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Bactrim (sulfamethoxazole / trimethoprim) Disease Interactions

There are 12 disease interactions with Bactrim (sulfamethoxazole / trimethoprim):

Major

Antibiotics (applies to Bactrim) colitis

Major Potential Hazard, Moderate plausibility. Applicable conditions: Colitis/Enteritis (Noninfectious)

Clostridioides difficile-associated diarrhea (CDAD), formerly pseudomembranous colitis, has been reported with almost all antibacterial drugs and may range from mild diarrhea to fatal colitis. The most common culprits include clindamycin and lincomycin. Antibacterial therapy alters the normal flora of the colon, leading to overgrowth of C difficile, whose toxins A and B contribute to CDAD development. Morbidity and mortality are increased with hypertoxin-producing strains of C difficile; these infections can be resistant to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea after antibacterial use. Since CDAD has been reported to occur more than 2 months after antibacterial use, careful medical history is necessary. Therapy with broad-spectrum antibacterials and other agents with significant antibacterial activity should be administered cautiously in patients with history of gastrointestinal disease, particularly colitis; pseudomembranous colitis (generally characterized by severe, persistent diarrhea and severe abdominal cramps, and sometimes associated with the passage of blood and mucus), if it occurs, may be more severe in these patients and may be associated with flares in underlying disease activity. Antibacterial drugs not directed against C difficile may need to be stopped if CDAD is suspected or confirmed. Appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C difficile, and surgical evaluation should be started as clinically indicated.

References

  1. Moriarty HJ, Scobie BA "Pseudomembranous colitis in a patient on rifampicin and ethambutol." N Z Med J 04/23/80 (1980): 294-5
  2. Thomas E, Mehta JB "Pseudomembranous colitis due to oxacillin therapy." South Med J 77 (1984): 532-3
  3. Davies J, Beck E "Recurrent colitis following antibiotic-associated pseudomembranous colitis." Postgrad Med J 57 (1981): 599-601
  4. Bauwens JE, McFarland LV, Melcher SA "Recurrent clostridium difficile disease following ciprofloxacin use." Ann Pharmacother 31 (1997): 1090
  5. Dan M, Samra Z "Clostridium difficile colitis associated with ofloxacin therapy." Am J Med 87 (1989): 479
  6. Harmon T, Burkhart G, Applebaum H "Perforated pseudomembranous colitis in the breast-fed infant." J Pediatr Surg 27 (1992): 744-6
  7. Milstone EB, McDonald AJ, Scholhamer CF Jr "Pseudomembranous colitis after topical application of clindamycin." Arch Dermatol 117 (1981): 154-5
  8. Burt RA "A review of the drug events reported by 12,917 patients treated with cephalexin." Postgrad Med J 59 (1983): 47-50,51-3
  9. Cone JB, Wetzel W "Toxic megacolon secondary to pseudomembranous colitis." Dis Colon Rectum 25 (1982): 478-82
  10. Bernstein L "Adverse reaction to trimethoprim-sulfamethoxazole, with particular reference to long-term therapy." Can Med Assoc J 112 (1975): s96-8
  11. Calandra GB, Brown KR, Grad LC, et al "Review of adverse experiences and tolerability in the first 2,516 patients treated with imipenem/cilastatin." Am J Med 78 (1985): 73-8
  12. Cannon SR, Dyson PH, Sanderson PJ "Pseudomembranous colitis associated with antibiotic prophylaxis in orthopaedic surgery." J Bone Joint Surg Br 70-B (1988): 600-2
  13. Miller DL, Sedlack JD, Holt RW "Perforation complicating rifampin-associated pseudomembranous enteritis." Arch Surg 124 (1989): 1082
  14. Miller SN, Ringler RP "Vancomycin-induced pseudomembranous colitis." J Clin Gastroenterol 9 (1987): 114-5
  15. Van Ness MM, Cattau EL Jr "Fulminant colitis complicating antibiotic-associated pseudomembranous colitis: case report and review of the clinical manifestations and treatment." Am J Gastroenterol 82 (1987): 374-7
  16. Wang C, Calandra GB, Aziz MA, Brown KR "Efficacy and safety of imipenem/cilastatin: a review of worldwide clinical experience." Rev Infect Dis 7 (1985): s528-36
  17. Hutcheon DF, Milligan FD, Yardley JH, Hendrix TR "Cephalosporin-associated pseudomembranous colitis." Am J Dig Dis 23 (1978): 321-6
  18. Bingley PJ, Harding GM "Clostridium difficile colitis following treatment with metronidazole and vancomycin." Postgrad Med J 63 (1987): 993-4
  19. Pokorney BH, Nichols TW, Jr "Pseudomembranous colitis. A complication of sulfasalazine therapy in a patient with Crohn's colitis." Am J Gastroenterol 76 (1981): 374-6
  20. Hinton NA "The effect of oral tetracycline HCl and doxycycline on the intestinal flora." Curr Ther Res Clin Exp 12 (1970): 341-52
  21. Sankarankutty M, McGeorge D, Galasko CS "Pseudomembranous colitis following cephradine prophylaxis." Postgrad Med J 58 (1982): 726-8
  22. Saadah HA "Carbenicillin and pseudomembranous enterocolitis." Ann Intern Med 93 (1980): 645
  23. Daly JJ, Chowdary KV "Pseudomembranous colitis secondary to metronidazole." Dig Dis Sci 28 (1983): 573-4
  24. Trexler MF, Fraser TG, Jones MP "Fulminant pseudomembranous colitis caused by clindamycin phosphate vaginal cream." Am J Gastroenterol 92 (1997): 2112-3
  25. Gordin F, Gibert C, Schmidt ME "Clostridium difficile colitis associated with trimethoprim-sulfamethoxazole given as prophylaxis for pneumocystis carinii pneumonia." Am J Med 96 (1994): 94-5
  26. Saginur R, Hawley CR, Bartlett JG "Colitis associated with metronidazole therapy." J Infect Dis 141 (1980): 772-4
  27. Midtvedt T, Carlstedt-Duke B, Hoverstad T, et al "Influence of peroral antibiotics upon the biotransformatory activity of the intestinal microflora in healthy subjects." Eur J Clin Invest 16 (1986): 11-7
  28. Lyon JA "Imipenem/cilastatin: the first carbapenem antibiotic." Drug Intell Clin Pharm 19 (1985): 894-8
  29. Altamirano A, Bondani A "Adverse reactions to furazolidone and other drugs. A comparative review." Scand J Gastroenterol Suppl 169 (1989): 70-80
  30. O'Meara TF, Simmons RA "Carbenicillin and pseudomembranous enterocolitis." Ann Intern Med 92 (1980): 440-1
  31. Meadowcroft AM, Diaz PR, Latham GS "Clostridium difficile toxin-induced colitis after use of clindmycin phosphate vaginal cream." Ann Pharmacother 32 (1998): 309-11
  32. Boriello SP, Jones RH, Phillips I "Rifampicin-associated pseudomembranous colitis." Br Med J 281 (1980): 1180-1
  33. Klinger D, Radford P, Collin J "Pneumoperitoneum without faecal peritonitis in a patient with pseudomembranous colitis." Br Med J 288 (1984): 1271-2
  34. Ring FA, Hershfield NB, Machin GA, Scott RB "Sulfasalazine-induced colitis complicating idiopathic ulcerative colitis." Can Med Assoc J 131 (1984): 43-5
  35. Friedman RJ, Mayer IE, Galambos JT, Hersh T "Oxacillin-induced pseudomembranous colitis." Am J Gastroenterol 73 (1980): 445-7
  36. "Multum Information Services, Inc. Expert Review Panel"
  37. Ehrenpreis ED, Lievens MW, Craig RM "Clostridium difficile-associated diarrhea after norfloxacin." J Clin Gastroenterol 12 (1990): 188-9
  38. Edlund C, Brismar B, Nord CE "Effect of lomefloxacin on the normal oral and intestinal microflora." Eur J Clin Microbiol Infect Dis 1 (1990): 35-9
  39. Leigh DA, Simmons K, Williams S "Gastrointestinal side effects following clindamycin and lincomycin treatment: a follow up study." J Antimicrob Chemother 6 (1980): 639-45
  40. Hecht JR, Olinger EJ "Clostridium difficile colitis secondary to intravenous vancomycin." Dig Dis Sci 34 (1989): 148-9
  41. Brause BD, Romankiewicz JA, Gotz V, Franklin JE Jr, Roberts RB "Comparative study of diarrhea associated with clindamycin and ampicillin therapy." Am J Gastroenterol 73 (1980): 244-8
  42. Parry MF, Rha CK "Pseudomembranous colitis caused by topical clindamycin phosphate." Arch Dermatol 122 (1986): 583-4
  43. Osler T, Lott D, Bordley J, et al "Cefazolin-induced pseudomembranous colitis resulting in perforation of the sigmoid colon." Dis Colon Rectum 29 (1986): 140-3
  44. Clissold SP, Todd PA, Campoli-Richards DM "Imipenem/cilastatin: a review of its antibacterial activity, pharmacokinetic properties and therapeutic efficacy." Drugs 33 (1987): 185-241
  45. Sugarman B "Trimethoprim-sulfamethoxazole, pseudomembranous colitis, and spinal cord injury." South Med J 78 (1985): 711-3
  46. Golledge CL, Riley TV "Clostridium difficile-associated diarrhoea after doxycycline malaria prophylaxis." Lancet 345 (1995): 1377-8
  47. Edlund C, Lidbeck A, Kager L, Nord CE "Effect of enoxacin on colonic microflora of healthy volunteers." Eur J Clin Microbiol 6 (1987): 298-300
View all 47 references
Major

