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Drug Interactions between Bactrim and dapsone

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

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Interactions between your drugs

Moderate

dapsone trimethoprim

Applies to: dapsone and Bactrim (sulfamethoxazole / trimethoprim)

MONITOR: Serum levels of both trimethoprim and dapsone may be increased during coadministration. The mechanism is unknown. Steady state levels are reached within approximately one week.

MANAGEMENT: When these agents are coadministered, monitoring for methemoglobinemia may be important, especially in patients with respiratory insufficiency, anemia, or cardiovascular disease.

References (4)
  1. Lee B, Medina I, Benowitz N, et al. (1989) "Dapsone, trimethoprim, and sulfamethoxazole plasma levels during treatment of pneumocystis pneumonia in patients with the acquired immunodeficiency syndrome (AIDS)." Ann Intern Med, 110, p. 606-11
  2. McKinsey D, Durfee D, Kurtin P (1989) "Megaloblastic pancytopenia associated with dapsone and trimethorprim treatment of pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome." Arch Intern Med, 149, p. 965
  3. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  4. Cerner Multum, Inc. "Australian Product Information."

Drug and food interactions

Moderate

sulfamethoxazole food

Applies to: Bactrim (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 (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

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Antipneumocystis agents

Therapeutic duplication

The recommended maximum number of medicines in the 'antipneumocystis agents' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'antipneumocystis agents' category:

  • Bactrim (sulfamethoxazole/trimethoprim)
  • dapsone

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

See also

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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.

Medical Disclaimer