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- What is sulfamethoxazole and trimethoprim, and how does it work (mechanism of action)?
- What brand names are available for sulfamethoxazole and trimethoprim?
- Is sulfamethoxazole and trimethoprim available as a generic drug?
- Do I need a prescription for sulfamethoxazole and trimethoprim?
- What are the uses for sulfamethoxazole and trimethoprim?
- What are the side effects of sulfamethoxazole and trimethoprim?
- What is the dosage for sulfamethoxazole and trimethoprim?
- Which drugs or supplements interact with sulfamethoxazole and trimethoprim?
- Is sulfamethoxazole and trimethoprim safe to take if I'm pregnant or breastfeeding?
- What else should I know about sulfamethoxazole and trimethoprim?
What is sulfamethoxazole and trimethoprim, and how does it work (mechanism of action)?
Bactrim is a combination of two synthetic (man-made) antibiotics, sulfamethoxazole and trimethoprim. Both drugs reduce the ability of some bacteria to utilize folic acid for growing. Sulfamethoxazole is an anti-bacterial sulfonamide, a "sulfa" drug. It disrupts the production of dihydrofolic acid while trimethoprim disrupts the production of tetrahydrofolic acid. Dihydrofolic acid and tetrahydrofolic acid are forms of folic acid that bacteria and human cells use for producing proteins. Trimethoprim inhibits production of tetrahydrofolic acid by inhibiting the enzyme responsible for making tetrahydrofolic acid from dihydrofolic acid. By combining both drugs, two important steps required in the production of bacterial proteins are interrupted, and the combination is more effective than either drug alone. Bactrim was approved by the FDA in 1973.
What brand names are available for sulfamethoxazole and trimethoprim?
Bactrim, Bactrim DS, Sulfatrim Pediatric
What are the uses for sulfamethoxazole and trimethoprim?
Sulfamethoxazole/trimethoprim is used for treating infections due to susceptible bacteria. Examples include urinary tract infections, flares of chromic bronchitis due to bacteria, middle ear infections, for prevention of infections due to pneumococcus in organ transplant recipients, for the treatment or prevention of Pneumocystis carinii pneumonia, chancroid, and prevention of toxoplasma encephalitis in patients with AIDS.
What are the side effects of sulfamethoxazole and trimethoprim?
Common side effects of sulfamethoxazole/trimethoprim are:
Other side effects include:
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What is the dosage for sulfamethoxazole and trimethoprim?
The recommended adult dose for urinary tract infections is one double strength tablet (Bactrim DS, Septra DS) or two single strength tablets every 12 hours for 10 to 14 days.
Flares of chronic bronchitis are treated with a similar regimen for 14 days.
Sulfamethoxazole/trimethoprim should be taken with 6 to 8 ounces of liquid to prevent crystals from forming in the urine. Persons with advanced kidney disease may require lower doses.
Which drugs or supplements interact with sulfamethoxazole and trimethoprim?
Sulfamethoxazole/trimethoprim can enhance the blood-thinning effects of warfarin (Coumadin), possibly leading to bleeding. Sulfonamides such as sulfamethoxazole can increase the metabolism (break-down and elimination) of cyclosporine (causing loss of effectiveness of cyclosporine), and can add to the kidney damage caused by cyclosporine.
Blood levels of phenytoin (Dilantin) may be increased by treatment with sulfamethoxazole/trimethoprim. This may lead to side effects associated with phenytoin (Dilantin, Dilantin-125) such as dizziness, and reduced attention.
Sulfamethoxazole/trimethoprim also may increase blood levels of digoxin (Lanoxin) and possibly lead to serious toxic effects. Anemia, due to a reduction in folic acid, can occur in persons receiving sulfamethoxazole/trimethoprim in combination with:
- valproic acid (Depakote, Depakote ER, Depakene, Depacon, Stavzor),
- methotrexate (Rheumatrex, Trexall),
- triamterene, or
Increased blood levels of potassium may occur when sulfamethoxazole/trimethoprim is combined with ACE inhibitors.
Is sulfamethoxazole and trimethoprim safe to take if I'm pregnant or breastfeeding?
Use of sulfonamides may cause bilirubin to be displaced from proteins in the infant's blood. Displacement of bilirubin can lead to jaundice and a dangerous condition called kernicterus in the infant. For this reason, sulfamethoxazole/trimethoprim should not be used near term (late in pregnancy) among women.
Sulfamethoxazole/trimethoprim should not be used by nursing mothers because sulfamethoxazole is excreted in milk and can cause kernicterus.
What else should I know about sulfamethoxazole and trimethoprim?
What preparations of sulfamethoxazole and trimethoprim are available?
