Bactrim 400 80mg

Bambini al di sotto dei due mesi di eta'. Durante la gravidanza e durante l'allattamento, onde evitare il rischio che la mancata eliminazione delmedicamento dall'organismo della madre e, rispettivamente, il passaggio nel latte, possano determinare un ittero neonatale. Insufficienza di glucosiofosfato deidrogenasi. Non somministrare in combinazione con dofetilide. Dosi, modi e tempi di assunzione di questo farmaco Somministrare ogni 12 ore.

Da 8 settimane a 5 mesi. Da 6 mesi a 5 anni. Da 6 a 12 anni. In caso di infezioni acute, somministrare per almeno 5giorni oppure sino a quando il malato sia esente da sintomi da 2 giorni. For the treatment of documented Pneumocystis jiroveci pneumonia and for prophylaxis against P. Traveler's Diarrhea in Adults: For the treatment of traveler's diarrhea due to susceptible strains of enterotoxigenic E. Bactrim is contraindicated in pediatric patients less than 2 months of age.

Bactrim is also contraindicated in patients with marked hepatic damage or with severe renal insufficiency when renal function status cannot be monitored. Hypersensitivity and Other Fatal Reactions Fatalities associated with the administration of sulfonamides, although rare, have occurred due to severe reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, fulminant hepatic necrosis, agranulocytosis, aplastic anemia and other blood dyscrasias.

Clinical signs, such as rash, sore throat, fever, arthralgia, pallor, purpura or jaundice may be early indications of serious reactions. Cough, shortness of breath, and pulmonary infiltrates are hypersensitivity reactions of the respiratory tract that have been reported in association with sulfonamide treatment.

Severe cases of thrombocytopenia that are fatal or life threatening have been reported. In an established infection, they will not eradicate the streptococcus and, therefore, will not prevent sequelae such as rheumatic fever. Clostridium difficile associated diarrhea Clostridium difficile associated diarrhea CDAD has been reported with use of nearly all antibacterial agents, including Bactrim, and may range in severity from mild diarrhea to fatal colitis.

Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. Hypertoxin producing strains of C. CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents.

Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. Adjunctive treatment with Leucovorin for Pneumocystis jiroveci pneumonia Treatment failure and excess mortality were observed when trimethoprim-sulfamethoxazole was used concomitantly with leucovorin for the treatment of HIV positive patients with Pneumocystis jiroveci pneumonia in a randomized placebo controlled trial.

Precautions Development of drug resistant bacteria Prescribing Bactrim sulfamethoxazole and trimethoprim tablets in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria. Folate deficiency Bactrim should be given with caution to patients with impaired renal or hepatic function, to those with possible folate deficiency e.

Hematological changes indicative of folic acid deficiency may occur in elderly patients or in patients with preexisting folic acid deficiency or kidney failure. These effects are reversible by folinic acid therapy. Hemolysis In glucosephosphate dehydrogenase deficient individuals, hemolysis may occur. Hypoglycemia Cases of hypoglycemia in non-diabetic patients treated with Bactrim are seen rarely, usually occurring after a few days of therapy.

Patients with renal dysfunction, liver disease, malnutrition or those receiving high doses of Bactrim are particularly at risk. Phenylalanine metabolism Trimethoprim has been noted to impair phenylalanine metabolism, but this is of no significance in phenylketonuric patients on appropriate dietary restriction.

Porphyria and Hypothyroidism As with all drugs containing sulfonamides, caution is advisable in patients with porphyria or thyroid dysfunction. The incidence of side effects, particularly rash, fever, leukopenia and elevated aminotransferase transaminase values, with Bactrim therapy in AIDS patients who are being treated for P.

Adverse effects are generally less severe in patients receiving Bactrim for prophylaxis. A history of mild intolerance to Bactrim in AIDS patients does not appear to predict intolerance of subsequent secondary prophylaxis.

Co-administration of Bactrim and leucovorin should be avoided with P. Electrolyte Abnormalities High dosage of trimethoprim, as used in patients with P. Even treatment with recommended doses may cause hyperkalemia when trimethoprim is administered to patients with underlying disorders of potassium metabolism, with renal insufficiency, or if drugs known to induce hyperkalemia are given concomitantly.

Close monitoring of serum potassium is warranted in these patients. Severe and symptomatic hyponatremia can occur in patients receiving Bactrim, particularly for the treatment of P. Evaluation for hyponatremia and appropriate correction is necessary in symptomatic patients to prevent life-threatening complications.

