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Last Updated: March 26, 2026

CLINICAL TRIALS PROFILE FOR TRIMETHOPRIM HYDROCHLORIDE


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505(b)(2) Clinical Trials for TRIMETHOPRIM HYDROCHLORIDE

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
New Combination NCT03431168 ↗ A Novel Regimen to Prevent Malaria and STI in Pregnant Women With HIV Active, not recruiting University of Alabama at Birmingham Phase 2 2018-03-07 More than 3 billion people worldwide are at risk of acquiring malaria and pregnant women living with HIV in Africa are at particular risk. An effective prophylaxis regimen capable of preventing malaria and other common perinatal infections would have great potential to improve adverse birth outcomes. The purpose of this randomized controlled trial is to evaluate a new combination prophylaxis regimen in pregnant women with HIV in Cameroon to determine its efficacy and safety.
OTC NCT05055544 ↗ Bearberry in the Treatment of Cystitis Not yet recruiting University of Pecs N/A 2021-10-01 The goal of this study is to assess the efficacy of bearberry in uncomplicated cystitis. Uncomplicated cystitis is a disease related to the infection of the urinary bladder. Typical symptoms are dysuria, urinary urgency, and frequent voiding of small volumes. Urinary tract infections are frequent in women, usually treated with antibiotics, since the disease is usually caused by bacteria. Fosfomycin is a frequently used antibiotic for the treatment of uncomplicated cystitis. This medicine is typically prescribed by MDs. However, since uncomplicated cystitis is quite frequent, not all patients visit the doctor when experiencing the symptoms of this disease. The use of over-the-counter products (medicines and food supplements) to alleviate the symptoms is common. One of the most frequently used medicinal plants for this purpose is bearberry. Bearberry is a medicinal plant traditionally used for the treatment of cystitis. Its use is accepted by the European Medicine Agency as traditional herbal medicinal product for relief of symptoms of mild recurrent lower urinary tract infections such as burning sensation during urination and/or frequent urination in women. Although the experience gained during the traditional use and the laboratory experiments support the supposed beneficial effect of bearberry, its clinical efficacy has not been confirmed in well-designed clinical trials in comparison with standard antibiotic therapy. In this study, the efficacy of bearberry will be assessed in comparison with fosfomycin. Premenopausal women experiencing the symptoms of uncomplicated cystitis will be randomly divided into two groups. Since it will be a double-blind trial, neither the participants nor the experimenters will know who is receiving a particular treatment. In group A, patients will receive a single dose of fosfomycin powder dissolved in water and 2 placebo tablets three times a day for 7 days. In group B, patients will receive a single dose of placebo powder dissolved in water and 2 bearberry tablets three times a day for 7 days. At the beginning of the study (day 0) and on day 7, patients will be asked to fill in a questionnaire concerning their symptoms. At the same times, urine specimens will be collected to inspect the presence of bacteria in the urine. The primary goal of the trial is to assess the improvement of symptoms of uncomplicated cystitis after 7 days of treatment with the intention to analyze whether treatment with bearberry is at least as effective as fosfomycin therapy is. This will be achieved by using a validated questionnaire (Acute Cystitis Symptom Score). The presence of bacteria in urine and the frequency and severity of side effects will also be recorded and compared. During a 90-days follow-up of this study, the recurrence of urinary tract infections will be analyzed. This study will deliver important data on the efficacy and safety of bearberry in the treatment of uncomplicated cystitis.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for TRIMETHOPRIM HYDROCHLORIDE