Sulfonamides (applies to Bactrim) hematologic toxicity

Major Potential Hazard, Moderate plausibility. Applicable conditions: Bone Marrow Depression/Low Blood Counts, G-6-PD Deficiency

The use of sulfonamides has been associated with hematologic toxicity, including methemoglobinemia, sulfhemoglobinemia, leukopenia, granulocytopenia, eosinophilia, hemolytic anemia, aplastic anemia, purpura, clotting disorder, thrombocytopenia, hypofibrinogenemia, and hypoprothrombinemia. Acute dose-related hemolytic anemia may occur during the first week of therapy due to sensitization, while chronic hemolytic anemia may occur with prolonged use. Patients with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency should be observed closely for signs of hemolytic anemia. Therapy with sulfonamides should be administered cautiously in patients with preexisting blood dyscrasias or bone marrow suppression. Complete blood counts should be obtained regularly, especially during prolonged therapy (>2 weeks), and patients should be instructed to immediately report any signs or symptoms suggestive of blood dyscrasia such as fever, sore throat, local infection, bleeding, pallor, dizziness, or jaundice.

References

  1. Mitrane MP, Singh A, Seibold JR "Cholestasis and fatal agranulocytosis complicating sulfasalazine therapy: case report and review of the literature." J Rheumatol 13 (1986): 969-72
  2. Mechanick JI "Coombs' positive hemolytic anemia following sulfasalazine therapy in ulcerative colitis: case reports, review, and discussion of pathogenesis." Mt Sinai J Med 52 (1985): 667-70
  3. "Product Information. Gantrisin (sulfisoxazole)." Roche Laboratories, Nutley, NJ.
  4. Kuipers EJ, Vellenga E, de Wolf JT, Hazenberg BP "Sulfasalazine induced agranulocytosis treated with GM-CSF." J Rheumatol 19 (1992): 621-2
  5. Bates CM "HIV medicine: drug side effects and interactions." Postgrad Med J 72 (1996): 30-6
  6. Wheelan KR, Cooper B, Stone MJ "Multiple haematologic abnormalities associated with sulfasalazine." Ann Intern Med 97 (1982): 726-7
  7. Keisu M, Ekman E "Sulfasalazine associated agranulocytosis in sweden 1972-1989: clinical features, and estimation of its incidence." Eur J Clin Pharmacol 43 (1992): 215-8
  8. Finland M, Strauss E, Peterson O "Sulfadiazine." JAMA 251 (1984): 1467-74
  9. "Product Information. Zonegran (zonisamide)" Elan Pharmaceuticals, S. San Francisco, CA.
  10. Chan M, Beale D, Moorhead J "Acute megaloblastosis due to cotrimoxazole." Br J Clin Pract 34 (1980): 87-8
  11. Youssef PP, Bertouch JV "Sulphasalazine induced aplastic anaemia." Aust N Z J Med 22 (1992): 391-2
  12. Barak S, Shaked Y, Bar A, Samra Y "Drug-induced post-surgical hemorrhage resulting from trimethoprim-sulphamethoxazole." Int J Oral Maxillofac Surg 18 (1989): 206-7
  13. Guillemin F, Aussedat R, Guerci A, Lederlin P, Trechot P, Pourel J "Fatal agranulocytosis in sulfasalazine treated rheumatoid arthritis." J Rheumatol 16 (1989): 1166-7
  14. Logan EC, Williamson LM, Ryrie DR "Sulphasalazine associated pancytopenia may be caused by acute folate deficiency." Gut 27 (1986): 868-72
  15. Damergis J, Stoker J, Abadie J "Methemoglobinemia after sulfamethoxazole and trimethoprim therapy." JAMA 249 (1983): 590-1
  16. Pena JM, Gonzalez-Garcia JJ, Garcia-Alegria J, Barbado FJ, Vazquez JJ "Thrombocytopenia and sulfasalazine." Ann Intern Med 102 (1985): 277-8
  17. "Product Information. Gantranol (sulfamethoxazole)." Roche Laboratories, Nutley, NJ.
  18. Davies GE, Palek J "Selective erythroid and magakaryocytic aplasia after sulfasalazine administration." Arch Intern Med 140 (1980): 1122
  19. "Product Information. Azulfidine (sulfasalazine)." Pharmacia and Upjohn, Kalamazoo, MI.
  20. Jacobson IM, Kelsey PB, Blyden GT, Demirjian ZN, Isselbacher KJ "Sulfasalazine-induced agranulocytosis." Am J Gastroenterol 80 (1985): 118-21
  21. Hopkinson ND, Garcia FS, Gumpel JM "Haematological side-effects pf sulphasalazine in inflammatory arthritis." Br J Rheumatol 28 (1989): 414-7
  22. Gales BJ, Gales MA "Granulocyte-colony stimulating factor for sulfasalazine-induced agranulocytosis." Ann Pharmacother 27 (1993): 1052-4
  23. Peppercorn MA "Sulfasalazine. Pharmacology, clinical use, toxicity, and related new drug development." Ann Intern Med 101 (1984): 377-86
  24. Betkowski AS, Lubin A "Sulfamethoxazole-related antiplatelet antibody." Blood 82 (1993): 1683
  25. "Product Information. Sulfadiazine (sulfadiazine)." Eon Labs Manufacturing Inc, Laurelton, NY.
View all 25 references
Major

