TRIMETHOPRIM + SULFAMETHOXAZOLE

Do not use sulfamethoxazole/trimethoprim if:

• You are allergic to any ingredient in Sulfamethoxazole/Trimethoprim or to any other Sulfonamide (Sulfa) medicine (eg, Glipizide, Hydrochlorothiazide)
• You have a history of low blood platelet levels (immune thrombocytopenia) caused by Trimethoprim or a Sulfa medicine
• You have liver damage or severe kidney problems
• You have anemia caused by low levels of folate in the blood
• The patient is a child younger than 2 months old
• You are taking Dofetilide or Methenamine

If any of these apply to you, contact your doctor or healthcare provider right away.

Rare Side effects may include:

• Abdominal or Stomach Pain
• Black, Tarry Stools
• Blistering, Peeling, or Loosening Of The Skin
• Changes in Skin Color
• Chest Pain
• Chills
• Cough or Hoarseness
• Dark Urine
• Diarrhea
• Dizziness
• Fever With or Without Chills
• General Feeling of Tiredness or Weakness
• Headache
• Itching
• Joint or Muscle Pain
• Light-Colored Stools
• Loss of Appetite
• Lower Back or Side Pain
• Nausea
• Pain, Tenderness, or Swelling of the Foot or Leg
• Painful or Difficult Urination
• Pale Skin
• Rash
• Red Skin Lesions, Often with a Purple Center
• Red, Irritated Eyes
• Shortness of Breath
• Sore Throat
• Sores, Ulcers, or White Spots in the Mouth or on The Lips
• Swollen or Painful Glands
• Tightness in the Chest
• Unpleasant Breath Odor
• Unusual Bleeding or Bruising
• Vomiting of Blood
• Wheezing
• Yellow Eyes or Skin

Incidence not known:

• Abdominal or Stomach Tenderness
• Back, Leg, or Stomach Pains
• Bleeding Gums
• Blindness or Vision Changes
• Blisters, Hives, or Itching
• Bloating
• Blood in the Urine or Stools
• Bluish-Colored Lips, Fingernails, or Palms
• Burning, Crawling, Itching, Numbness, Painful, Prickling, “Pins and Needles”, or Tingling Feelings
• Burning of the Face or Mouth
• Chest Pain
• Cloudy Urine
• Confusion
• Constipation
• Continuing Ringing or Buzzing or Other Unexplained Noise in the Ears
• Convulsions
• Cracks in the Skin
• Decreased Frequency or Amount of Urine
• Diarrhea, Watery and Severe, which may also be Bloody
• Difficulty with Breathing
• Difficulty with Swallowing
• Fainting Spells
• General Body Swelling
• General Feeling of Discomfort or Illness
• Hair Loss
• Hearing Loss
• Hives
• Increased Thirst
• Indigestion
• Irregular Heartbeat
• Large, Flat, Blue, or Purplish Patches in the Skin
• Large, Hive-like Swelling on the Face, Eyelids, Lips, Tongue, Throat, Hands, Legs, Feet, or Sex Organs
• Loss of Heat from the Body
• Muscle or Joint Pain
• Nosebleeds
• Not Able to Pass Urine
• Numbness or Tingling in the Hands, Feet, or Lips
• Pain or Burning While Urinating
• Pinpoint Red Spots on the Skin
• Puffiness or Swelling of the Eyelids or around the Eyes, Face, Lips, or Tongue
• Raised Red Swellings on the Skin, the Buttocks, Legs, or Ankles
• Redness of the White Part of the Eyes
• Redness, Swelling, or Soreness of the Tongue
• Sores, Ulcers, or White Spots on the Lips or in the Mouth
• Soreness of the Muscles
• Stiff Neck or Back
• Swelling of the Face, Hands, Legs, and Feet
• Unsteadiness, Trembling, or Other Problems With Muscle Control or Coordination
• Unusual Weight Loss
• Weakness in the Hands or Feet
• Weakness or Heaviness of the Legs
• Weight Gain

Precautions

Before taking Sulfamethoxazole with Trimethoprim, tell your doctor or pharmacist:

• If you are allergic to sulfa medications or trimethoprim; or if you have any other allergies.
• Your medical history, especially of:
  • Kidney Disease
  • Liver Disease
  • Certain Blood Disorders (Such as Porphyria, Anemia Due to Folate Vitamin Deficiency)
  • History of Blood Disorders Caused by Trimethoprim or Sulfa Medications
  • Vitamin Deficiency (Folate or Folic Acid)
  • Severe Allergies
  • Asthma
  • Decreased Bone Marrow Function (Bone Marrow Suppression)
  • A Certain Metabolic Disorder (G6pd Deficiency)
  • Underactive Thyroid
  • Mineral Imbalances (such as High Level of Potassium or Low Level of Sodium in the Blood)

This medication may cause live bacterial vaccines (such as Typhoid Vaccine) to not work as well. Do not have any immunizations/vaccinations while using this medication unless your doctor tells you to.

Interactions

Some medicines may interact with sulfamethoxazole/trimethoprim, especially any of the following:

• Angiotensin-Converting Enzyme (ACE) inhibitors (eg, Enalapril), Diuretics (eg, Hydrochlorothiazide), or Indomethacin

– They may increase the risk of Sulfamethoxazole/Trimethoprim’s side effects

• Anticoagulants (eg, Warfarin)

–The risk of bleeding may be increased

• Dofetilide

-The risk of its side effects, including severe irregular heartbeat, may be increased by Sulfamethoxazole/Trimethoprim

• Pyrimethamine because it is possible that a certain type of anemia may develop
• Methenamine because certain urinary problems may occur
• Amantadine, Digoxin, Hydantoins (eg, Phenytoin), Methotrexate, Sulfones (eg, Dapsone), or oral medicine for diabetes (eg, Glipizide, Metformin, Pioglitazone)

-the risk of their side effects may be increased by sulfamethoxazole/trimethoprim

• Tricyclic antidepressants (eg, Amitriptyline)

–their effectiveness may be decreased by Sulfamethoxazole/Trimethoprim

• Cyclosporine because its effectiveness may be decreased and the risk of kidney side effects may be increased by Sulfamethoxazole/Trimethoprim

Call emergency hotline if someone has overdosed and has serious symptoms such as passing out or trouble breathing.

Symptoms of overdose may include:

• Severe Nausea
• Vomiting
• Diarrhea
• Severe Dizziness or Drowsiness
• Mental/Mood Changes

Available brand/s:

• Alcotri
• Bactille-TS
• Bactrim
• Bactinol
• Chromo-Z