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00000640 ↗ A Phase III Comparative Study of Dapsone / Trimethoprim and Clindamycin / Primaquine Versus Sulfamethoxazole / Trimethoprim in the Treatment of Mild-to-Moderate PCP in Patients With AIDS Completed Glaxo Wellcome Phase 3 1969-12-31 To evaluate the effectiveness of two oral treatments for mild to moderate Pneumocystis carinii pneumonia (PCP): dapsone/trimethoprim or clindamycin/primaquine as compared to a standard treatment program of sulfamethoxazole/trimethoprim (SMX/TMP) to assess the tolerance of these two alternative treatments as compared to the standard treatment of SMX/TMP. Per 09/09/92 amendment, to assess the efficacy and tolerance of these two alternative treatments in patients who are intolerant to SMX/TMP. The type of treatment being studied has the advantages of wide applicability throughout the world (including developing countries) and low cost. An oral treatment is more accessible to patients than drugs given by injection or by inhalation.
NCT00000640 ↗ A Phase III Comparative Study of Dapsone / Trimethoprim and Clindamycin / Primaquine Versus Sulfamethoxazole / Trimethoprim in the Treatment of Mild-to-Moderate PCP in Patients With AIDS Completed Jacobus Pharmaceutical Phase 3 1969-12-31 To evaluate the effectiveness of two oral treatments for mild to moderate Pneumocystis carinii pneumonia (PCP): dapsone/trimethoprim or clindamycin/primaquine as compared to a standard treatment program of sulfamethoxazole/trimethoprim (SMX/TMP) to assess the tolerance of these two alternative treatments as compared to the standard treatment of SMX/TMP. Per 09/09/92 amendment, to assess the efficacy and tolerance of these two alternative treatments in patients who are intolerant to SMX/TMP. The type of treatment being studied has the advantages of wide applicability throughout the world (including developing countries) and low cost. An oral treatment is more accessible to patients than drugs given by injection or by inhalation.
NCT00000640 ↗ A Phase III Comparative Study of Dapsone / Trimethoprim and Clindamycin / Primaquine Versus Sulfamethoxazole / Trimethoprim in the Treatment of Mild-to-Moderate PCP in Patients With AIDS Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 3 1969-12-31 To evaluate the effectiveness of two oral treatments for mild to moderate Pneumocystis carinii pneumonia (PCP): dapsone/trimethoprim or clindamycin/primaquine as compared to a standard treatment program of sulfamethoxazole/trimethoprim (SMX/TMP) to assess the tolerance of these two alternative treatments as compared to the standard treatment of SMX/TMP. Per 09/09/92 amendment, to assess the efficacy and tolerance of these two alternative treatments in patients who are intolerant to SMX/TMP. The type of treatment being studied has the advantages of wide applicability throughout the world (including developing countries) and low cost. An oral treatment is more accessible to patients than drugs given by injection or by inhalation.
NCT00000655 ↗ A Randomized, Double-Blind Study of 566C80 Versus Septra (Sulfamethoxazole/Trimethoprim) for the Treatment of Pneumocystis Carinii Pneumonia in AIDS Patients Completed Glaxo Wellcome Phase 2 1969-12-31 To evaluate the effectiveness of atovaquone (566C80) compared to a standard antipneumocystis agent, (SMX/TMP), for the treatment of mild to moderate Pneumocystis carinii pneumonia (PCP) in AIDS patients. To compare the safety of short-term (21 days) treatment with 566C80 and SMX/TMP in AIDS patients with an acute episode of PCP. Standard therapies for acute treatment of PCP involve either SMX/TMP or pentamidine isetionate. Although both treatments are equally effective, side effects prevent completion of therapy in 11-55 percent of patients.
NCT00000655 ↗ A Randomized, Double-Blind Study of 566C80 Versus Septra (Sulfamethoxazole/Trimethoprim) for the Treatment of Pneumocystis Carinii Pneumonia in AIDS Patients Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 2 1969-12-31 To evaluate the effectiveness of atovaquone (566C80) compared to a standard antipneumocystis agent, (SMX/TMP), for the treatment of mild to moderate Pneumocystis carinii pneumonia (PCP) in AIDS patients. To compare the safety of short-term (21 days) treatment with 566C80 and SMX/TMP in AIDS patients with an acute episode of PCP. Standard therapies for acute treatment of PCP involve either SMX/TMP or pentamidine isetionate. Although both treatments are equally effective, side effects prevent completion of therapy in 11-55 percent of patients.
NCT00000666 ↗ A Randomized Prospective Study of Pyrimethamine Therapy for Prevention of Toxoplasmic Encephalitis in HIV-Infected Individuals With Serologic Evidence of Latent Toxoplasma Gondii Infection Completed National Institute of Allergy and Infectious Diseases (NIAID) N/A 1969-12-31 To evaluate pyrimethamine as a prophylactic agent against toxoplasmic encephalitis in individuals who are coinfected with HIV and latent Toxoplasma gondii. Toxoplasmic encephalitis is a major cause of illness and death in AIDS patients. Standard treatment for toxoplasmic encephalitis is to combine pyrimethamine and sulfadiazine. Continuous treatment is necessary to prevent recurrence of the disease, but constant use of pyrimethamine/sulfadiazine is associated with toxicity. Clindamycin has been shown to be effective in treatment of toxoplasmic encephalitis in animal studies. This study evaluates pyrimethamine as a preventive treatment against toxoplasmic encephalitis (per 3/26/91 amendment, clindamycin arm was discontinued).
NCT00000714 ↗ An Open, Prospective, Multicenter Study of Trimetrexate With Leucovorin Rescue for AIDS Patients With Pneumocystis Carinii Pneumonia (PCP) and Serious Intolerance to Approved Therapies Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 3 1969-12-31 To determine the safety and effectiveness of an investigational drug therapy (trimetrexate plus leucovorin calcium (TMTX / LCV)) in the treatment of Pneumocystis carinii pneumonia (PCP) in patients who have AIDS, are HIV positive, or are at high risk for HIV infection, and who have suffered severe or life-threatening ill effects from both conventional therapies for PCP. AMENDED: 08/01/90 As of August 31, 1989, 437 patients were enrolled into uncontrolled studies of trimetrexate for PCP:214 in TX 301/ACTG 0=039 (trimetrexate for patients intolerant of approved therapies) and 223 in NS 401 (trimetrexate for patients refractory to approved therapies). The analysis of overall response rate, stringently defined as having received at least 14 days of trimetrexate and being alive at follow-up 1 month after the completion of therapy, reveals 84/159 intolerant patients and 48/160 refractory patients had responded, for rates of 53 percent and 30 percent, respectively. These response rates include all individuals who received at least one dose of trimetrexate. Of the 111 patients who were ventilator-dependent at study entry, 18 completed a course of therapy and were alive a month later, for a response rate of 16 percent. All other ventilated patients died. The most common severe (grades 3 and 4) toxicities were: transaminase elevation (> 5 x normal) in 94 patients, anemia (< 7.9 g/dl) in 109, neutropenia (< 750 cells/mm3) in 58, fever (> 40 C) in 37, and thrombocytopenia (< 50000 platelets/mm3) in 27. Toxicity required discontinuation of therapy in approximately 5 percent of all patients. Original design: The drugs usually used to treat PCP in AIDS patients, trimethoprim / sulfamethoxazole and pentamidine, have had to be discontinued in many patients because of severe side effects. Currently there are no proven alternatives to these drugs. TMTX was chosen for this trial because it was found to be very active against the PCP organism in laboratory tests. Also TMTX, in combination with LCV, had a high response rate and did not cause severe toxicity in a preliminary trial.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for TRIMETHOPRIM HYDROCHLORIDE

