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Sulfamethoxazole/trimethoprim (Intravenous route)

Pronunciation:

sul-fa-meth-OX-a-zole, trye-METH-oh-prim

Dosage Forms:

  • Solution

Classifications:

Therapeutic—

Sulfonamide Combination

Pharmacologic—

Folic Acid Antagonist

Chemical—

Sulfonamide

Uses of This Medicine:

Sulfamethoxazole and trimethoprim combination is used to treat intestinal or urinary tract infections. It is also used to treat 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, such as cancer patients, transplant patients, and patients with acquired immune deficiency syndrome (AIDS).

Sulfamethoxazole and trimethoprim combination is an antibiotic. It 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.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of sulfamethoxazole and trimethoprim combination in children older than 2 months of age. Safety and efficacy have not been established for infants less than 2 months of age.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of sulfamethoxazole and trimethoprim combination in the elderly. However, elderly patients are more likely to have age-related kidney or liver problems, which may require an adjustment in the dose for patients receiving sulfamethoxazole and trimethoprim combination.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersDStudies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast-feeding—

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Bepridil
  • Cisapride
  • Dofetilide
  • Levomethadyl
  • Mesoridazine
  • Methenamine
  • Pimozide
  • Terfenadine
  • Thioridazine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acecainide
  • Acenocoumarol
  • Ajmaline
  • Amiodarone
  • Amisulpride
  • Amitriptyline
  • Amoxapine
  • Aprindine
  • Arsenic Trioxide
  • Astemizole
  • Azimilide
  • Bretylium
  • Chloral Hydrate
  • Chloroquine
  • Chlorpromazine
  • Clarithromycin
  • Dabrafenib
  • Desipramine
  • Dibenzepin
  • Disopyramide
  • Dolasetron
  • Doxepin
  • Droperidol
  • Eltrombopag
  • Enflurane
  • Erythromycin
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Foscarnet
  • Gemifloxacin
  • Halofantrine
  • Haloperidol
  • Halothane
  • Hydroquinidine
  • Ibutilide
  • Imipramine
  • Isoflurane
  • Isradipine
  • Leucovorin
  • Lidoflazine
  • Lorcainide
  • Mefloquine
  • Methotrexate
  • Nortriptyline
  • Octreotide
  • Pentamidine
  • Pirmenol
  • Prajmaline
  • Probucol
  • Procainamide
  • Prochlorperazine
  • Propafenone
  • Pyrimethamine
  • Quinidine
  • Risperidone
  • Sematilide
  • Sertindole
  • Sotalol
  • Spiramycin
  • Spironolactone
  • Sultopride
  • Tedisamil
  • Telithromycin
  • Trifluoperazine
  • Trimipramine
  • Vasopressin
  • Warfarin
  • Zotepine

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acetohexamide
  • Amantadine
  • Anisindione
  • Chlorpropamide
  • Didanosine
  • Digoxin
  • Enalaprilat
  • Enalapril Maleate
  • Fosphenytoin
  • Glipizide
  • Glyburide
  • Phenytoin
  • Quinapril
  • Repaglinide
  • Rifabutin
  • Rosiglitazone
  • Tolazamide
  • Tolbutamide

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Ethanol

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Anemia, megaloblastic (caused by not enough folic acid)—Should not be used in patients with this condition.
  • Asthma or
  • Folate deficiency (vitamin B9) or
  • Glucose-6-phosphate dehydrogenase (G6PD) deficiency or
  • HIV or AIDS or
  • Kidney disease or
  • Liver disease or
  • Seizures, history of—Use with caution. May have an increased chance of side effects.

Proper Use of This Medicine:

A nurse or other trained health professional will give you this medicine. This medicine is given through a needle placed in one of your veins.

Precautions While Using This Medicine:

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away. Do not breastfeed while using the medicine.

Very rarely, this medicine has caused severe side effects. If you start to have a skin rash, or if you think you are having a severe skin reaction, call your doctor or nurse right away. Symptoms of a severe reaction may include a skin rash, skin color that is very pale or yellow, or skin with purple spots, along with a sore throat, fever, muscle pain, cough, and trouble with breathing.

Check with your doctor right away if you have abdominal or stomach cramps; bloating; watery and severe diarrhea, which may also be bloody; nausea or vomiting; or unusual tiredness or weakness. These may be symptoms of a serious intestinal infection.

This medicine may cause serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Check with your doctor right away if you have a rash; itching; swelling of the face, tongue, and throat; trouble with breathing; shortness of breath; or chest pain after you get the injection.

Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests may be affected by this medicine.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Rare
Abdominal or stomach pain
black, tarry stools
blistering, peeling, or loosening of 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 foot or leg
painful or difficult urination
pale skin
rash
red irritated eyes
red skin lesions, often with a purple center
shortness of breath
sore throat
sores, ulcers, or white spots in mouth or on lips
swollen or painful glands
tightness in chest
unpleasant breath odor
unusual bleeding or bruising
unusual tiredness or weakness
vomiting of blood
wheezing
yellow eyes or skin
Incidence not known
Abdominal tenderness
back, leg, or stomach pains
bleeding gums
bleeding under the skin
blindness or vision changes
blisters, hives, or itching
bloating
blood in urine or stools
bluish-colored lips, fingernails, or palms
burning, crawling, itching, numbness, painful, prickling, "pins and needles", or tingling feelings
burning of face or mouth
clumsiness or unsteadiness
cloudy urine
confusion
constipation
continuing ringing or buzzing or other unexplained noise in ears
convulsions
cracks in the skin
decreased frequency or amount of urine
diarrhea, watery and severe, which may also be bloody
difficulty breathing
difficulty swallowing
dizziness or lightheadedness
fainting spells
general body swelling
general feeling of discomfort or illness
hair loss
hearing loss
increased blood pressure
increased thirst
indigestion
irregular heartbeat
large, flat, blue or purplish patches in the skin
large, hive-like swelling on 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 hands, feet, or lips
pain or burning while urinating
pains in the stomach, side, or abdomen, possibly radiating to the back
painful knees and ankles
pinpoint red spots on 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
rapid heart rate
red, swollen skin
redness of the white part of the eyes
redness, swelling, or soreness of tongue
scaly skin
shakiness and unsteady walk
soreness of muscles
stiff neck or back
swelling of face, hands, legs, and feet
swelling or inflammation of the mouth
trouble breathing
unsteadiness, trembling, or other problems with muscle control or coordination
unusual weight loss
weakness in hands or feet
weakness or heaviness of legs
weight gain

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Hives or welts
passing of gas
redness of skin
stomach pain, fullness, or discomfort
Incidence not known
Discouragement
feeling of constant movement of self or surroundings
feeling sad or empty
increased sensitivity of skin to sunlight
irritability
lack of feeling or emotion
loss of interest or pleasure
nervousness
redness or other discoloration of skin
seeing, hearing, or feeling things that are not there
sensation of spinning
severe sunburn
sleeplessness
trouble concentrating
trouble sleeping
unable to sleep
uncaring

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 4/4/2014

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