During treatment, adequate fluid intake and urinary output should be ensured to prevent crystalluria. Patients who are "slow acetylators" may be more prone to idiosyncratic reactions to sulfonamides. Patients should be counseled that antibacterial drugs including Bactrim sulfamethoxazole and trimethoprim tablets should only be used to treat bacterial infections. They do not treat viral infections e.

When Bactrim sulfamethoxazole and trimethoprim tablets are prescribed to treat a bacterial infection, patients should be told that although it is common to feel better early in the course of therapy, the medication should be taken exactly as directed. Skipping doses or not completing the full course of therapy may 1 decrease the effectiveness of the immediate treatment and 2 increase the likelihood that bacteria will develop resistance and will not be treatable by Bactrim sulfamethoxazole and trimethoprim tablets or other antibacterial drugs in the future.

Patients should be instructed to maintain an adequate fluid intake in order to prevent crystalluria and stone formation. Diarrhea is a common problem caused by antibiotics which usually ends when the antibiotic is discontinued. Sometimes after starting treatment with antibiotics, patients can develop watery and bloody stools with or without stomach cramps and fever even as late as two or more months after having taken the last dose of the antibiotic.

If fenoprofen is used concurrently with sulfonamides, monitor patients for toxicity from any of the drugs.

Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include fingolimod.

Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include flecainide. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include fluconazole. Major Use of other folate antagonists should be avoided during therapy with trimethoprim.

Hematologic toxicity can be increased by concurrent use of fluorouracil, 5-FU. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously with sulfamethoxazole; trimethoprim include olanzapine. Drugs with a possible risk for QT prolongation that should be used cautiously with sulfamethoxazole; trimethoprim include fluphenazine. Moderate In theory, concurrent use CYP2C9 inhibitors, such as sulfonamides, and fluvastatin, a CYP2C9 substrate, may result in reduced metabolism of fluvastatin and potential for toxicity.

Moderate There may be an increased risk for QT prolongation and torsade de pointes TdP during concurrent use of fluvoxamine and sulfamethoxazole; trimethoprim. Cases of QT prolongation and TdP have been reported during postmarketing use of fluvoxamine. Folic Acid, Vitamin B9: Moderate The incidence of marijuana associated adverse effects may change following coadministration with sulfamethoxazole. Sulfamethoxazole is an inhibitor of CYP2C9, an isoenzyme partially responsible for the metabolism of marijuana's most psychoactive compound, deltatetrahydrocannabinol DeltaTHC.

When given concurrently with sulfamethoxazole, the amount of DeltaTHC converted to the active metabolite hydroxy-deltatetrahydrocannabinol OH-THC may be reduced. Major When possible, avoid concurrent use of foscarnet with other drugs known to prolong the QT interval, such as sulfamethoxazole. Foscarnet has been associated with postmarketing reports of both QT prolongation and torsade de pointes TdP.

QT prolongation resulting in ventricular tachycardia and TdP has also been reported during postmarketing use of sulfamethoxazole; trimethoprim. If these drugs are administered together, obtain an electrocardiogram and electrolyte concentrations before and periodically during treatment. Major When possible, avoid concurrent use of foscarnet with other drugs known to prolong the QT interval, such as trimethoprim. Moderate Concomitant use of sulfamethoxazole with fosphenytoin which is metabolized to phenytoin may result in increased serum concentrations of phenytoin and increase the risk for adverse reactions.

Phenytoin is a substrate of hepatic isoenzyme CYP2C9; sulfamethoxazole is an inhibitor of this enzyme. Caution and close monitoring of phenytoin serum concentrations are advised if these drugs are used together; dosage adjustments may be necessary in some patients.

Monitor for signs of phenytoin toxicity. Moderate The half-life of phenytoin may be increased when trimethoprim is given concurrently with phenytoin. It is thought that trimethoprim may interfere with phenytoin hepatic metabolism. Reduced phenytoin clearance can lead to toxicity. Phenytoin or fosphenytoin doses may need to be reduced during concomitant use of trimethoprim.

Moderate Use ganciclovir and sulfamethoxazole; trimethoprim together only if the potential benefits outweigh the risks; bone marrow suppression, spermatogenesis inhibition, skin toxicity, and gastrointestinal toxicity may be additive as both drugs inhibit rapidly dividing cells.

Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include gemifloxacin. Moderate Use gemtuzumab ozogamicin and sulfamethoxazole together with caution due to the potential for additive QT interval prolongation and risk of torsade de pointes TdP.

