sulfamethoxazole and trimethoprim

Take all of the sulfamethoxazole and trimethoprim that has been prescribed for you even if you begin to feel better. Your symptoms may start to improve before the infection is completely treated.

Sulfamethoxazole and trimethoprim are both antibiotics that treat different types of bacterial infections. Sulfamethoxazole and trimethoprim fight bacteria in your body.

Sulfamethoxazole and trimethoprim is used to treat infections such as urinary tract infections, bronchitis, ear infections (otitis), traveler's diarrhea, and Pneumocystis carinii pneumonia.

Sulfamethoxazole and trimethoprim may also be used for purposes other than those listed in this medication guide.

Before taking this medication, tell your doctor if you have

• kidney or liver disease, or
• a glucose-6-phosphate dehydrogenase deficiency (G6PD deficiency).

You may not be able to take sulfamethoxazole and trimethoprim, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.

Sulfamethoxazole and trimethoprim is in the FDA pregnancy category C. This means that it is not known whether sulfamethoxazole and trimethoprim will harm an unborn baby. This medication affects folic acid in your body, which is necessary for the normal development of a baby. Do not take sulfamethoxazole and trimethoprim without first talking to your doctor if you are pregnant.

Sulfamethoxazole and trimethoprim passes into breast milk and may harm a nursing baby. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.

Sulfamethoxazole and trimethoprim is not approved for use in children younger than 2 months of age.

Take this drug exactly as directed by your physician. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water.

Take sulfamethoxazole and trimethoprim with food or milk if it upsets your stomach.

You may crush the tablets and put them in water or a soft food like applesauce or pudding if you cannot swallow them whole.

To ensure that you get a correct dose, measure the liquid form of sulfamethoxazole and trimethoprim with a special dose-measuring spoon or cup, not with a regular tablespoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one. Shake the suspension well before measuring a dose.

Take all of the sulfamethoxazole and trimethoprim that has been prescribed for you even if you begin to feel better. Your symptoms may start to improve before the infections is completely treated.

Store the tablets and liquid at room temperature away from moisture and heat.

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the dose you missed and take only your next regularly scheduled dose. Do not take a double dose of this medication unless otherwise directed by your doctor.

If you have only missed one dose, you can take the rest of your scheduled doses for that day at evenly spaced intervals.

Seek emergency medical attention.

Symptoms of a sulfamethoxazole and trimethoprim overdose include nausea, vomiting, decreased appetite, diarrhea, headache, yellowing of the skin or eyes, decreased urine production, bloody urine, and coma.

Avoid prolonged exposure to sunlight. Sulfamethoxazole and trimethoprim may increase the sensitivity of your skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.

Stop taking sulfamethoxazole and trimethoprim and seek emergency medical attention if you experience any of the following serious side effects:

• an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
• unusual bleeding or bruising; or
• yellow skin or eyes.

Other, less serious side effects may be more likely to occur. Continue to take your medication and talk to your doctor if you experience

• headache, fatigue, or dizziness;
• nausea, vomiting, decreased appetite, or diarrhea;
• weakness; or
• increased sensitivity to the sun.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

Sulfamethoxazole and trimethoprim may increase the effects of oral anticoagulants such as warfarin (Coumadin) and lead to bleeding. Tell your doctor if you are taking a blood thinner.

Sulfamethoxazole and trimethoprim may also increase the effects of drugs used to treat diabetes, such as glipizide (Glucotrol), glyburide (Glynase, Micronase, Diabeta), chlorpropamide (Diabinese), tolbutamide (Orinase), and tolazamide (Tolinase). Very low blood sugar levels may result. Watch for changes in your blood sugar if you are a diabetic.

Sulfamethoxazole and trimethoprim may increase the effects of phenytoin (Dilantin) and lead to dangerous side effects. Watch for unusual side effects during treatment.

Drugs other than those listed here may also interact with sulfamethoxazole and trimethoprim. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Your pharmacist has additional information about sulfamethoxazole and trimethoprim written for health professionals that you may read.

Sulfamethoxazole and trimethoprim is available with a prescription under the brand names Bactrim and Septra. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Bactrim 400mg/80 mg--capsule-shaped, light-green, scored tablets
• Bactrim DS 800 mg/160 mg--capsule-shaped, white, scored tablets
• Bactrim Suspension 200 mg/40 mg per teaspoon--pink, cherry-flavored liquid
• Septra 400 mg/80 mg--round, pink, scored tablets
• Septra DS 800 mg/160 mg--oval, pink, scored tablets
• Septra Suspension 200 mg/40 mg per teaspoon --pink, cherry-flavored liquid