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Drug Interactions between Bactrim DS and Hivid

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

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Interactions between your drugs

Moderate

trimethoprim zalcitabine

Applies to: Bactrim DS (sulfamethoxazole / trimethoprim) and Hivid (zalcitabine)

MONITOR: Trimethoprim may increase plasma concentrations and decrease clearance of zalcitabine. The mechanism may be inhibition of renal tubular secretion of zalcitabine. The clinical significance is unknown.

MANAGEMENT: Close clinical monitoring for evidence of zalcitabine toxicity (peripheral neuropathy, pancreatitis, lactic acidosis, hepatotoxicity) is recommended when these drugs are used together. In addition, a reduction in zalcitabine dosage may be warranted. Patients should be advised to promptly notify their doctor if they experience numbness, tingling, severe nausea and vomiting, diarrhea, abdominal pain, severe fatigue, or jaundice.

References

  1. "Multum Information Services, Inc. Expert Review Panel"
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

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Drug and food interactions

Moderate

sulfamethoxazole food

Applies to: Bactrim DS (sulfamethoxazole / trimethoprim)

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

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

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Minor

zalcitabine food

Applies to: Hivid (zalcitabine)

Zalcitabine bioavailability may be decreased by 14% if taken with meals. The mechanism and clinical significance are unknown.

References

  1. "Product Information. HIVID (zalcitabine)." Roche Laboratories PROD (2001):

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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.