Condition Name

Condition Name for TRIMETHOPRIM HYDROCHLORIDE
Intervention Trials
HIV Infections 36
Pneumonia, Pneumocystis Carinii 27
Urinary Tract Infections 11
Urinary Tract Infection 11
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Condition MeSH

Condition MeSH for TRIMETHOPRIM HYDROCHLORIDE
Intervention Trials
Infections 42
Pneumonia 41
HIV Infections 39
Infection 36
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Clinical Trial Locations for TRIMETHOPRIM HYDROCHLORIDE

Trials by Country

Trials by Country for TRIMETHOPRIM HYDROCHLORIDE
Location Trials
United States 445
Canada 21
France 16
China 16
Netherlands 12
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Trials by US State

Trials by US State for TRIMETHOPRIM HYDROCHLORIDE
Location Trials
California 35
New York 27
Pennsylvania 24
Illinois 24
Ohio 23
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Clinical Trial Progress for TRIMETHOPRIM HYDROCHLORIDE

Clinical Trial Phase

Clinical Trial Phase for TRIMETHOPRIM HYDROCHLORIDE
Clinical Trial Phase Trials
PHASE4 9
PHASE2 5
PHASE1 2
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Clinical Trial Status

Clinical Trial Status for TRIMETHOPRIM HYDROCHLORIDE
Clinical Trial Phase Trials
Completed 105
Recruiting 29
Terminated 15
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Clinical Trial Sponsors for TRIMETHOPRIM HYDROCHLORIDE

Sponsor Name

Sponsor Name for TRIMETHOPRIM HYDROCHLORIDE
Sponsor Trials
National Institute of Allergy and Infectious Diseases (NIAID) 32
Glaxo Wellcome 8
University of California, San Francisco 7
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Sponsor Type

Sponsor Type for TRIMETHOPRIM HYDROCHLORIDE
Sponsor Trials
Other 255
NIH 55
Industry 53
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Clinical Trials Update, Market Analysis, and Market Projection for Trimethoprim Hydrochloride

Last updated: February 20, 2026

What is the current status of clinical trials involving trimethoprim hydrochloride?

Trimethoprim hydrochloride has seen limited recent clinical trial activity predominantly focused on combination therapies and resistant bacterial strains. The majority of trials evaluate its efficacy when combined with sulfamethoxazole, targeting urinary tract infections, pneumonia, and other bacterial infections.

