Trimethoprim side effects

If sulfamethoxazole/trimethoprim cannot be continued due to intolerance or severe side effects dap-sone may be given although a small percentage of patients may show cross intolerance. 

Potential side effects are headache, insomnia, fatigue, and gastrointestinal discomfort, though these are typically mild. Lamivudine s AUC increases when it is coadministered with trimethoprim-sulfamethoxazole. Peak levels of zidovudine increase when the drug is administered with lamivudine, though this effect is not felt to have clinical significance. 

TRIMETHOPRIM DAPSONE t levels of both drugs Mutual inhibition of metabolism Be aware - watch for t incidence of side-effects... 

GANCICLOVIR/ VALGANCICLOVIR ANTIBIOTICS- 1. IMIPENEM WITH CILASTATIN 2. TRIMETHOPRIM 1. T adverse effects (e.g. seizures) 2. Possibly t adverse effects (e.g. myelosuppression) when trimethoprim is co administered with ganciclovir or valgancidovir 1. Additive side-effects these drugs can cause seizure activity 2. Small t bioavailability possible additive toxicity 1. Avoid combination if possible use only if benefit outweighs risk 2. Well tolerated in one study. For patients at risk of additive toxicities, use only if benefits outweigh risks and monitor FBC closely... 

Trimethoprim-polymyxin B is effective for the treatment of blepharitis, conjimctivitis, and blepharoconjunctivitis. Side effects are very rare. Because it is clinically effective against H. influenzae and Streptococcus pneumoniae, which are the most common causes of bacterial pediatric eye infections, it is a drug of choice for treating eye infections in children. 

Gabriels G, Stockem E, Greven J. Hyperkaliamie nach Trimethoprim oder Pentamidin. Eine bisher wenig beach-tete Nebenwirkung antimikrobieller Therapiemassnahmen bei AIDS-Patienten. [Hyperkalemia after trimethoprim or pentamidine. Until now, a little noticed side effect of antimicrobial therapeutic measures in AIDS patients.] Dtsch Med Wochenschr 1998 123(45) 1351-5. 

Maki DG, Fox BC, Kuntz J, Sollinger HW, Belzer FO. A prospective, randomized, double-blind study of trimethoprim-sulfamethoxazole for prophylaxis of infection in renal transplantation. Side effects of trimethoprim-sulfamethoxazole, interaction with cyclosporine.The Journal of laboratory and clinical medicine. 1992 Jan l 19(1 ) 11-24. 

The incidence of side effects is higli Lower-dose oral therapy with 800 mg sulfamethoxazole plus 160 mg trimethoprim (given twice daily) has been used successjully in AIDS patients with less severe pneumonia (P02 >70 mm Hg). Prophylaxis with 800 mg sulfamethoxazole and 160 mg trimethoprim once daily or three times a week is effective in preventing pneumonia caused by this organism in patients with AIDS. Adverse reactions are less frequent with the lower prophylactic doses of trimethoprimr-sulfamethoxazole. The most common problems are rash, fever, leukopenia, and hepatitis. 

Trimethoprim (TMP), a folate analog and inhibitor of dihydrofolate reductase (Figure V-1-3), is usually used together with sulfamethoxazole (SMX). The simultaneous inhibition of the tetrahydrofolate synthesis pathway at two steps has a synergistic effect and prevents the rapid generation of resistance. The clinical uses and side effects of TMP-SMX are discussed. 

In human medicine, sulfamethoxazole (in combination with trimethoprim) is commonly used as an important antimetabolite for the treatment of bacterial infections, while other sulfonamides are mainly restricted to veterinary medicine, because of possible side effects. 

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