If sulfamethoxazole/trimethoprim is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be advised of the potential hazards to the fetus.Fatalities associated with the administration of sulfonamides, although rare, have occurred due to severe reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, fulminant hepatic necrosis, agranulocytosis, aplastic anemia and other blood dyscrasias.Sulfonamides, including sulfonamide-containing products such as sulfamethoxazole/trimethoprim, should be discontinued at the first appearance of skin rash or any sign of adverse reaction. 0. The mean maximum serum trimethoprim concentration was higher and mean renal clearance of trimethoprim was lower in geriatric subjects compared with younger subjects (see The most common adverse effects are gastrointestinal disturbances (nausea, vomiting, anorexia) and allergic skin reactions (such as rash and urticaria). Acidification of the urine will increase renal elimination of trimethoprim. Patients with renal dysfunction, liver disease, malnutrition or those receiving high doses of Bactrim are particularly at risk.Trimethoprim has been noted to impair phenylalanine metabolism, but this is of no significance in phenylketonuric patients on appropriate dietary restriction.As with all drugs containing sulfonamides, caution is advisable in patients with porphyria or thyroid dysfunction.Co-administration of Bactrim and leucovorin should be avoided with High dosage of trimethoprim, as used in patients with Severe and symptomatic hyponatremia can occur in patients receiving Bactrim, particularly for the treatment of During treatment, adequate fluid intake and urinary output should be ensured to prevent crystalluria.

Peritoneal dialysis is not effective and hemodialysis is only moderately effective in eliminating sulfamethoxazole and trimethoprim.The usual adult dosage in the treatment of acute exacerbations of chronic bronchitis is 1 Bactrim DS (double strength) tablet or 2 Bactrim tablets every 12 hours for 14 days.The recommended dosage for treatment of patients with documented For the lower limit dose (75 mg/kg sulfamethoxazole and 15 mg/kg trimethoprim per 24 hours) administer 75% of the dose in the above table.The recommended dosage for prophylaxis in adults is 1 Bactrim DS (double strength) tablet daily.For the treatment of traveler's diarrhea, the usual adult dosage is 1 Bactrim DS (double strength) tablet or 2 Bactrim tablets every 12 hours for 5 days.Bactrim™ DS (double strength) TABLETS (white, oval shaped, scored) containing 160 mg trimethoprim and 800 mg sulfamethoxazole – bottles of 100 (NDC 49708-146-01). Thrombocytopenia usually resolves within a week upon discontinuation of sulfamethoxazole/trimethoprim.The sulfonamides should not be used for treatment of group A β-hemolytic streptococcal infections. A history of mild intolerance to Bactrim in AIDS patients does not appear to predict intolerance of subsequent secondary prophylaxis. 2 doctors agree.

The patient should be monitored with blood counts and appropriate blood chemistries, including electrolytes.

The presence of 10 mg percent sulfamethoxazole in plasma decreases the protein binding of trimethoprim by an insignificant degree; trimethoprim does not influence the protein binding of sulfamethoxazole.Peak blood levels for the individual components occur 1 to 4 hours after oral administration. Co-administration of Bactrim and leucovorin should be avoided with P. jirovecii pneumonia (see WARNINGS). Dr. Hunter Handsfield answered. Select one or more newsletters to continue. In rare instances, a skin rash may be followed by a more severe reaction, such as Stevens-Johnson syndrome, toxic epidermal necrolysis, hepatic necrosis, and serious blood disorders (see Cough, shortness of breath, and pulmonary infiltrates are hypersensitivity reactions of the respiratory tract that have been reported in association with sulfonamide treatment.Sulfamethoxazole/trimethoprim-induced thrombocytopenia may be an immune-mediated disorder. Acute Exacerbations of Chronic Bronchitis in Adults:Adjunctive treatment with Leucovorin for Pneumocystis jirovecii pneumoniaUse in the Treatment of and Prophylaxis for Pneumocystis jirovecii Pneumonia in Patients with Acquired Immunodeficiency Syndrome (AIDS):Carcinogenesis, Mutagenesis, Impairment of Fertility:FATALITIES ASSOCIATED WITH THE ADMINISTRATION OF SULFONAMIDES, ALTHOUGH RARE, HAVE OCCURRED DUE TO SEVERE REACTIONS, INCLUDING STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, FULMINANT HEPATIC NECROSIS, AGRANULOCYTOSIS, APLASTIC ANEMIA AND OTHER BLOOD DYSCRASIAS (SEE Bactrim is contraindicated in pediatric patients less than 2 months of age.Urinary Tract Infections and Shigellosis in Adults and Pediatric Patients, and Acute Otitis Media in Children:Acute Exacerbations of Chronic Bronchitis in Adults:We comply with the HONcode standard for trustworthy health information -