Tablets: 160 mg trimethoprim and 800 mg sulfamethoxazole (Bactrim DS, Septra DS); 80 mg trimethoprim and 400 mg sulfamethoxazole (Bactrim; Septra).
How should I keep sulfamethoxazole and trimethoprim stored?
The tablets should be kept at room temperature, 15 C -30 C (59 F - 86 F).
Reference: FDA Prescribing Information
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Top sulfamethoxazole and trimethoprim Related ArticlesComplete List
Chancroid PictureA sexually transmitted infection (STI) caused by the bacterium Haemophilus ducreyi. See a picture of Chancroid and learn more about the health topic.
DiarrheaDiarrhea is a change is the frequency and looseness of bowel movements. Symptoms associated with diarrhea are cramping, abdominal pain, and the sensation of rectal urgency. Causes of diarrhea include viral, bacterial, or parasite infection, gastroenteritis, food poisoning, and drugs. Absorbents and anti-motility medications are used to treat diarrhea.
Middle ear infection or inflammation (otitis media) is inflammation of the middle ear. There are two forms of this type of ear infection, acute and chronic. Acute otitis media is generally short in duration, and chronic otitis media generally lasts several weeks. Seventy-five percent of children in the U.S. suffer from otitis media at some point.
Signs and symptoms in babies, toddlers, and children may:
- Be irritable and pull and tug at their ears
- Be fussy
- Have problems feeding or sleeping
- Complain about pain and fullness in the ear
- Have a fever
- A buildup of pus in the ear
- Have signs and symptoms of an upper respiratory infection
Treatment depends upon the type (chronic or acute).
Human Immunodeficiency Virus (HIV)The human immunodeficiency virus (HIV) causes HIV infection and the acquired immunodeficiency syndrome (AIDS). Symptoms and signs of HIV infection include fatigue, enlarged lymph glands, and recurrent vaginal yeast infections. Highly active antiretroviral therapy (ART) is the standard treatment for HIV infection.
MelioidosisMelioidosis (Whitmore's disease) is an infectious disease caused by Burkholderia pseudomallei bacteria. Symptoms include bronchitis, pneumonia, fever, headache, loss of appetite, cough, and chest pain. Treatment involves antibiotics or surgical removal of the lung abscess in severe cases.
Take the MRSA Quiz!It's the MRSA Quiz! For the carriers among us, you'd be surprised that the infectious superbug is lurking on this body part! Take the quiz and learn how to keep this Staph infection at bay.
Mycobacterium MarinumMycobacterium marinum (M. marinum) is bacteria found in fresh and saltwater that can infect the skin through cuts or scrapes, causing granulomas to appear on the skin near the site of infection. This infection may be treated with a long course of oral antibiotics.
PertussisWhooping cough (pertussis) is highly contagious respiratory infection that is caused by the bacteria Bordetella pertussis. There are an estimated 300,000 plus deaths annually from whooping cough (pertussis). Whooping cough commonly affects infants and young children but can be prevented with immunization with the vaccine. First stage whooping cough symptoms are a runny nose, sneezing, low-grade fever, a mild cough with the cough gradually becoming more severe. After one to two weeks, the second stage of whooping cough begins.
ToxoplasmosisToxoplasmosis (toxo) is a parasitic infection that causes flulike symptoms, swollen lymph nodes, and muscle aches and pains that may last from a few days to several weeks. Toxoplasmosis can be contracted by touching the hands to the mouth after gardening, cleaning a cat's litter box, or anything that came into contact with cat feces. Toxoplasmosis can also be contracted by eating raw or partly cooked meat, especially pork or lamb, or touching the hands to the mouth after contact with raw or undercooked meat.
Typhoid FeverTyphoid fever is an illness caused by the Salmonella typhi bacteria. The illness is contracted by ingesting the bacteria in contaminated water or food. Symptoms include headaches, fever, diarrhea, lethargy, aches and pains, and poor appetite. Treatment focuses on killing the Salmonella bacteria with antibiotics.
Urinary Tract InfectionA urinary tract infection (UTI) is an infection of the bladder, kidneys, ureters, or urethra. E. coli, a type of bacteria that lives in the bowel and near the anus, causes most UTIs. UTI symptoms include pain, abdominal pain, mild fever, urinary urgency and frequency. Treatment involves a course of antibiotics.
Wegener's GranulomatosisGranulomatosis with Polyangiitis (GPA or Wegener's granulomatosis) is a condition that usually affects young or middle-aged adults, is an inflammation of the arteries supplying blood to the sinuses, lungs, and kidneys. Symptoms of granulomatosis with polyangiitis include:
- bloody sputum,
- weight loss,
- joint pain,
- shortness of breath,
- and fever.