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Drug Interactions between Aczone and sulfamethoxazole

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Minor

sulfamethoxazole dapsone topical

Applies to: sulfamethoxazole and Aczone (dapsone topical)

Systemic levels of dapsone and its metabolites following topical administration may be increased in the presence of trimethoprim/sulfamethoxazole (TMP/SMX). In a drug interaction study, systemic exposure (AUC) of dapsone and N-acetyl-dapsone were increased by about 40% and 20%, respectively, during coadministration with double-strength (160 mg/800 mg) TMP/SMX. Systemic exposure of dapsone hydroxylamine, a metabolite associated with hemolysis, was more than doubled by TMP/SMX. The clinical significance of these changes is unknown. Exposure from the recommended topical dose for acne vulgaris is about 1% of that from a 100 mg oral dose, even when coadministered with TMP/SMX. There were no effects on the systemic levels of TMP or SMX.

References (1)
  1. (2005) "Product Information. Aczone (dapsone topical)." QLT USA, Inc

Drug and food interactions

Moderate

sulfamethoxazole food

Applies to: sulfamethoxazole

MONITOR: Two cases have been reported in which patients on sulfamethoxazole-trimethoprim therapy, after consuming beer, reported flushing, heart palpitations, dyspnea, headache, and nausea (disulfiram - alcohol type reactions). First-generation sulfonylureas have been reported to cause facial flushing when administered with alcohol by inhibiting acetaldehyde dehydrogenase and subsequently causing acetaldehyde accumulation. Since sulfamethoxazole is chemically related to first-generation sulfonylureas, a disulfiram-like reaction with products containing sulfamethoxazole is theoretically possible. However, pharmacokinetic/pharmacodynamic data are lacking and in addition, the two reported cases cannot be clearly attributed to the concomitant use of sulfamethoxazole-trimethoprim and alcohol.

MANAGEMENT: Patients should be alerted to the potential for this interaction and although the risk for this interaction is minimal, caution is recommended while taking sulfamethoxazole-trimethoprim concomitantly with alcohol.

References (2)
  1. Heelon MW, White M (1998) "Disulfiram-cotrimoxazole reaction." Pharmacotherapy, 18, p. 869-70
  2. Mergenhagen KA, Wattengel BA, Skelly MK, Clark CM, Russo TA (2020) "Fact versus fiction: a review of the evidence behind alcohol and antibiotic interactions." Antimicrob Agents Chemother, 64, e02167-19

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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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.

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