If these agents are used together, obtain an ECG and serum electrolytes prior to the start of gemtuzumab and as needed during treatment. Although QT interval prolongation has not been reported with gemtuzumab, it has been reported with other drugs that contain calicheamicin. Moderate Use gemtuzumab ozogamicin and trimethoprim together with caution due to the potential for additive QT interval prolongation and risk of torsade de pointes TdP.

Moderate It is possible that an increase in the exposure of rosiglitazone may occur when coadministered with drugs that inhibit CYP2C8 such as trimethoprim. Patients should be monitored for changes in glycemic control if any CYP2C8 inhibitors are coadministered with rosiglitazone. Moderate Androgen deprivation therapy e.

Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include granisetron. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include haloperidol. Moderate Consider periodic monitoring of EGCs for QT prolongation and monitor electrolytes if coadministration of histrelin and sulfamethoxazole is necessary; correct any electrolyte abnormalities.

Prolongation of the QT interval resulting in ventricular tachycardia and torsade de pointes TdP has been reported during postmarketing use of sulfamethoxazole; trimethoprim. Androgen deprivation therapy e. Moderate Consider periodic monitoring of EGCs for QT prolongation and monitor electrolytes if coadministration of histrelin and trimethoprim is necessary; correct any electrolyte abnormalities.

Minor Inhibitors of the hepatic CYP2C9 isoenzyme, such as sulfonamides, have potential to inhibit the conversion of losartan to its active metabolite. Monitor therapeutic response to individualize losartan dosage. Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine: Major Avoid coadministration of hydroxychloroquine and sulfamethoxazole; trimethoprim.

Hydroxychloroquine increases the QT interval and should not be administered with other drugs known to prolong the QT interval. Ventricular arrhythmias and torsade de pointes TdP have been reported with the use of hydroxychloroquine.

Moderate Use potassium phosphate cautiously with trimethoprim especially high dose , as both drugs increase serum potassium concentrations. Concurrent use can cause hyperkalemia, especially in elderly patients or patients with impaired renal function. Patients should have serum potassium concentration determinations at periodic intervals. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include ibutilide.

Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include iloperidone.

Minor Concomitant administration of indinavir and trimethoprim should be done with caution. There was no effect on the AUC of indinavir or sulfamethoxazole. Major Avoid the concomitant use of sulfamethoxazole and indomethacin as coadministration may result in increased serum concentrations of sulfamethoxazole. Coadministration may increase the risk of sulfamethoxazole toxicity.

Major Avoid coadministration of inotuzumab ozogamicin with sulfamethoxazole due to the potential for additive QT prolongation and risk of torsade de pointes TdP. If coadministration is unavoidable, obtain an ECG and serum electrolytes prior to the start of treatment, after treatment initiation, and periodically during treatment. Inotuzumab has been associated with QT interval prolongation.

Major Avoid coadministration of inotuzumab ozogamicin with trimethoprim due to the potential for additive QT prolongation and risk of torsade de pointes TdP. Iodine; Potassium Iodide, KI: Moderate Rifampin is a potent enzyme inducer. A pharmacokinetic effect on the combination has been reported with another rifamycin.

The drugs are often given clinically together with certain patient populations, so the ultimate clinical significance of a possible pharmacokinetic interaction is not clear. Monitor for therapeutic response to therapy. Additionally, sulfamethoxazole; trimethoprim may increase the serum concentration of rifampin. The drugs are often given together for certain patient populations, so the ultimate clinical significance of a possible pharmacokinetic interaction is not clear. Monitor for therapeutic response to therapy and increased rifampin toxicity Isoniazid, INH; Rifampin: Monitor for therapeutic response to therapy and increased rifampin toxicity Itraconazole: Major Itraconazole has been associated with prolongation of the QT interval.

In vitro studies showed ivacaftor to be a weak inhibitor of CYP2C9. Co-administration may lead to increased exposure to CYP2C9 substrates; however, the clinical impact of this has not yet been determined.

Major Avoid coadministration of ivosidenib with sulfamethoxazole; trimethoprim due to an increased risk of QT prolongation. If concomitant use is unavoidable, monitor ECGs for QTc prolongation and monitor electrolytes; correct any electrolyte abnormalities as clinically appropriate. An interruption of therapy and dose reduction of ivosidenib may be necessary if QT prolongation occurs.