Sulfonamides (applies to Bactrim) hypersensitivity reactions

Major Potential Hazard, Moderate plausibility. Applicable conditions: Asthma, HIV Infection, Allergies

The use of sulfonamides is associated with large increases in the risk of Stevens-Johnson syndrome, toxic epidermal necrolysis and other serious dermatologic reactions, although these phenomena are rare as a whole. Hepatitis, pneumonitis, and interstitial nephritis have also occurred in association with sulfonamide hypersensitivity. Therapy with sulfonamides should be administered cautiously in patients with severe allergies, bronchial asthma or AIDS, since these patients may be at increased risk for potentially severe hypersensitivity reactions. Patients should be instructed to promptly report signs and symptoms that may precede the onset of cutaneous manifestations of the Stevens-Johnson syndrome, such as high fever, severe headache, stomatitis, conjunctivitis, rhinitis, urethritis, and balanitis. Sulfonamide therapy should be stopped at once if a rash develops.

References

  1. Averbuch M, Halpern Z, Hallak A, Topilsky M, Levo Y "Sulfasalazine pneumonitis." Am J Gastroenterol 80 (1985): 343-5
  2. "Product Information. Zonegran (zonisamide)" Elan Pharmaceuticals, S. San Francisco, CA.
  3. Stevenson D, Christie D, Haas J "Hepatic injury in a child caused by trimethoprim-sulfamethoxazole." Pediatrics 61 (1978): 864-6
  4. Fischl M, Dickinson G, LaVoie L "Safety and efficacy of sulfamethoxazole and trimethoprim chemoprophylaxis for pneumocystis carinii pneumonia in AIDS." JAMA 259 (1988): 1185-9
  5. Pisanty S, Brayer L "Erythema multiforme-like eruption due to sulfadiazine." J Dent Med 20 (1965): 154-7
  6. Fich A, Schwartz J, Braverman D, Zifroni A, Rachmilewitz D "Sulfasalazine hepatotoxicity." Am J Gastroenterol 79 (1984): 401-2
  7. Valcke Y, Pauwels R, Van der Straeten M "Bronchoalveolar lavage in acute hypersensitivity pneumonitis caused by sulfasalazine." Chest 92 (1987): 572-3
  8. Carbone L, Bendixen B, Appel G "Sulfadiazine-associated obstructive nephropathy occurring in a patient with the acquired immunodeficiency syndrome." Am J Kidney Dis 12 (1988): 72-5
  9. Goadsby P, Donaghy A, Lloyd A, Wakefield D "Acquired immunodeficiency syndrome (AIDS) and sulfadiazine-associated acute renal failure." Ann Intern Med 107 (1987): 783-4
  10. Johnson M, Goodwin D, Shands J "Trimethoprim-sulfamethoxazole anaphylactoid reactions in patients with AIDS: case reports and literature review." Pharmacotherapy 10 (1990): 413-16
  11. Kanner RS, Tedesco FJ, Kalser MH "Azulfidine- (sulfasalazine-) induced hepatic injury." Am J Dig Dis 23 (1978): 956-8
  12. Finland M, Strauss E, Peterson O "Sulfadiazine." JAMA 251 (1984): 1467-74
  13. Rubin R "Sulfasalazine-induced fulminant hepatic failure and necrotizing pancreatitis." Am J Gastroenterol 89 (1994): 789-91
  14. Hamadeh MA, Atkinson J, Smith LJ "Sulfasalazine-induced pulmonary disease." Chest 101 (1992): 1033-7
  15. Wang KK, Bowyer BA, Fleming CR, Schroeder KW "Pulmonary infiltrates and eosinophilia associated with sulfasalazine." Mayo Clin Proc 59 (1984): 343-6
  16. Rudra T, Webb D, Evans A "Acute tubular necrosis following co-trimoxazole therapy." Nephron 53 (1989): 85-6
  17. Losek JD, Werlin SL "Sulfasalazine hepatotoxicity." Am J Dis Child 135 (1981): 1070-2
  18. Heer M, Altorfer J, Burger H, Walti M "Bullous esophageal lesions due to co-trimoxazole: an immune-mediated process?" Gastroenterology 88 (1985): 1954-7
  19. Haines JD, Jr "Hepatotoxicity after treatment with sulfasalazine." Postgrad Med 79 (1986): 193-4,
  20. "Product Information. Sulfadiazine (sulfadiazine)." Eon Labs Manufacturing Inc, Laurelton, NY.
  21. Sotolongo RP, Neefe LI, Rudzki C, Ishak KG "Hypersensitivity reaction to sulfasalazine with severe hepatotoxicity." Gastroenterology 75 (1978): 95-9
  22. Poland GA, Love KR "Marked atypical lymphocytosis, hepatitis, and skin rash in sulfasalazine drug allergy." Am J Med 81 (1986): 707-8
  23. "Product Information. Gantranol (sulfamethoxazole)." Roche Laboratories, Nutley, NJ.
  24. "Product Information. Gantrisin (sulfisoxazole)." Roche Laboratories, Nutley, NJ.
  25. Gibson J "Recurrent trimethoprim-associated fixed skin eruption." Br Med J 284 (1982): 1529-30
  26. Gremse DA, Bancroft J, Moyer MS "Sulfasalazine hypersensitivity with hepatotoxicity, thrombocytopenia, and erythroid hypoplasia." J Pediatr Gastroenterol Nutr 9 (1989): 261-3
  27. Kelly W, Dooley D, Lattuada C, Smith C "A severe, unusual reaction to trimethoprim-sulfamethoxazole in patients infected with human immunodeficiency virus." Clin Infect Dis 14 (1992): 1034-9
  28. Holdcroft C, Ellison R "Trimethoprim-sulfamethoxazole reaction simulating pneumocystis carinii pneumonia." AIDS 5 (1991): 1029-42
  29. Gabazza EC, Taguchi O, Yamakami T, Machishi M, Ibata H, Suzuki S, Matsumoto K, Kitagawa T, Yamamoto J "Pulmonary infiltrates and skin pigmentation associated with sulfasalazine." Am J Gastroenterol 87 (1992): 1654-7
  30. Marinos G, Riley J, Painter DM, McCaughan GW "Sulfasalazine-induced fulminant hepatic failure." J Clin Gastroenterol 14 (1992): 132-5
  31. Bates CM "HIV medicine: drug side effects and interactions." Postgrad Med J 72 (1996): 30-6
  32. Leroux JL, Ghezail M, Chertok P, Blotman F "Hypersensitivity reactions to sulfasalazine: skin rash, fever, hepatitis and activated lymphocytes." Clin Exp Rheumatol 10 (1992): 427
  33. Ribe J, Benkov KJ, Thung SN, Shen SC, LeLeiko NS "Fatal massive hepatic necrosis: a probable hypersensitivity reaction to sulfasalazine." Am J Gastroenterol 81 (1986): 205-8
  34. Pearl RK, Nelson RL, Prasad ML, Orsay CP, Abcarian H "Serious complications of sulfasalazine." Dis Colon Rectum 29 (1986): 201-2
  35. Moore RD, Fortgang I, Keruly J, Chaisson RE "Adverse events from drug therapy for human immunodeficiency virus disease." Am J Med 101 (1996): 34-40
  36. Tenant-Flowers M, Boyle M, Carey D, et al "Sulphadiazine desenitization in patients with AIDS and cerebral toxoplasmosis." AIDS 5 (1991): 311-5
  37. Robson M, Levi J, Dolberg L, Rosenfeld J "Acute tubulo-interstitial nephritis following sulfadiazine therapy." Isr J Med Sci 6 (1970): 561-6
  38. Taffet SL, Das KM "Sulfasalazine. Adverse effects and desensitization." Dig Dis Sci 28 (1983): 833-42
  39. Horak J, Mertl L, Hrabal P "Severe liver injuries due to sulfamethoxazole-trimethoprim and sulfamethoxydiazine." Hepatogastroenterology 31 (1984): 199-200
  40. Yaffe BH, Korelitz BI "Sulfasalazine pneumonitis." Am J Gastroenterol 78 (1983): 493-4
  41. Whittington R "Toxic epidermal necrolysis and co-trimoxazole." Lancet 2 (1989): 574
  42. Marinac JS, Stanford JF "A severe hypersensitive reaction to trimethoprim-sulfamethoxazole in a patient infected with human immunodeficiency virus." Clin Infect Dis 16 (1993): 178-9
  43. Ulstad D, Ampel N, Shon B, Galgiani JN, Cutcher AB "Reaction after re-exposure to trimethoprim-sulfamethoxazole." Chest 95 (1989): 937-8
  44. Steinbrecher U, Mishkin S "Sulfamethoxazole-induced hepatic injury." Dig Dis Sci 26 (1981): 756-9
  45. Hofer T, Becker EW, Weigand K, Berg PA "Demonstration of sensititzed lymphocytes to trimethoprim/sulfamethoxazole and ofloxacin in a patient with cholestatic hepatitis." J Hepatol 15 (1992): 262-3
  46. Roujeau JC, Kelly JP, Naldi L, et al. "Medication use and the risk of Stevens-Johnson syndrome or toxic epidermal necrolysis." N Engl J Med 333 (1995): 1600-7
  47. "Product Information. Azulfidine (sulfasalazine)." Pharmacia and Upjohn, Kalamazoo, MI.
  48. Smith E, Light J, Filo R, Yum M "Interstitial nephritis caused by trimethoprim-sulfamethoxazole in renal transplant recipients." JAMA 244 (1980): 360-1
  49. Namias A, Bhalotra R, Donowitz M "Reversible sulfasalazine-induced granulomatous hepatitis." J Clin Gastroenterol 3 (1981): 193-8
  50. Kawada A, Kobayashi T, Noguchi H, Hiruma M, Ishibashi A, Marshall J "Fixed drug eruption induced by sulfasalazine." Contact Dermatitis 34 (1996): 155-6
  51. Peppercorn MA "Sulfasalazine. Pharmacology, clinical use, toxicity, and related new drug development." Ann Intern Med 101 (1984): 377-86
  52. Faintuch J, Mott CB, Machado MC "Pancreatitis and pancreatic necrosis during sulfasalazine therapy." Int Surg 70 (1985): 271-2
  53. Williams T, Eidus L, Thomas P "Fibrosing alveolitis, bronchiolitis obliterans, and sulfasalazine therapy." Chest 81 (1982): 766-8
View all 53 references
Major

