1969–2026)

References

The PetCare.AI drug reference is built from 13 authoritative sources cited across 580 drug monographs.

Textbooks & handbooks — 5

  • Plumb's Veterinary Drug Handbook
  • Withrow & MacEwen's Small Animal Clinical Oncology
  • Merck Veterinary Manual
  • NRC Nutrient Requirements of Dogs and Cats
  • Veterinary Pharmacology and Therapeutics (Riviere & Papich)

Clinical guidelines & consensus — 4

  • ASPCA Animal Poison Control Center Guidelines
  • AAHA Diabetes Management Guidelines
  • ASPCA Poison Control Guidelines
  • RECOVER CPR Guidelines

Journals & peer-reviewed studies — 2

  • EPIC Study (J Vet Intern Med 2016)
  • JVIM FAT CAT Study

Regulatory & approvals — 1

  • CDSCO Veterinary Drug Approval Registry (1969–2026)

Databases — 1

  • Washington State University VCPL MDR1 Database

Related medicines

Other medicines in the same class (Potentiated sulfonamide antibiotic).

Sulfa-Trimethoprim (TMP-Sulfa)
Rx
Sequential inhibition of folate synthesis: sulfonamide inhibits dihydropteroate synthase (DHPS) and trimethoprim inhibits dihydrofolate reductase (DHFR). Combined, they are synergistically bactericidal despite each being bacteriostatic alone. 1:5 TMP:sulfa ratio.
dogcat
Sulfadimethoxine/Ormetoprim
Rx
Synergistic combination: sulfadimethoxine inhibits DHPS and ormetoprim inhibits DHFR (same sequential folate blockade as TMP-sulfa). Long half-life allows once-daily dosing. FDA-approved for dogs.
dogcat
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