Prolongation of the QTc interval and ventricular arrhythmias have been reported in patients treated with ivosidenib. Major Ketoconazole has been associated with prolongation of the QT interval. Moderate Lamotrigine inhibits dihydrofolate reductase. Caution should be exercised when administering trimethoprim, which also inhibits this enzyme. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include lapatinib.

Moderate Use lesinurad and sulfamethoxazole together with caution; sulfamethoxazole may increase the systemic exposure of lesinurad.

Minor Racemic leucovorin may be used to offset the toxicity of folate antagonists such as trimethoprim; however, the concomitant use of leucovorin with sulfamethoxazole; trimethoprim for the acute treatment of Pneumocystis carinii pneumonia in patients with HIV infection was associated with an increased risk of treatment failure and morbidity. Levoleucovorin may result in the same effect. Minor The concomitant use of leucovorin with sulfamethoxazole; trimethoprim, for the acute treatment of Pneumocystis carinii pneumonia in patients with HIV infection was associated with an increased risk of treatment failure and morbidity.

Drugs with a possible risk for QT prolongation and TdP that should be used cautiously with leuprolide include sulfamethoxazole; trimethoprim.

Drugs with a possible risk for QT prolongation and TdP that should be used cautiously with leuprolide include trimethoprim. Major Use sulfamethoxazole; trimethoprim and levofloxacin together with caution due to an increased risk for QT prolongation and torsade de pointes TdP. Levofloxacin has been associated with prolongation of the QT interval and infrequent cases of arrhythmia.

Rare cases of TdP have been reported during postmarketing surveillance in patients receiving levofloxacin.

QT prolongation, resulting in ventricular tachycardia and TdP, has been reported during postmarketing use of sulfamethoxazole; trimethoprim. Moderate Sulfamethoxazole; trimethoprim should be used cautiously and with close monitoring with lithium. Lithium has been associated with QT prolongation. Moderate Monitor ECG if lofexidine is coadministered with sulfamethoxazole; trimethoprim due to the potential for additive QT prolongation and torsade de pointes TdP.

Lofexidine prolongs the QT interval. In addition, there are postmarketing reports of TdP. Moderate If these drugs are used together, the plasma concentrations of loperamide may increase. Loperamide is a substrate for CYP2C8. Trimethoprim has been shown in vitro and in studies of healthy human volunteers to selectively inhibit the CYP2C8 isoenzyme. Monitor for cardiac toxicities i.

At high doses, loperamide has been associated with serious cardiac toxicities, including syncope, ventricular tachycardia, QT prolongation, torsade de pointes TdP , and cardiac arrest.

Coadministration may increase the risk for QT prolongation and torsade de pointes TdP. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include lopinavir; ritonavir. Minor Concomitant use of sulfamethoxazole; trimethoprim and lumacaftor; ivacaftor may alter sulfamethoxazole; trimethoprim, SMX-TMP, Cotrimoxazole exposure.

Sulfamethoxazole is a substrate of CYP2C9; in vitro data suggest it is also a substrate for the P-glycoprotein P-gp drug transporter. The net effect of lumacaftor; ivacaftor on CYP2C9-mediated metabolism and P-gp transport is not clear, but substrate exposure may be affected leading to decreased efficacy or increased or prolonged therapeutic effects and adverse events.

Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include maprotiline.

Inhibitors of the 2C9 isoenzyme, such as trimethoprim, may lead to increased serum concentrations of mefenamic acid. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include mefloquine. Moderate Increased bone marrow suppression may occur if mercaptopurine is coadministered with trimethoprim sulfamethoxazole.

If concomitant use is necessary, monitor complete blood counts and adjust the dose of mercaptopurine if severe neutropenia or thrombocytopenia occur. The possibility of an increased risk of hypoglycemia should be considered during concomitant use of trimethoprim and repaglinide. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include methadone.

Methenamine; Sodium Acid Phosphate: Major Methotrexate is partially bound to plasma proteins, and drugs that can displace methotrexate from these proteins, such as sulfonamides could cause methotrexate-induced toxicity.

Due to the potential toxicity of methotrexate, interactions with sulfonamides can be very serious even if methotrexate is administered in low doses. Moderate Use of other folate antagonists, such as methotrexate, should be avoided during therapy with trimethoprim.

Hematologic toxicity can be increased by concurrent use of methotrexate. If concurrent use is necessary, closely monitor patients for signs or symptoms of skin toxicity. Major The concomitant use of midostaurin and sulfamethoxazole; trimethoprim may lead to additive QT interval prolongation.