Sulfonamides (applies to Bactrim) liver disease

Major Potential Hazard, Moderate plausibility.

Hepatotoxicity, including jaundice, diffuse hepatocellular necrosis, hypersensitivity hepatitis and hepatic failure, has rarely been reported in patients receiving sulfonamides. In addition, sulfonamides are partially metabolized by the liver and may accumulate in patients with hepatic impairment. Therapy with sulfonamides should be administered cautiously in patients with liver disease.

References

  1. Sotolongo RP, Neefe LI, Rudzki C, Ishak KG "Hypersensitivity reaction to sulfasalazine with severe hepatotoxicity." Gastroenterology 75 (1978): 95-9
  2. Marinos G, Riley J, Painter DM, McCaughan GW "Sulfasalazine-induced fulminant hepatic failure." J Clin Gastroenterol 14 (1992): 132-5
  3. Madsen S "A comparative study of the excretion of sulfonamide-metabolites in cases of renal failure and hepatitis." Chemotherapy 11 (1966): 1-9
  4. "Product Information. Gantrisin (sulfisoxazole)." Roche Laboratories, Nutley, NJ.
  5. Klotz U "Clinical pharmacokinetics of sulphasalazine, its metabolites and other prodrugs of 5-aminosalicylic acid." Clin Pharmacokinet 10 (1985): 285-302
  6. Mannisto PT, Mantyla R, Mattila J, Nykanen S, Lamminsivu U "Comparison of pharmacokinetics of sulphadiazine and sulphamethoxazole after intravenous infusion." J Antimicrob Chemother 9 (1982): 461-70
  7. "Product Information. Azulfidine (sulfasalazine)." Pharmacia and Upjohn, Kalamazoo, MI.
  8. Kowdley K, Keeffe E, Fawaz K "Prolonged cholestasis due to trimethoprim-sulfamethoxazole." Gastroenterology 102 (1992): 2148-50
  9. Hekster C, Vree T "Clinical pharmacokinetics of sulphonamides and their N4-acetyl derivatives." Antibiot Chemother 31 (1982): 22-118
  10. Kaplan SA, Weinfeld RE, Abruzzo CW, Lewis M "Pharmacokinetic profile of sulfisoxazole following intravenous, intramuscular, and oral administration to man." J Pharm Sci 61 (1972): 773-8
  11. Ortengren B, Magni L, Bergan T "Development of sulphonamide-trimethoprim combinations for urinary tract infections. part 3: pharmacokinetic characterization of sulphadiazine and sulphamethoxazole." Infection 7 (1979): s371-81
  12. Ribe J, Benkov KJ, Thung SN, Shen SC, LeLeiko NS "Fatal massive hepatic necrosis: a probable hypersensitivity reaction to sulfasalazine." Am J Gastroenterol 81 (1986): 205-8
  13. Namias A, Bhalotra R, Donowitz M "Reversible sulfasalazine-induced granulomatous hepatitis." J Clin Gastroenterol 3 (1981): 193-8
  14. Gremse DA, Bancroft J, Moyer MS "Sulfasalazine hypersensitivity with hepatotoxicity, thrombocytopenia, and erythroid hypoplasia." J Pediatr Gastroenterol Nutr 9 (1989): 261-3
  15. Basista MP "Randomized study to evaluate efficacy and safety of ofloxacin vs trimethoprim and sulfamethoxazole in treatment of uncomplicated urinary tract infection." Urology 37 (1991): 21-7
  16. Bates CM "HIV medicine: drug side effects and interactions." Postgrad Med J 72 (1996): 30-6
  17. Peppercorn MA "Sulfasalazine. Pharmacology, clinical use, toxicity, and related new drug development." Ann Intern Med 101 (1984): 377-86
  18. Finland M, Strauss E, Peterson O "Sulfadiazine." JAMA 116 (1941): 2641-7
  19. Steinbrecher U, Mishkin S "Sulfamethoxazole-induced hepatic injury." Dig Dis Sci 26 (1981): 756-9
  20. Rubin R "Sulfasalazine-induced fulminant hepatic failure and necrotizing pancreatitis." Am J Gastroenterol 89 (1994): 789-91
  21. Patel RB, Welling PG "Clinical pharmacokinetics of co-trimoxazole (trimethoprim-sulphamethoxazole)." Clin Pharmacokinet 5 (1980): 405-23
  22. Vergin H, Ferber H, Zimmermann I, Neurath GB "Single and multiple dose kinetics of co-tetroxazine and co-trimoxazole in patients." Int J Clin Pharmacol Ther Toxicol 19 (1981): 350-7
  23. Stachowska B, Senczuk W "Studies on kinetics of sulfadiazine and trimethoprim excretion in man." Int J Clin Pharmacol Ther Toxicol 25 (1987): 81-5
  24. Kremers P, Duvivier J, Heusghem C "Pharmacokinetic studies of co-trimoxazole in man after single and repeated doses." J Clin Pharmacol 14 (1974): 112-7
  25. Kanner RS, Tedesco FJ, Kalser MH "Azulfidine- (sulfasalazine-) induced hepatic injury." Am J Dig Dis 23 (1978): 956-8
  26. Haines JD, Jr "Hepatotoxicity after treatment with sulfasalazine." Postgrad Med 79 (1986): 193-4,
  27. Das KM, Chowdhury JR, Zapp B, Fara JW "Small bowel absorption of sulfasalazine and its hepatic metabolism in human beings, cats, and rats." Gastroenterology 77 (1979): 280-4
  28. Andreasen F, Elsborg L, Husted S, Thomsen O "Pharmacokinetics of sulfadiazine and trimethoprim in man." Eur J Clin Pharmacol 14 (1978): 57-67
  29. Bergan T, Brodwall EK "Human pharmacokinetics of a sulfamethoxazole-trimethoprim combination." Acta Med Scand 192 (1972): 483-92
