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Drug Interactions between Bactrim and fecal microbiota, live

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

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Interactions between your drugs

Moderate

sulfamethoxazole fecal microbiota, live

Applies to: Bactrim (sulfamethoxazole / trimethoprim) and fecal microbiota, live

ADJUST DOSING INTERVAL: Antibiotics may interfere with the therapeutic effects of fecal microbiota, which contains live bacteria. The mechanism may be related to the antibiotic inactivating the bacteria or reducing bacterial replication. In clinical studies an antibiotic washout period between 24 to 72 hours was required prior to the rectal administration of fecal microbiota.

MANAGEMENT: Although data are limited, it may be prudent to have an antibiotic washout period between 24 to 72 hours prior to administration of the rectal formulation of fecal microbiota. In addition, the manufacturer recommends avoiding oral antibiotics for up to 8 weeks after administration of the rectal formulation of fecal microbiota.

References (2)
  1. (2022) "Product Information. Rebyota (fecal microbiota, live)." Ferring Pharmaceuticals Inc
  2. singh p, Alm EJ, Kelley JM, Cheng V, Smith M, Kassam Z, Nee J, Iturrino J, Lembo A (2022) "Effect of antibiotic pretreatment on bacterial engraftment after Fecal Microbiota Transplant (FMT) in IBS-D" National Library of Medicine, 14, p. 1
Moderate

trimethoprim fecal microbiota, live

Applies to: Bactrim (sulfamethoxazole / trimethoprim) and fecal microbiota, live

ADJUST DOSING INTERVAL: Antibiotics may interfere with the therapeutic effects of fecal microbiota, which contains live bacteria. The mechanism may be related to the antibiotic inactivating the bacteria or reducing bacterial replication. In clinical studies an antibiotic washout period between 24 to 72 hours was required prior to the rectal administration of fecal microbiota.

MANAGEMENT: Although data are limited, it may be prudent to have an antibiotic washout period between 24 to 72 hours prior to administration of the rectal formulation of fecal microbiota. In addition, the manufacturer recommends avoiding oral antibiotics for up to 8 weeks after administration of the rectal formulation of fecal microbiota.

References (2)
  1. (2022) "Product Information. Rebyota (fecal microbiota, live)." Ferring Pharmaceuticals Inc
  2. singh p, Alm EJ, Kelley JM, Cheng V, Smith M, Kassam Z, Nee J, Iturrino J, Lembo A (2022) "Effect of antibiotic pretreatment on bacterial engraftment after Fecal Microbiota Transplant (FMT) in IBS-D" National Library of Medicine, 14, p. 1

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

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.

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.

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