Drug interactions between Bactrim IV and Coumadin
|Bactrim IV (sulfamethoxazole/trimethoprim)|
Interactions between your selected drugs
Using warfarin together with sulfamethoxazole may increase the risk of bleeding, especially if you are elderly or have kidney or liver impairment. You may need more frequent monitoring of your prothrombin time or INR by your doctor to safely use both medications. Call your doctor promptly if you experience any unusual bleeding or bruising, swelling, vomiting, blood in your urine or stools, headache, dizziness, or weakness during treatment with these medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Consumer information for this interaction is not currently available.
MONITOR: Many antibacterials may potentiate the hypoprothrombinemic effect of oral warfarin and other coumarin anticoagulants. The exact mechanism is unknown but may involve inhibition of coumarin metabolism and/or depletion of certain clotting factors due to suppression of vitamin K-producing intestinal flora. Other influences such as fever, infection, malnutrition, renal impairment, age, and other concomitant underlying conditions on clotting mechanisms and anticoagulant pharmacokinetics should also be considered.
MANAGEMENT: Given the potential for clinically significant interaction and even fatality in the occasional, susceptible patient, monitoring is recommended during concomitant therapy. The INR should be checked frequently and coumarin dosage adjusted accordingly, particularly following initiation or discontinuation of the antibacterial therapy in patients who are stabilized on their anticoagulant regimen. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.
- Ministerio de Sanidad y Consumo. Gobierno de España "AEMPS. Agencia Española de Medicamentos y Productos Sanitarios. Available from: URL: https://sinaem4.agemed.es/consaem/fichasTecnicas.do?metodo=detalleForm."
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
Drug Interaction Classification
The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
|Major||Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.|
|Moderate||Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.|
|Minor||Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.|
Do not stop taking any medications without consulting your healthcare provider.
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