  30. Fich A, Schwartz J, Braverman D, Zifroni A, Rachmilewitz D "Sulfasalazine hepatotoxicity." Am J Gastroenterol 79 (1984): 401-2
  31. "Product Information. Gantranol (sulfamethoxazole)." Roche Laboratories, Nutley, NJ.
  32. Simma B, Meister B, Deutsch J, Sperl W, Fend F, Ofner D, Margreiter R, Vogel W "Fulminant hepatic failure in a child as a potential adverse effect of trimethoprim-sulphamethoxazole." Eur J Pediatr 154 (1995): 530-3
  33. Poland GA, Love KR "Marked atypical lymphocytosis, hepatitis, and skin rash in sulfasalazine drug allergy." Am J Med 81 (1986): 707-8
  34. "Product Information. Sulfadiazine (sulfadiazine)." Eon Labs Manufacturing Inc, Laurelton, NY.
  35. Boisvert A, Barbeau G, Belanger PM "Pharmacokinetics of sulfisoxazole in young and elderly subjects." Gerontology 30 (1984): 125-31
  36. Mannisto PT, Mantyla R, Mattila J, Nykanen S, Lamminsivu U "Comparison of pharmacokinetics of sulphadiazine and sulphamethoxazole after intravenous infusion." J Antimicrob Chemother 9 (1982): 461-70
  37. Ortengren B, Fellner H, Bergan T "Development of sulphonamide-trimethoprim combinations for urinary tract infections. Part 2: Comparative pharmacokinetics of five sulphonamides." Infection 7 Suppl 4 (1979): s367-70
  38. Schroder H, Campbell DE "Absorption, metabolism, and excretion of salicylazosulfapyridine in man." Clin Pharmacol Ther 13 (1972): 539-51
  39. Hofer T, Becker EW, Weigand K, Berg PA "Demonstration of sensititzed lymphocytes to trimethoprim/sulfamethoxazole and ofloxacin in a patient with cholestatic hepatitis." J Hepatol 15 (1992): 262-3
  40. Ransohoff D, Jacobs G "Terminal hepatic failure following a small dose of sulfamethoxazole-trimethoprim." Gastroenterology 80 (1981): 816-9
  41. Horak J, Mertl L, Hrabal P "Severe liver injuries due to sulfamethoxazole-trimethoprim and sulfamethoxydiazine." Hepatogastroenterology 31 (1984): 199-200
  42. Leroux JL, Ghezail M, Chertok P, Blotman F "Hypersensitivity reactions to sulfasalazine: skin rash, fever, hepatitis and activated lymphocytes." Clin Exp Rheumatol 10 (1992): 427
  43. Oie S, Gambertoglio JG, Fleckenstein L "Comparison of the disposition of total and unbound sulfisoxazole after single and multiple dosing." J Pharmacokinet Biopharm 10 (1982): 157-72
  44. Stevenson D, Christie D, Haas J "Hepatic injury in a child caused by trimethoprim-sulfamethoxazole." Pediatrics 61 (1978): 864-6
  45. Alberti-Flor JJ, Hernandez ME, Ferrer JP, Howell S, Jeffers L "Fulminant liver failure and pancreatitis associated with the use of sulfamethoxazole-trimethoprim." Am J Gastroenterol 84 (1989): 1577-9
  46. Gleckman R, Gantz NM, Joubert DW "Intravenous sulfamethoxazole-trimethoprim: pharmacokinetics, therapeutic indications, and adverse reactions." Pharmacotherapy 1 (1981): 206-11
  47. Taffet SL, Das KM "Sulfasalazine. Adverse effects and desensitization." Dig Dis Sci 28 (1983): 833-42
  48. Khan AK, Truelove SC, Aronson JK "The disposition and metabolism of sulphasalazine (salicylazosulphapyridine) in man." Br J Clin Pharmacol 13 (1982): 523-8
  49. Losek JD, Werlin SL "Sulfasalazine hepatotoxicity." Am J Dis Child 135 (1981): 1070-2
View all 49 references
Major

Sulfonamides (applies to Bactrim) porphyria

Major Potential Hazard, High plausibility.

The use of sulfonamides is contraindicated in patients with porphyria, since these drugs can precipitate an acute attack.

References

  1. "Product Information. Azulfidine (sulfasalazine)." Pharmacia and Upjohn, Kalamazoo, MI.
  2. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. "Harrison's Principles of Internal Medicine. 14th ed." New York, NY: McGraw-Hill Health Professionals Division (1998):
Major

Sulfonamides (applies to Bactrim) renal dysfunction

Major Potential Hazard, High plausibility.

Sulfonamides and their metabolites are eliminated by the kidney. Patients with renal impairment may be at greater risk for adverse effects from sulfonamides due to decreased drug clearance. Dosage adjustments may be necessary and modifications should be based on the degree of renal impairment and severity of infection. Additionally, sulfonamides may cause renal toxicity secondary to crystalluria, including uro- and nephrolithiasis, nephritis, toxic nephrosis, hematuria, proteinuria, and elevated BUN and creatinine. Hydration (8 oz. glass of water with each dose and throughout the day) and adequate urinary output (> 1.5 L/day) should be maintained during sulfonamide administration. Renal function tests and urinalysis should be performed weekly or as often as indicated by the patient's status. Rarely, alkalinization of the urine is necessary.