If these drugs are used together, consider electrocardiogram monitoring. In clinical trials, QT prolongation has been reported in patients who received midostaurin as single-agent therapy or in combination with cytarabine and daunorubicin.

QT prolongation resulting in ventricular tachycardia and torsade de pointes has been reported during postmarketing use of sulfamethoxazole; trimethoprim. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously with sulfamethoxazole; trimethoprim include mifepristone.

Moderate There may be an increased risk for QT prolongation and torsade de pointes TdP during concurrent use of mirtazapine and sulfamethoxazole; trimethoprim. Cases of QT prolongation, TdP, ventricular tachycardia, and sudden death have been reported during postmarketing use of mirtazapine, primarily following overdose or in patients with other risk factors for QT prolongation, including concomitant use of other medications associated with QT prolongation.

Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include moxifloxacin.

Major Avoid the concomitant use of nilotinib and sulfamethoxazole; trimethoprim because significant prolongation of the QT interval may occur. Sudden death and QT prolongation have occurred in patients who received nilotinib therapy.

QT prolongation resulting in ventricular tachycardia and torsade de pointes have been reported during post-marketing use of sulfamethoxazole; trimethoprim. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously with sulfamethoxazole; trimethoprim include norfloxacin.

Drugs with a possible risk for QT prolongation and TdP that should be used cautiously with sulfamethoxazole; trimethoprim include octreotide. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include ofloxacin. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include ondansetron.

If these drugs are administered concurrently, monitor for sulfamethoxazole toxicity such as diarrhea, anorexia, or nausea. Major Avoid coadministration of sulfamethoxazole with osimertinib if possible due to the risk of QT prolongation and torsade de pointes TdP. If concomitant use is unavoidable, periodically monitor ECGs for QT prolongation and monitor electrolytes; an interruption of osimertinib therapy with dose reduction or discontinuation of therapy may be necessary if QT prolongation occurs.

Concentration-dependent QTc prolongation occurred during clinical trials of osimertinib. Major Monitor electrolytes and ECGs for QT prolongation if coadministration of sulfamethoxazole with oxaliplatin is necessary; correct electrolyte abnormalities prior to administration of oxaliplatin. There have been reports of QT prolongation and ventricular arrhythmias including fatal torsade de pointes in postmarketing experience with both oxaliplatin and sulfamethoxazole; trimethoprim. Major Monitor electrolytes and ECGs for QT prolongation if coadministration of trimethoprim with oxaliplatin is necessary; correct electrolyte abnormalities prior to administration of oxaliplatin.

If coadministration is necessary, use caution and monitor for increased paclitaxel side effects, including myelosuppression and peripheral neuropathy. This interaction may also be applicable to combination products containing trimethoprim, including sulfamethoxazole; trimethoprim also known as SMX-TMP or cotrimoxazole. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include paliperidone.

Major QT prolongation has been reported with panobinostat therapy in patients with multiple myeloma in a clinical trial; use of panobinostat with other agents that prolong the QT interval is not recommended. Obtain an electrocardiogram at baseline and periodically during treatment. Drugs with a possible risk for QT prolongation and torsade de pointes that should be used cautiously and with close monitoring with panobinostat include sulfamethoxazole; trimethoprim, SMX-TMP, Cotrimoxazole.

Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include pasireotide. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include pazopanib. Pazopanib is also a weak inhibitor of CYP3A4. Minor Sulfonamides may compete with penicillin for renal tubular secretion, increasing penicillin serum concentrations.

These combinations should be used with caution and patients monitored for increased side effects. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include pentamidine.

Drugs with a possible risk for QT prolongation and TdP that should be used cautiously with sulfamethoxazole; trimethoprim include perphenazine. Moderate Concomitant use of sulfamethoxazole with phenytoin may result in increased serum concentrations of phenytoin and increase the risk for adverse reactions.

Moderate The half-life of phenytoin may be increased with trimethoprim. Phenytoin doses may need to be reduced during concomitant use of trimethoprim. Major Pimavanserin may cause QT prolongation and should generally be avoided in patients receiving other medications known to prolong the QT interval, such as sulfamethoxazole; trimethoprim.

Coadministration may increase the risk for QT prolongation. Severe Pimozide is associated with a well-established risk of QT prolongation and torsade de pointes TdP. Major Posaconazole and sulfamethoxazole should be coadministered with caution due to an increased potential for sulfamethoxazole-related adverse events. Posaconazole is a potent inhibitor of CYP3A4, an isoenzyme partially responsible for the metabolism of sulfamethoxazole.

