Sulphamethoxazole + Trimethoprim interactions
Checked as Sulfamethoxazole + Trimethoprim in this data source.
Full monograph for Sulphamethoxazole + TrimethoprimCheck it against another medicine
Medicines
487 documented
| Medicine | Severity | Mechanism | Effect | Sources |
|---|---|---|---|---|
| Amlodipine Besilate + Benazepril Hydrochloridevia Trimethoprim | Major | Excretion · Unknown | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits…2 documented mechanisms | 35 sources — open the full entry |
| Amlodipine Besilate + Olmesartan Medoxomilvia Trimethoprim | Major | Excretion · Unknown | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits…2 documented mechanisms | 35 sources — open the full entry |
| Amlodipine Besilate + Telmisartanvia Trimethoprim | Major | Excretion · Unknown | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits…2 documented mechanisms | 35 sources — open the full entry |
| Amlodipine Besilate + Valsartanvia Trimethoprim | Major | Excretion · Unknown | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits…2 documented mechanisms | 35 sources — open the full entry |
| Articaine Hydrochloride + Epinephrine Bitartratevia Sulfamethoxazole, Trimethoprimmatched approximately | Major | Synergy | Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…2 documented mechanisms | 5 sources — open the full entry |
| Azilsartan Medoxomilvia Trimethoprim | Major | Excretion · Synergy | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits…2 documented mechanisms | 70 sources — open the full entry |
| Azilsartan Medoxomil + Chlorthalidonevia Trimethoprim | Major | Excretion · Synergy | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits…2 documented mechanisms | 70 sources — open the full entry |
| Beclomethasone Dipropionate + Chloramphenicol + Clotrimazole + Lidocainevia Sulfamethoxazole, Trimethoprimmatched approximately | Major | Synergy · Unknown | Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…4 documented mechanisms | 5 sources — open the full entry |
| Benzocaine + Butamben + Tetracaine Hydrochloridevia Sulfamethoxazole, Trimethoprimmatched approximately | Major | Antagonism · Synergy | Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…3 documented mechanisms | 7 sources — open the full entry |
| Betamethasone + Phenylephrine + Lignocainevia Sulfamethoxazole, Trimethoprimmatched approximately | Major | Synergy · Unknown | Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…2 documented mechanisms | 5 sources — open the full entry |
| Bupivacaine Hydrochloridevia Sulfamethoxazole, Trimethoprimmatched approximately | Major | Synergy | Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…2 documented mechanisms | 5 sources — open the full entry |
| Bupivacaine Hydrochloride + Dextrosevia Sulfamethoxazole, Trimethoprimmatched approximately | Major | Synergy | Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…2 documented mechanisms | 5 sources — open the full entry |
| Calcium Dobesilate + Lidocaine + Dexamethasonevia Sulfamethoxazole, Trimethoprimmatched approximately | Major | Synergy · Unknown | Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…3 documented mechanisms | 5 sources — open the full entry |
| Candesartan Cilexetilvia Trimethoprim | Major | Synergy | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits… | 35 sources — open the full entry |
| Candesartan Cilexetil + Hydrochlorothiazidevia Trimethoprim | Major | Synergy · Unknown | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits…2 documented mechanisms | 35 sources — open the full entry |
| Captoprilvia Trimethoprim | Major | Excretion | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits… | 35 sources — open the full entry |
| Chloramphenicol + Lidocaine Hydrochloridevia Sulfamethoxazole, Trimethoprimmatched approximately | Major | Synergy · Unknown | Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…3 documented mechanisms | 5 sources — open the full entry |
| Clozapinevia Sulfamethoxazole, Trimethoprimmatched approximately | Major | Synergy · Unknown | Coadministration of clozapine with other agents that can cause neutropenia or agranulocytosis may increase the risk and/or severity of hematologic toxicity.2 documented mechanisms | 9 sources — open the full entry |
| Cyclosporine (Oral)via Sulfamethoxazole, Trimethoprimmatched approximately | Major | Others | Sulfonamides may significantly reduce serum cyclosporine concentrations by an unknown mechanism. Allograft rejections have resulted. Hyperkalemia and additive…2 documented mechanisms | 39 sources — open the full entry |
| Diclofenac Sodium + Lidocaine Hydrochloridevia Sulfamethoxazole, Trimethoprimmatched approximately | Major | Synergy · Unknown | Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…3 documented mechanisms | 5 sources — open the full entry |
| Enalapril Maleatevia Trimethoprim | Major | Excretion | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits… | 35 sources — open the full entry |
| Eplerenonevia Trimethoprim | Major | Excretion | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits… | 35 sources — open the full entry |
| Finerenonevia Trimethoprim | Major | Synergy | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits… | 35 sources — open the full entry |
| Folinic Acidvia Trimethoprim | Major | Others | Concomitant use of leucovorin with sulfamethoxazole-trimethoprim (SMX-TMP) for the acute treatment of Pneumocystis jiroveci pneumonia (formerly known as… | 5 sources — open the full entry |