References

  1. Finland M, Strauss E, Peterson O "Sulfadiazine." JAMA 251 (1984): 1467-74
  2. Kaplan SA, Weinfeld RE, Abruzzo CW, Lewis M "Pharmacokinetic profile of sulfisoxazole following intravenous, intramuscular, and oral administration to man." J Pharm Sci 61 (1972): 773-8
  3. Ortengren B, Magni L, Bergan T "Development of sulphonamide-trimethoprim combinations for urinary tract infections. part 3: pharmacokinetic characterization of sulphadiazine and sulphamethoxazole." Infection 7 (1979): s371-81
  4. Shermantine M, Gambertoglio J, Amend W, Vincenti F, Oie S "Pharmacokinetics of sulfisoxazole in renal transplant patients." Antimicrob Agents Chemother 28 (1985): 535-9
  5. Robson M, Levi J, Dolberg L, Rosenfeld J "Acute tubulo-interstitial nephritis following sulfadiazine therapy." Isr J Med Sci 6 (1970): 561-6
  6. Sahai J, Heimberger R, Collins K, Kaplowitz L, Polk R "Sulfadiazine-induced crystalluria in a patient with the acquired immunodeficiency syndrome: a reminder." Am J Med 84 (1988): 791-2
  7. Rieder J, Schwartz DE, Fernex M, et al "Pharmacokinetics of the antibacterial combination sulfamethoxazole plus trimethoprim in patients with normal or impaired kidney function." Antibiot Chemother 18 (1974): 148-98
  8. Ohnhaus EE, Spring P "Elimination kinetics of sulfadiazine in patients with normal and impaired renal function." J Pharmacokinet Biopharm 3 (1975): 171-9
  9. Hekster C, Vree T "Clinical pharmacokinetics of sulphonamides and their N4-acetyl derivatives." Antibiot Chemother 31 (1982): 22-118
  10. Bergan T, Brodwall E, Vik-Mo H, Anstad U "Pharmacokinetics of sulphadiazine, sulphamethoxazole and trimethoprim in patients with varying renal function." Infection 7 (1979): s382-7
  11. Adam W, Dawborn J "Urinary excretion and plasma levels of sulphonamides in patients with renal impairment." Australas Ann Med 19 (1970): 250-4
  12. Bergan T, Brodwall EK "Human pharmacokinetics of a sulfamethoxazole-trimethoprim combination." Acta Med Scand 192 (1972): 483-92
  13. Vergin H, Ferber H, Zimmermann I, Neurath GB "Single and multiple dose kinetics of co-tetroxazine and co-trimoxazole in patients." Int J Clin Pharmacol Ther Toxicol 19 (1981): 350-7
  14. Erturk E, Casemento JB, Guertin KR, Kende AS "Bilateral acetylsulfapyridine nephrolithiasis associated with chronic sulfasalazine therapy." J Urol 151 (1994): 1605-6
  15. Patel RB, Welling PG "Clinical pharmacokinetics of co-trimoxazole (trimethoprim-sulphamethoxazole)." Clin Pharmacokinet 5 (1980): 405-23
  16. Marques LP, Silva MT, Madeira EP, Santos OR "Obstructive renal failure due to therapy with sulfadiazine in an AIDS patient." Nephron 62 (1992): 361
  17. Goadsby P, Donaghy A, Lloyd A, Wakefield D "Acquired immunodeficiency syndrome (AIDS) and sulfadiazine-associated acute renal failure." Ann Intern Med 107 (1987): 783-4
  18. Bergan T, Brodwall EK, Vik-Mo H, Anstad U "Pharmacokinetics of sulphadiazine, sulphamethoxazole and trimethoprim in patients with varying renal function." Infection 7 (1979): s382-7
  19. Dwarakanath AD, Michael J, Allan RN "Sulphasalazine-induced renal failure." Gut 33 (1992): 1006-7
  20. Gleckman R, Gantz NM, Joubert DW "Intravenous sulfamethoxazole-trimethoprim: pharmacokinetics, therapeutic indications, and adverse reactions." Pharmacotherapy 1 (1981): 206-11
  21. Stachowska B, Senczuk W "Studies on kinetics of sulfadiazine and trimethoprim excretion in man." Int J Clin Pharmacol Ther Toxicol 25 (1987): 81-5
  22. Boisvert A, Barbeau G, Belanger PM "Pharmacokinetics of sulfisoxazole in young and elderly subjects." Gerontology 30 (1984): 125-31
  23. Cryst C, Hammar S "Acute granulomatous interstitial nephritis due to co-trimoxazole." Am J Nephrol 8 (1988): 483-8
  24. "Product Information. Azulfidine (sulfasalazine)." Pharmacia and Upjohn, Kalamazoo, MI.
  25. "Product Information. Gantranol (sulfamethoxazole)." Roche Laboratories, Nutley, NJ.
  26. Molina J, Belenfant X, Doco-Lecompte T, et al "Sulfadiazine-induced crystalluria in AIDS patients with toxoplasma encephalitis." AIDS 5 (1991): 587-9
  27. Farinas MC, Echevarria S, Sampedro I, Gonzalez A, Perez del Molino A, Gonzalez-Macias J "Renal failure due to sulphadiazine in AIDS patients with cerebral toxoplasmosis." J Intern Med 233 (1993): 365-7
  28. Sasson JP, Dratch PL, Shortsleeve MJ "Renal US findings in sulfadiazine-induced crystalluria." Radiology 185 (1992): 739-40
  29. "Product Information. Sulfadiazine (sulfadiazine)." Eon Labs Manufacturing Inc, Laurelton, NY.
  30. Adam WR, Henning M, Dawborn JK "Excretion of trimethoprim and sulphamethoxazole in patients with renal failure." Aust N Z J Med 3 (1973): 383-7
  31. Becker K, Jablonowski H, Haussinger D "Sulfadiazine-associated nephrotoxicity in patients with the acquired immunodeficiency syndrome." Medicine 75 (1996): 185-94
  32. Marques L, Silva M, Madeira E, Santos O "Obstructive renal failure due to therapy with sulfadiazine in an AIDS patient." Nephron 62 (1992): 361
  33. Mannisto PT, Mantyla R, Mattila J, Nykanen S, Lamminsivu U "Comparison of pharmacokinetics of sulphadiazine and sulphamethoxazole after intravenous infusion." J Antimicrob Chemother 9 (1982): 461-70
  34. Hein R, Brunkhorst R, Thon WF, Schedel I, Schmidt RE "Symptomatic sulfadiazine crystalluria in AIDS patients: a report of two cases." Clin Nephrol 39 (1993): 254-6
  35. Klotz U "Clinical pharmacokinetics of sulphasalazine, its metabolites and other prodrugs of 5-aminosalicylic acid." Clin Pharmacokinet 10 (1985): 285-302
  36. Rudra T, Webb D, Evans A "Acute tubular necrosis following co-trimoxazole therapy." Nephron 53 (1989): 85-6
  37. Madsen S "A comparative study of the excretion of sulfonamide-metabolites in cases of renal failure and hepatitis." Chemotherapy 11 (1966): 1-9
  38. Christin S, Baumelou A, Bahri S, Ben Hmida M, Deray G, Jacobs C "Acute renal failure due to sulfadiazine in patients with AIDS." Nephron 55 (1990): 233-4
  39. "Product Information. Gantrisin (sulfisoxazole)." Roche Laboratories, Nutley, NJ.
  40. Ortengren B, Fellner H, Bergan T "Development of sulphonamide-trimethoprim combinations for urinary tract infections. Part 2: Comparative pharmacokinetics of five sulphonamides." Infection 7 Suppl 4 (1979): s367-70
  41. Smith E, Light J, Filo R, Yum M "Interstitial nephritis caused by trimethoprim-sulfamethoxazole in renal transplant recipients." JAMA 244 (1980): 360-1
  42. Carbone L, Bendixen B, Appel G "Sulfadiazine-associated obstructive nephropathy occurring in a patient with the acquired immunodeficiency syndrome." Am J Kidney Dis 12 (1988): 72-5
  43. Kremers P, Duvivier J, Heusghem C "Pharmacokinetic studies of co-trimoxazole in man after single and repeated doses." J Clin Pharmacol 14 (1974): 112-7
  44. Andreasen F, Elsborg L, Husted S, Thomsen O "Pharmacokinetics of sulfadiazine and trimethoprim in man." Eur J Clin Pharmacol 14 (1978): 57-67
  45. Schroder H, Campbell DE "Absorption, metabolism, and excretion of salicylazosulfapyridine in man." Clin Pharmacol Ther 13 (1972): 539-51
  46. Simon D, Brosius F, Rothstein D "Sulfadiazine crystalluria revisited." Arch Intern Med 150 (1990): 2379-84
  47. Cohen M, Pocelinko R "Renal transport mechanisms for the excretion of sulfisoxazole." J Pharmacol Exp Ther 185 (1973): 703-12
  48. Mannisto PT, Mantyla R, Mattila J, Nykanen S, Lamminsivu U "Comparison of pharmacokinetics of sulphadiazine and sulphamethoxazole after intravenous infusion." J Antimicrob Chemother 9 (1982): 461-70
View all 48 references
Major