These drugs used in combination may result in elevated sulfamethoxazole plasma concentrations, causing an increased risk for sulfamethoxazole-related adverse events. Potassium Phosphate; Sodium Phosphate: Concomitant administration of drugs that undergo substantial renal clearance, such as sulfamethoxazole; trimethoprim, SMX-TMP, may result in delayed clearance of pralatrexate.

Minor Patients treated with prilocaine who are receiving other drugs that can cause methemoglobin formation, such as sulfonamides, are at greater risk for developing methemoglobinemia.

Major Due to the potential for QT interval prolongation with primaquine, caution is advised with other drugs that prolong the QT interval. Minor Probenecid may inhibit the renal transport of sulfonamides. Plasma concentrations of these agents may be increased. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include procainamide.

Major Trimethoprim and procainamide both undergo tubular secretion, and as a result, each drug can interfere with the renal clearance of the other.

Although it is not necessary to avoid concomitant use of these two drugs, lower doses of procainamide may be necessary during trimethoprim administration.

Drugs with a possible risk for QT prolongation and TdP that should be used cautiously with sulfamethoxazole; trimethoprim include prochlorperazine. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include propafenone. Major The combination of pyrimethamine with sulfonamides can be synergistic against susceptible organisms, however, bone marrow suppression may be more likely to occur with combination therapy.

CBCs should be monitored routinely in patients receiving both drugs simultaneously. Some references suggest routinely administering leucovorin during therapy with pyrimethamine even when used without any of the above drugs.

Hematologic toxicity can be increased by concurrent use of pyrimethamine. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include quetiapine. Moderate Ramelteon should be administered with caution to patients taking CYP2C9 inhibitors, such as sulfamethoxazole.

The patient should be monitored closely for toxicity even though ramelteon has a wide therapeutic index. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include ranolazine. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously with sulfamethoxazole; trimethoprim include regadenoson. Major Avoid coadministration of ribociclib with sulfamethoxazole; trimethoprim due to an increased risk for QT prolongation and torsade de pointes TdP.

Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Concomitant use may increase the risk for QT prolongation. Monitor for therapeutic response to therapy and increased rifampin toxicity Rilpivirine: Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include risperidone.

Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include romidepsin. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include saquinavir.

Major Consider a less frequent dosing regimen e. Reduce the selexipag dose when trimethoprim is initiated in patients already taking selexipag.

Coadministration can be expected to increase exposure to selexipag and its active metabolite. Moderate There have been postmarketing reports of QT prolongation and torsade de pointes TdP during treatment with sertraline and the manufacturer of sertraline recommends avoiding concurrent use with drugs known to prolong the QTc interval.

Moderate Sulfonamides may alter sodium iodide I pharmacokinetics and dynamics for up to 1 week after administrations. Sodium picosulfate; Magnesium oxide; Anhydrous citric acid: Major Prior or concomitant use of antibiotics with sodium picosulfate; magnesium oxide; anhydrous citric acid may reduce efficacy of the bowel preparation as conversion of sodium picosulfate to its active metabolite bis- p-hydroxy-phenyl -pyridylmethane BHPM is mediated by colonic bacteria.

If possible, avoid coadministration. Therefore, these antibiotics should be taken at least 2 hours before and not less than 6 hours after the administration of sodium picosulfate; magnesium oxide; anhydrous citric acid solution. Moderate Use caution when administering velpatasvir with trimethoprim. Taking these drugs together may increase velpatasvir plasma concentrations, potentially resulting in adverse events. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously with sulfamethoxazole; trimethoprim include solifenacin.

Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include sorafenib. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include sotalol. Drugs that may be affected in this manner include sulfinpyrazone. Major Monitor patients for QT prolongation if coadministration of sulfamethoxazole with sunitinib is necessary.

Sunitinib can cause dose-dependent QT prolongation, which may increase the risk for ventricular arrhythmias, including torsades de points TdP. Prolongation of the QT interval resulting in ventricular tachycardia and TdP has been reported during postmarketing use of sulfamethoxazole; trimethoprim.

Major Monitor patients for QT prolongation if coadministration of trimethoprim with sunitinib is necessary. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include tacrolimus.

Moderate Caution is advised with the concomitant use of tamoxifen and sulfamethoxazole; trimethoprim due to an increased risk of QT prolongation and torsade de pointes TdP.

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