General Warnings

Sulfamethoxazole Trimethoprim Side Effects

What are side effects?

 A side effect is usually regarded as an undesirable secondary effect that occurs in addition to the desired therapeutic effect of a drug or medication. Side effects may vary for each individual depending on the person’s disease state, age, weight, gender, ethnicity, and general health.

Side effects can occur when commencing, decreasing/increasing dosages, or ending a drug or medication regimen. Side effects may also lead to non-compliance with prescribed treatment. When side effects of a drug or medication are severe, the dosage may be adjusted or a second medication may be prescribed. Lifestyle or dietary changes may also help to minimize side effects.

What is Sulfamethoxazole Trimethoprim?

Sulfamethoxazole trimethoprim, sold under the brand name Bactrim among others, is a fixed-dose combination antibiotic medication used to treat infections including urinary tract infections, middle ear infections (otitis media), bronchitis, traveler’s diarrhea, and shigellosis (bacillary dysentery). This medicine is also used to prevent or treat Pneumocystis jiroveci pneumonia or Pneumocystis carinii pneumonia (PCP), a very serious kind of pneumonia. This type of pneumonia occurs more commonly in patients whose immune systems are not working normally, including cancer patients, transplant patients, and patients with acquired immune deficiency syndrome (AIDS).

Sulfamethoxazole and trimethoprim works by eliminating the bacteria that cause many kinds of infections. This medicine will not work for colds, flu, or other virus infections.

This medicine is available only with your doctor’s prescription.

This product is available in the following dosage forms:

  • Tablet
  • Suspension

What are the side effects of sulfamethoxazole trimethoprim?

Sulfamethoxazole and trimethoprim may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • nausea
  • vomiting
  • loss of appetite

If you experience any of the following symptoms, call your doctor immediately:

  • rash
  • itching
  • sore throat
  • fever or chills
  • severe diarrhea (watery or bloody stools) that may occur with or without fever and stomach cramps (may occur up to 2 months or more after your treatment)
  • shortness of breath
  • cough
  • unusual bruising or bleeding
  • yellowing of the skin or eyes
  • paleness
  • red or purple skin discolorations
  • joint or muscle pain

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What special precautions should I follow while using sulfamethoxazole and trimethoprim?

Before taking Sulfamethoxazole and trimethoprim,

tell your doctor and pharmacist if you are allergic to sulfamethoxazole or trimethoprim, any other medications, or any ingredients in sulfamethoxazole and trimethoprim tablets and suspension. Ask your pharmacist for a list of ingredients.

  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the following: amantadine; angiotensin converting enzyme inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik); anticoagulants (‘blood thinners’) such as warfarin (Coumadin, Jantoven); cyclosporine (Gengraf, Neoral, Sandimmune); oral diabetes medications such as glipizide (Glucotrol), glyburide (Diabeta, Glynase), metformin (Fortamet, Glucophage), pioglitazone (Actos), repaglinide (Prandin), rosiglitazone (Avandia); digoxin (Lanoxin); diuretics (‘water pills’); indomethacin (Indocin); leucovorin (Fusilev); medications for seizures such as phenytoin (Dilantin, Phenytek); memantine (Namenda); methotrexate (Trexall); pyrimethamine (Daraprim). and tricyclic antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor if you have or have ever had thrombocytopenia (less than normal number of platelets) caused by taking sulfonamides or trimethoprim; megaloblastic anemia (abnormal red blood cells) caused by folate deficiency (low blood levels of folic acid), phenylketonuria (PKU, an inherited condition in which a special diet must be followed to prevent mental retardation), or liver or kidney disease. Your doctor may tell you not to take sulfamethoxazole and trimethoprim. Co-trimoxazole should not be used in children less than 2 months of age.
  • tell your doctor if you have or have ever had severe allergies; asthma; low levels of folic acid in the body which may be caused by malnutrition (you do not eat or cannot digest the nutrients needed for good health); human immunodeficiency virus (HIV) infection; porphyria (an inherited blood disease that may cause skin or nervous system problems); thyroid disease; or glucose-6-phosphate dehydrogenase (G-6-PD) deficiency (an inherited blood disease).
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking sulfamethoxazole and trimethoprim, call your doctor immediately. Sulfamethoxazole and trimethoprim can harm the fetus.
  • plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Sulfamethoxazole and trimethoprim may make your skin sensitive to sunlight.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet. Drink plenty of fluids during your treatment with Sulfamethoxazole and trimethoprim.

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