Trimethoprim (applies to Bactrim) folate deficiency

Major Potential Hazard, High plausibility. Applicable conditions: Anemia Associated with Folate Deficiency, Folic Acid/Cyanocobalamin Deficiency, Renal Dysfunction, Hemolytic Anemia, Alcoholism, Malnourished

The use of trimethoprim is contraindicated in patients with documented megaloblastic anemia due to folate deficiency. Trimethoprim inhibits dihydrofolate reductase, an enzyme necessary in the synthesis of tetrahydrofolic acid, or the metabolically active form of folic acid. Thrombocytopenia, neutropenia, megaloblastic anemia, and methemoglobinemia have been reported rarely. However, the risk is increased in the presence of folate deficiency, chronic hemolytic anemia and/or renal impairment, as well as during prolonged therapy (e.g., > 6 months) with high dosages. Therapy with trimethoprim should be administered cautiously under these conditions and in patients with suspected folate depletion (e.g., elderly, alcoholic, malnourished or debilitated patients). Folic acid supplementation, if necessary, may be administered concomitantly without interfering with the antibacterial action of trimethoprim. Patients should be instructed to immediately report any signs or symptoms suggestive of hematologic toxicity such as fever, sore throat, local infection, bleeding, pallor, dizziness, or jaundice. Leucovorin (folinic acid) should be administered if bone marrow depression is detected.

References

  1. Sheehan J "Trimethoprim-associated marrow toxicity." Lancet 2 (1981): 692
  2. Chan M, Beale D, Moorhead J "Acute megaloblastosis due to cotrimoxazole." Br J Clin Pract 34 (1980): 87-8
  3. "Product Information. Proloprim (trimethoprim)." Glaxo Wellcome, Research Triangle Park, NC.
  4. "Product Information. Trimpex (trimethoprim)." Roche Laboratories, Nutley, NJ.
View all 4 references
Moderate

Sulfonamides (applies to Bactrim) crystalluria

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Dehydration, Diarrhea, Vomiting

Crystalluria can occur during sulfonamide therapy due to precipitation of the sulfonamide and/or its N4-acetyl metabolite in the urinary tract. Renal toxicity such as uro- and nephrolithiasis, nephritis, toxic nephrosis, hematuria, proteinuria, and elevated BUN and creatinine has been reported. Hydration (8 oz. glass of water with each dose and throughout the day) and adequate urinary output (> 1.5 L/day) should be maintained during sulfonamide administration. Patients who are dehydrated (e.g., due to severe diarrhea or vomiting) may be at increased risk for the development of crystalluria and lithiasis and should be encouraged to consume additional amounts of liquid or given intravenous fluid. Renal function tests and urinalysis should be performed weekly during prolonged therapy (> 2 weeks). Rarely, alkalinization of the urine is necessary.

References

  1. "Product Information. Azulfidine (sulfasalazine)." Pharmacia and Upjohn, Kalamazoo, MI.
  2. Molina J, Belenfant X, Doco-Lecompte T, et al "Sulfadiazine-induced crystalluria in AIDS patients with toxoplasma encephalitis." AIDS 5 (1991): 587-9
  3. Hein R, Brunkhorst R, Thon WF, Schedel I, Schmidt RE "Symptomatic sulfadiazine crystalluria in AIDS patients: a report of two cases." Clin Nephrol 39 (1993): 254-6
  4. Simon D, Brosius F, Rothstein D "Sulfadiazine crystalluria revisited." Arch Intern Med 150 (1990): 2379-84
  5. "Product Information. Gantrisin (sulfisoxazole)." Roche Laboratories, Nutley, NJ.
  6. Finland M, Strauss E, Peterson O "Sulfadiazine." JAMA 251 (1984): 1467-74
  7. Sasson JP, Dratch PL, Shortsleeve MJ "Renal US findings in sulfadiazine-induced crystalluria." Radiology 185 (1992): 739-40
  8. Sahai J, Heimberger R, Collins K, Kaplowitz L, Polk R "Sulfadiazine-induced crystalluria in a patient with the acquired immunodeficiency syndrome: a reminder." Am J Med 84 (1988): 791-2
  9. Robson M, Levi J, Dolberg L, Rosenfeld J "Acute tubulo-interstitial nephritis following sulfadiazine therapy." Isr J Med Sci 6 (1970): 561-6
  10. "Product Information. Gantranol (sulfamethoxazole)." Roche Laboratories, Nutley, NJ.
  11. "Product Information. Sulfadiazine (sulfadiazine)." Eon Labs Manufacturing Inc, Laurelton, NY.
  12. Erturk E, Casemento JB, Guertin KR, Kende AS "Bilateral acetylsulfapyridine nephrolithiasis associated with chronic sulfasalazine therapy." J Urol 151 (1994): 1605-6
View all 12 references
Moderate

Sulfonamides (applies to Bactrim) hemodialysis

Moderate Potential Hazard, High plausibility.

The sulfonamides, sulfadiazine, sulfamethoxazole, and sulfisoxazole, are partially removed by hemodialysis and should be administered after dialysis.