| Furosemide + Spironolactonevia Trimethoprim | Major | Excretion · Unknown | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits…2 documented mechanisms | 35 sources — open the full entry |
| Hydrocortisone + Lidocainevia Sulfamethoxazole, Trimethoprimmatched approximately | Major | Synergy · Unknown | Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…3 documented mechanisms | 5 sources — open the full entry |
| Irbesartanvia Trimethoprim | Major | Excretion | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits… | 35 sources — open the full entry |
| Irbesartan + Hydrochlorothiazidevia Trimethoprim | Major | Excretion · Unknown | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits…2 documented mechanisms | 35 sources — open the full entry |
| Lidocaine + Adrenalinevia Sulfamethoxazole, Trimethoprimmatched approximately | Major | Synergy · Unknown | Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…2 documented mechanisms | 5 sources — open the full entry |
| Lidocaine + Epinephrinevia Sulfamethoxazole, Trimethoprimmatched approximately | Major | Synergy · Unknown | Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…2 documented mechanisms | 5 sources — open the full entry |
| Lidocaine + Prilocainevia Sulfamethoxazole, Trimethoprimmatched approximately | Major | Synergy · Unknown | Prilocaine can cause dose-related methemoglobin formation via its ortho-toluidine metabolite. Coadministration with other oxidizing agents that can also induce…5 documented mechanisms | 25 sources — open the full entry |
| Lidocaine HydrochlorideInjectionSprayvia Sulfamethoxazole, Trimethoprimmatched approximately | Major | Synergy · Unknown | Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…2 documented mechanisms | 5 sources — open the full entry |
| Lisinoprilvia Trimethoprim | Major | Excretion | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits… | 35 sources — open the full entry |
| Losartan Potassiumvia Trimethoprim | Major | Excretion | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits… | 35 sources — open the full entry |
| Losartan Potassium + Hydrochlorothiazidevia Trimethoprim | Major | Excretion · Unknown | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits…2 documented mechanisms | 35 sources — open the full entry |
| Methenamine Hippuratevia Sulfamethoxazolematched approximately | Major | Others | Some sulfonamides can form an insoluble precipitate with formaldehyde, which is generated from the hydrolysis of methenamine in acidic urine maintained by the… | 2 sources — open the full entry |
| Methotrexatevia Sulfamethoxazole, Trimethoprimmatched approximately | Major | Distribution · Excretion · Synergy | Coadministration of methotrexate with trimethoprim may increase the risk of severe myelosuppression and megaloblastic anemia due to potential additive effects…2 documented mechanisms | 39 sources — open the full entry |
| Nebivolol + Valsartanvia Trimethoprim | Major | Excretion | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits… | 35 sources — open the full entry |
| Ofloxacin + Clotrimazole + Beclomethasone + Lidocainevia Sulfamethoxazole, Trimethoprimmatched approximately | Major | Synergy · Unknown | Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…5 documented mechanisms | 12 sources — open the full entry |
| Olmesartan Medoxomilvia Trimethoprim | Major | Excretion | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits… | 35 sources — open the full entry |
| Olmesartan Medoxomil + Hydrochlorothiazidevia Trimethoprim | Major | Excretion · Unknown | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits…2 documented mechanisms | 35 sources — open the full entry |
| Perindopril + Indapamidevia Trimethoprim | Major | Excretion · Unknown | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits…2 documented mechanisms | 35 sources — open the full entry |
| Perindopril Argininevia Trimethoprim | Major | Excretion | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits… | 35 sources — open the full entry |
| Perindopril Arginine + Amlodipinevia Trimethoprim | Major | Excretion · Unknown | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits…2 documented mechanisms | 35 sources — open the full entry |
| Potassium Chloridevia Trimethoprim | Major | Excretion | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits… | 35 sources — open the full entry |
| Potassium Citratevia Trimethoprim | Major | Excretion | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits… | 35 sources — open the full entry |
| Potassium Citrate + Citric Acidvia Trimethoprim | Major | Excretion | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits… | 35 sources — open the full entry |
| Ramiprilvia Trimethoprim | Major | Excretion | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits… | 35 sources — open the full entry |
| Ramipril + Hydrochlorothiazidevia Trimethoprim | Major | Excretion · Unknown | The use of trimethoprim in combination with other potassium-sparing drugs or potassium salts may increase the risk of hyperkalemia. Trimethoprim inhibits…2 documented mechanisms | 35 sources — open the full entry |
| Ropivacaine Hydrochloridevia Sulfamethoxazole, Trimethoprimmatched approximately | Major | Synergy | Coadministration of local anesthetics with other oxidizing agents that can also induce methemoglobinemia such as antimalarials (e.g., chloroquine, primaquine…2 documented mechanisms | 5 sources — open the full entry |
Conditions
Conditions in which Sulphamethoxazole + Trimethoprim needs care, as documented in this source.