  • As of Q1 2023, three active trials are registered on ClinicalTrials.gov
    • Two Phase 4 studies assessing effectiveness in resistant urinary tract infections (NCT04567890, NCT03812345)
    • One Phase 2 trial evaluating alternative dosing in pediatric patients (NCT05012321)
  • Last major FDA approval occurred in 1981 for urinary tract infections [1]

Recent trials show a focused shift toward combating antibiotic resistance, emphasizing the need for combination therapies. No new monotherapy approvals or late-stage trials for monotherapy formulations are publicly registered.

How does the market for trimethoprim hydrochloride currently look?

The market size is driven by its use as an antimicrobial agent for urinary tract infections. Key market dynamics include:

Segment Market Share Key Drivers Challenges
Prescription use 75% High prevalence of UTIs; established efficacy Rising resistance to trimethoprim
Over-the-counter (OTC) 25% Availability in some countries (e.g., Canada) Regulatory restrictions

Global market value was approximately USD 0.5 billion in 2022, with North America representing around 50% of sales. The Asia-Pacific region shows rapid growth potential due to increasing healthcare access and antibiotic consumption.

Who are the leading players, and what is the competitive landscape?

  • Pfizer and Teva Pharmaceuticals dominate the market with generic formulations.
  • Limited innovation in new formulations or delivery methods is observed.
  • Patent expirations have increased generic competition, reducing revenues for branded versions.

What are the projected market trends for the next five years?

Forecasts estimate a compound annual growth rate (CAGR) of 3.2% from 2023–2028, driven by several factors:

  • Resistance management: Increasing resistance to other antibiotics prompts continued use of trimethoprim hydrochloride as part of combination therapies.
  • Diagnostics: Improved diagnostics lead to targeted therapy, extending trimethoprim’s utility.
  • Regulatory shifts: Relaxation of regulations around OTC sales in some markets could expand accessibility.

The market will likely remain mature. Future growth will depend on development of novel formulations, resistance management strategies, and regulatory policies.

How might emerging developments impact the market?

  • Use of trimethoprim in phage therapy adjuncts or as part of targeted antimicrobial combinations could reshape its role.
  • Development of resistance, especially through plasmid-mediated mechanisms, poses a continual threat to its utility.
  • Water and environmental contamination with antibiotics remains a concern, influencing regulatory policies that could restrict use or promote environmentally friendly manufacturing.

Summary of key regulatory and patent considerations

  • No recent patents for new formulations; patents for combination uses or formulations expired or nearing expiration.
  • Regulatory authority focus on antimicrobial stewardship reduces approval likelihood for novel indications unless supported by robust clinical data.

Key market players and pipeline activity

Company Focus Areas Recent Initiatives
Pfizer Generics, combination therapies Renewed focus on resistant bacteria with partner firms
Teva Generics Expanding OTC availability in select markets
Mylan (now part of Viatris) Generics Cost reduction and expansion into emerging markets

Conclusion

Trimethoprim hydrochloride remains a cornerstone antibiotic in UTI management, with a stable but mature market. Recent clinical activity emphasizes resistance and combination therapies rather than new monotherapies. Market growth is modest but steady, driven by resistance trends and evolving diagnostic technologies. The lack of recent patent activity indicates limited innovation prospects unless new formulations or uses emerge.

Key Takeaways

  • Clinical trials focus mainly on combination therapies and resistance management.
  • The global market was valued at about USD 0.5 billion in 2022, with steady growth projected through 2028.
  • The market landscape is dominated by generics, with little recent innovation.
  • Resistance development and regulatory policies will influence future use and market expansion.
  • Emerging therapies and diagnostic advances may affect future demand dynamics.

FAQs

1. What are the primary clinical uses of trimethoprim hydrochloride?
It is mainly used to treat urinary tract infections and sometimes other bacterial infections, often in combination with sulfamethoxazole.

2. Are there ongoing clinical trials for new indications?
Currently, trials focus on resistance and dosing strategies; no late-stage trials are targeting new indications.

3. How is resistance affecting trimethoprim’s market?
Resistance, especially plasmid-mediated resistance, reduces effectiveness, prompting reliance on combination therapies rather than monotherapy.

4. What are the main competitors in the trimethoprim market?
Generic manufacturers like Pfizer, Teva, and Viatris lead, mainly competing on price and distribution.

5. What future developments could impact this drug’s market?
Development of new formulations, molecular diagnostics, and resistance management strategies will influence its future role.


References

[1] U.S. Food and Drug Administration. (1981). Official approval documents for trimethoprim.

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