References

  1. "Product Information. Sulfadiazine (sulfadiazine)." Eon Labs Manufacturing Inc, Laurelton, NY.
  2. Nissenson AR, Wilson C, Holazo A "Pharmacokinetics of intravenous trimethoprim-sulfamethoxazole during hemodialysis." Am J Nephrol 7 (1987): 270-4
  3. "Product Information. Gantranol (sulfamethoxazole)." Roche Laboratories, Nutley, NJ.
  4. "Product Information. Gantrisin (sulfisoxazole)." Roche Laboratories, Nutley, NJ.
  5. Adam W, Dawborn J "Urinary excretion and plasma levels of sulphonamides in patients with renal impairment." Australas Ann Med 19 (1970): 250-4
  6. Patel RB, Welling PG "Clinical pharmacokinetics of co-trimoxazole (trimethoprim-sulphamethoxazole)." Clin Pharmacokinet 5 (1980): 405-23
View all 6 references
Moderate

Sulfonamides (applies to Bactrim) urinary obstruction

Moderate Potential Hazard, High plausibility. Applicable conditions: Urinary Retention

Sulfonamides are excreted and concentrated in the urine. Therapy with sulfonamides should be administered cautiously in patients with urinary obstruction or retention, since excessive drug accumulation may occur. These patients may also be at increased risk for sulfonamide crystalluria, which may be associated with renal toxicity such as uro- and nephrolithiasis, nephritis, toxic nephrosis, hematuria, proteinuria, and elevated BUN and creatinine. A urinary output of at least 1.5 L/day should be maintained during sulfonamide administration. Renal function tests and urinalysis should be performed weekly, especially during prolonged therapy (> 2 weeks).

References

  1. Marques LP, Silva MT, Madeira EP, Santos OR "Obstructive renal failure due to therapy with sulfadiazine in an AIDS patient." Nephron 62 (1992): 361
  2. Carbone L, Bendixen B, Appel G "Sulfadiazine-associated obstructive nephropathy occurring in a patient with the acquired immunodeficiency syndrome." Am J Kidney Dis 12 (1988): 72-5
  3. Sahai J, Heimberger R, Collins K, Kaplowitz L, Polk R "Sulfadiazine-induced crystalluria in a patient with the acquired immunodeficiency syndrome: a reminder." Am J Med 84 (1988): 791-2
  4. Molina J, Belenfant X, Doco-Lecompte T, et al "Sulfadiazine-induced crystalluria in AIDS patients with toxoplasma encephalitis." AIDS 5 (1991): 587-9
  5. "Product Information. Sulfadiazine (sulfadiazine)." Eon Labs Manufacturing Inc, Laurelton, NY.
  6. Sasson JP, Dratch PL, Shortsleeve MJ "Renal US findings in sulfadiazine-induced crystalluria." Radiology 185 (1992): 739-40
  7. Erturk E, Casemento JB, Guertin KR, Kende AS "Bilateral acetylsulfapyridine nephrolithiasis associated with chronic sulfasalazine therapy." J Urol 151 (1994): 1605-6
  8. "Product Information. Gantranol (sulfamethoxazole)." Roche Laboratories, Nutley, NJ.
  9. "Product Information. Azulfidine (sulfasalazine)." Pharmacia and Upjohn, Kalamazoo, MI.
  10. Hein R, Brunkhorst R, Thon WF, Schedel I, Schmidt RE "Symptomatic sulfadiazine crystalluria in AIDS patients: a report of two cases." Clin Nephrol 39 (1993): 254-6
  11. Simon D, Brosius F, Rothstein D "Sulfadiazine crystalluria revisited." Arch Intern Med 150 (1990): 2379-84
  12. Marques L, Silva M, Madeira E, Santos O "Obstructive renal failure due to therapy with sulfadiazine in an AIDS patient." Nephron 62 (1992): 361
  13. "Product Information. Gantrisin (sulfisoxazole)." Roche Laboratories, Nutley, NJ.
View all 13 references
Moderate

Trimethoprim (applies to Bactrim) dialysis

Moderate Potential Hazard, High plausibility. Applicable conditions: hemodialysis

Trimethoprim is moderately removed by hemodialysis. Doses should either be scheduled for administration after dialysis or supplemental doses be given after dialysis.

References

  1. "Product Information. Proloprim (trimethoprim)." Glaxo Wellcome, Research Triangle Park, NC.
  2. Nissenson AR, Wilson C, Holazo A "Pharmacokinetics of intravenous trimethoprim-sulfamethoxazole during hemodialysis." Am J Nephrol 7 (1987): 270-4
  3. "Product Information. Trimpex (trimethoprim)." Roche Laboratories, Nutley, NJ.
  4. Patel RB, Welling PG "Clinical pharmacokinetics of co-trimoxazole (trimethoprim-sulphamethoxazole)." Clin Pharmacokinet 5 (1980): 405-23
View all 4 references
Moderate

Trimethoprim (applies to Bactrim) renal dysfunction

Moderate Potential Hazard, High plausibility.

Trimethoprim is primarily eliminated by the kidney. The serum concentration of trimethoprim may be increased and the half-life prolonged in patients with impaired renal function. Dosage adjustments may be necessary and modifications should be based on the degree of renal impairment as well as severity of infection. The manufacturers recommend a dosage of 50 mg every 12 hours in patients with creatinine clearance between 15 to 30 mL/min and not using the drug in patients with creatinine clearance below 15 mL/min.

References

  1. Nolte H, Buttner H "Pharmacokinetics of trimethoprim and its combination with sulfamethoxazole in man after single and chronic oral administration." Chemotherapy 18 (1973): 274-84
  2. Watson ID, Stewart MJ, Wiles A, McIntosh SJ "Pharmacokinetics of two dosage levels of trimethoprim to "steady-state" in normal volunteers." J Int Med Res 11 (1983): 137-44
  3. Bergan T, Brodwall E, Vik-Mo H, Anstad U "Pharmacokinetics of sulphadiazine, sulphamethoxazole and trimethoprim in patients with varying renal function." Infection 7 (1979): s382-7
  4. Ahlmen J, Brorson J-E "Pharmacokinetics of trimethoprim given in single daily doses for three days." Scand J Infect Dis 14 (1982): 143-5
  5. "Product Information. Trimpex (trimethoprim)." Roche Laboratories, Nutley, NJ.
  6. Andreasen F, Elsborg L, Husted S, Thomsen O "Pharmacokinetics of sulfadiazine and trimethoprim in man." Eur J Clin Pharmacol 14 (1978): 57-67
  7. Odlind B, Hartvig P, Fjellstrom KE, Lindstrom B, Bengtsson S "Steady state pharmacokinetics of trimethoprim 300 mg once daily in healthy volunteers assessed by two independent methods." Eur J Clin Pharmacol 26 (1984): 393-7
  8. Adam WR, Henning M, Dawborn JK "Excretion of trimethoprim and sulphamethoxazole in patients with renal failure." Aust N Z J Med 3 (1973): 383-7
  9. Hengstmann JH "Pharmacokinetics of trimethoprim and tetroxoprim: a review." Antibiot Chemother 31 (1982): 211-24
  10. Bergan T, Brodwall EK "Kidney transport in man of sulfamethoxazole and trimethoprim." Chemotherapy 17 (1972): 320-33
  11. Rieder J, Schwartz DE, Fernex M, et al "Pharmacokinetics of the antibacterial combination sulfamethoxazole plus trimethoprim in patients with normal or impaired kidney function." Antibiot Chemother 18 (1974): 148-98
View all 11 references

Bactrim (sulfamethoxazole / trimethoprim) drug interactions

There are 371 drug interactions with Bactrim (sulfamethoxazole / trimethoprim)

Bactrim (sulfamethoxazole / trimethoprim) alcohol/food interactions

There is 1 alcohol/food interaction with Bactrim (sulfamethoxazole / trimethoprim)

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.