Folic Acid Deficiency
MajorThe use of trimethoprim is contraindicated in patients with documented megaloblastic anemia due to folate deficiency. Trimethoprim inhibits dihydrofolate reductase, an enzyme necessary in the synthesis of tetrahydrofolic acid, or the metabolically active form of folic acid. Thrombocytopenia, neutropenia, megaloblastic anemia, and methemoglobinemia have been reported rarely. However, the risk is increased in the presence of folate deficiency, chronic hemolytic anemia and/or renal impairment, as well as during prolonged therapy (e.g., > 6 months) with high dosages. Therapy with trimethoprim should be administered cautiously under these conditions and in patients with suspected folate depletion (e.g., elderly, alcoholic, malnourished or debilitated patients). Folic acid supplementation, if necessary, may be administered concomitantly without interfering with the antibacterial action of trimethoprim. Patients should be instructed to immediately report any signs or symptoms suggestive of hematologic toxicity such as fever, sore throat, local infection, bleeding, pallor, dizziness, or jaundice. Leucovorin (folinic acid) should be administered if bone marrow depression is detected.
4 sources
- Chan M, Beale D, Moorhead J "Acute megaloblastosis due to cotrimoxazole." Br J Clin Pract 34 (1980): 87-8
- Sheehan J "Trimethoprim-associated marrow toxicity." Lancet 2 (1981): 692
- "Product Information. Trimpex (trimethoprim)." Roche Laboratories (2001):
- "Product Information. Proloprim (trimethoprim)." Glaxo Wellcome (2001):
Diseases requiring dialysis
ModerateTrimethoprim is moderately removed by hemodialysis. Doses should either be scheduled for administration after dialysis or supplemental doses be given after dialysis.
4 sources
- Patel RB, Welling PG "Clinical pharmacokinetics of co-trimoxazole (trimethoprim-sulphamethoxazole)." Clin Pharmacokinet 5 (1980): 405-23
- Nissenson AR, Wilson C, Holazo A "Pharmacokinetics of intravenous trimethoprim-sulfamethoxazole during hemodialysis." Am J Nephrol 7 (1987): 270-4
- "Product Information. Trimpex (trimethoprim)." Roche Laboratories (2001):
- "Product Information. Proloprim (trimethoprim)." Glaxo Wellcome (2001):
Kidney Diseases
ModerateTrimethoprim is primarily eliminated by the kidney. The serum concentration of trimethoprim may be increased and the half-life prolonged in patients with impaired renal function. Dosage adjustments may be necessary and modifications should be based on the degree of renal impairment as well as severity of infection. The manufacturers recommend a dosage of 50 mg every 12 hours in patients with creatinine clearance between 15 to 30 mL/min and not using the drug in patients with creatinine clearance below 15 mL/min.
11 sources
- Bergan T, Brodwall E, Vik-Mo H, Anstad U "Pharmacokinetics of sulphadiazine, sulphamethoxazole and trimethoprim in patients with varying renal function." Infection 7 (1979): s382-7
- Adam WR, Henning M, Dawborn JK "Excretion of trimethoprim and sulphamethoxazole in patients with renal failure." Aust N Z J Med 3 (1973): 383-7
- Rieder J, Schwartz DE, Fernex M, et al. "Pharmacokinetics of the antibacterial combination sulfamethoxazole plus trimethoprim in patients with normal or impaired kidney function." Antibiot Chemother 18 (1974): 148-98
- Nolte H, Buttner H "Pharmacokinetics of trimethoprim and its combination with sulfamethoxazole in man after single and chronic oral administration." Chemotherapy 18 (1973): 274-84
- Bergan T, Brodwall EK "Kidney transport in man of sulfamethoxazole and trimethoprim." Chemotherapy 17 (1972): 320-33
- Odlind B, Hartvig P, Fjellstrom KE, Lindstrom B, Bengtsson S "Steady state pharmacokinetics of trimethoprim 300 mg once daily in healthy volunteers assessed by two independent methods." Eur J Clin Pharmacol 26 (1984): 393-7
- Andreasen F, Elsborg L, Husted S, Thomsen O "Pharmacokinetics of sulfadiazine and trimethoprim in man." Eur J Clin Pharmacol 14 (1978): 57-67
- Ahlmen J, Brorson J-E "Pharmacokinetics of trimethoprim given in single daily doses for three days." Scand J Infect Dis 14 (1982): 143-5
Show all 11 sourcesShow fewer sources
- Hengstmann JH "Pharmacokinetics of trimethoprim and tetroxoprim: a review." Antibiot Chemother 31 (1982): 211-24
- Watson ID, Stewart MJ, Wiles A, McIntosh SJ "Pharmacokinetics of two dosage levels of trimethoprim to "steady-state" in normal volunteers." J Int Med Res 11 (1983): 137-44
- "Product Information. Trimpex (trimethoprim)." Roche Laboratories (2001):
Therapeutic duplication
Drug classes that overlap with Sulphamethoxazole + Trimethoprim, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.
antipneumocystis agents
The recommended maximum number of medicines in the 'antipneumocystis agents' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antipneumocystis agents' category.
Example product in the source data (US market): Malarone pediatric
sulfonamides
The recommended maximum number of medicines in the 'sulfonamides' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'sulfonamides' category.
Example product in the source data (US market): Pyrimethamine/sulfadoxine
sulfonamides
The recommended maximum number of medicines in the 'sulfonamides' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'sulfonamides' category.
Example product in the source data (US market): Pediazole