Bactrim

The active ingredients in Bactrim are sulfamethoxazole (SMX) and trimethoprim (TMP). Both of these antibiotics inhibit the bacteria's production of folic acid or folate, which it needs for growth and survival. TMP blocks one step in the pathway, while SMX blocks another. In this way, they work synergistically to kill the bacteria.

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide before using Bactrim. However, the following is a synopsis of the general guidelines for the use of Bactrim:

• Bactrim is typically taken by mouth twice a day with or without food for most infections. Make sure to take with a full glass of water to prevent kidney stones from developing. The duration of treatment will depend on the type of infection and how severe it is.
• Bactrim should be used exactly as prescribed and do not stop the course of treatment if you start to feel better unless directed by a healthcare provider. Doing so may contribute to bacterial resistance and result in the infection coming back.
• Bactrim does not work for viral infections.
• If your infection becomes worse or does not get better after completing a course of Bactrim, follow up with your healthcare provider.

The most common side effects of Bactrim seen in clinical trials include:

• Diarrhea
• Nausea and vomiting
• Allergic skin reactions such as a rash or hives
• Sun sensitivity
• Joint or muscle pain
• Loss of appetite

Some individuals may experience serious side effects while using Bactrim. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

• Signs of a severe allergic reaction or anaphylaxis such as difficulty breathing, wheezing, swelling of the face, eyes, tongue, or throat, hives, low blood pressure, stomach cramps, nausea and vomiting, or feeling faint.
• Signs of a severe skin reaction such as a widespread skin rash with fever and blisters or peeling of the skin. These symptoms could be a sign of a life-threatening condition such as SCARs, Stevens-Johnson Syndrome, toxic epidermal necrolysis, DRESS, acute febrile neutrophilic dermatosis, or AGEP.
• Signs of a Clostridium difficile infection such as frequent watery and bloody stools following the course of Bactrim treatment.
• Signs of a blood cell disorder such as bruising or bleeding more than usual, lightheadedness, shortness of breath, or fatigue.
• Signs of hepatic impairment or liver problems such as jaundice or yellowing of the skin or eyes, pain in the upper right abdomen, or dark urine.
• Signs of a kidney problem such as blood in the urine, flank pain, confusion, swelling of the legs, feet, arms, or hands, or a decrease in the total amount you urinate per day.
• Signs of hyperkalemia or high blood potassium levels such as chest pain, stomach cramps, nausea and vomiting, or heart palpitations.
• Signs of hyponatremia or low blood sodium levels such as fatigue, confusion, seizures, or muscle cramps.
• Signs of an abnormal heart rhythm such as chest pain, heart palpitations or a fluttering sensation in the chest, or shortness of breath.

These are not all of the possible side effects of Bactrim. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting Bactrim, it is crucial to discuss any existing health conditions with your healthcare provider. You should be sure that your healthcare provider is aware of all your medical conditions, including if you have:

• An allergy to sulfonamides or trimethoprim
• A past history of thrombocytopenia (low platelets) in response to taking a sulfa medication or trimethoprim
• Kidney disease
• Liver disease
• A blood disorder (especially porphyria or megaloblastic anemia)
• Folic acid or folate deficiency
• Asthma
• Bone marrow suppression
• G6PD or glucose-6-phosphate dehydrogenase deficiency
• Underactive thyroid
• Abnormalities in electrolyte levels such as potassium or sodium

Do not use Bactrim if you have any of the following:

• Past allergic reactions to sulfonamides or trimethoprim
• Past history of thrombocytopenia (low platelets) in response to taking a sulfonamide or trimethoprim
• Megaloblastic anemia due to a folate deficiency
• Pediatric patients less than 2 months of age
• Liver problems
• Kidney problems
• Are taking Tikosyn (dofetilide)

Bactrim will start to work against the infection right after the first dose. However, depending on the type of infection and the severity, you may not notice the effects until after a few days of regular use.

When Bactrim is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Make sure that you tell your healthcare professional about anything that you are taking to avoid any negative drug interactions, including:

• Diuretics
• Warfarin
• Phenytoin
• Methotrexate
• Cyclosporine
• Leucovorin
• Digoxin
• Indomethacin
• Pyrimethamine
• TCAs (tricyclic antidepressants)
• Oral diabetic medications such as pioglitazone, repaglinide, rosiglitazone, glipizide, glyburide, or metformin
• Amantadine
• ACE inhibitors
• Zidovudine
• Dofetilide
• Procainamide

Bactrim tablets are available in the following strengths:

• Sulfamethoxazole 400 mg/trimethoprim 80 mg

Bactrim is also available as a double-strength tablet known as Bactrim DS that is available in the following strengths:

• Sulfamethoxazole 800 mg/trimethoprim 160 mg

Bactrim should be stored at room temperature away from light and out of reach of children.

Bactrim is manufactured by Sun Pharmaceutical Industries.

There are generic versions of the brand name Bactrim or Bactrim DS available. One of them includes co-trimoxazole.

Consult your doctor or pharmacist before starting, stopping, or changing your dose while taking Bactrim.

Some studies suggest that Bactrim may cause harm to the unborn child and it is typically not recommended to take if you are pregnant. Talk to your doctor if you are already pregnant or if you have any plans to become pregnant. They will know or recommend what is best for you.

Bactrim can pass into the breast milk and may cause harm to the breastfeeding infant. Talk to your doctor if you are already breastfeeding or if you have any plans to breastfeed. They will know or recommend what is best for you.