Bactrim Warnings and Precautions

If you have asthma, anemia, or a thyroid disorder, talk to your healthcare provider before taking Bactrim. Warnings and precautions for the drug should also be discussed with your healthcare provider, as it is important to be aware of potential side effects (such as jaundice, fever, and blood/watery diarrhea). You should not take Bactrim if you have severe liver disease or kidney problems.

What Should I Tell My Healthcare Provider Before Taking Bactrim?

You should talk with your healthcare provider prior to taking Bactrim® (sulfamethoxazole/trimethoprim) if you have:
 
  • Anemia
  • Asthma
  • Glucose-6-phosphate dehydrogenase deficiency
  • A folic acid deficiency
  • Phenylketonuria (PKU)
  • A thyroid disorder
  • Porphyria
  • HIV or AIDS
  • Kidney disease, such as kidney failure (renal failure)
  • Liver disease, such as liver failure, cirrhosis, or hepatitis
  • Any other allergies, including allergies to food, dyes, or preservatives.
     
Also, let your healthcare provider know if you are:
 
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
     
Make sure to tell your healthcare provider about all other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 

Some Precautions and Warnings for Bactrim

Some warnings and precautions to be aware of with Bactrim include the following:
 
  • Rarely, Bactrim has caused deaths due to various problems, although it is generally a relatively safe antibiotic for most people.
     
  • Stop taking Bactrim and contact your healthcare provider immediately if you develop a skin rash while taking Bactrim. While it may just be a simple rash, it could turn out to be a life-threatening reaction, such as Stevens-Johnson syndrome or toxic epidermal necrolysis.
     
  • Let your healthcare provider know if you develop an unexplained sore throat, fever, joint pain, pale skin, bruising, yellow skin (jaundice), coughing, or shortness of breath while taking Bactrim. These may be signs of serious reactions to Bactrim.
     
  • Check with your healthcare provider before taking Bactrim if you have glucose-6-phosphate dehydrogenase deficiency or severe asthma, as serious Bactrim side effects could occur.
     
  • Bactrim should not be used to treat infections caused by β-hemolytic streptococcal bacteria, as it is not effective for completely getting rid of this type of bacteria (which might increase the risk of developing rheumatic fever due to the infection).
     
  • Let your healthcare provider know if you experience bloody or watery diarrhea. While diarrhea is a common side effect of Bactrim, bloody or watery diarrhea may be a sign of a serious reaction to Bactrim that can occur when certain bacteria (Clostridium difficile) overgrow in the colon. This severe reaction can occur long after you stop taking Bactrim and can be life-threatening.
     
  • Overuse of antibiotics (including Bactrim) increases the risk for developing antibiotic-resistant bacteria. Your healthcare provider should prescribe antibiotics only when necessary (and only to treat bacterial infections). Antibiotics are not effective for treating viral infections, such as the common cold or the flu.
     
  • Make sure your healthcare provider knows if you have kidney or liver disease, as you may need a lower Bactrim dosage (or Bactrim may not be recommended, in severe cases).
     
  • There have been reports of low blood sugar (hypoglycemia) possibly due to Bactrim. While most common in people with diabetes, it has also been reported in non-diabetic individuals.
     
  • Bactrim may worsen certain thyroid disorders (especially hypothyroidism) or porphyria. If you have either of these problems, check with your healthcare provider before taking Bactrim.
     
  • Although Bactrim is approved to treat and prevent Pneumocystis carinii pneumonia in people with HIV or AIDS, it should be noted that people with HIV or AIDS have a higher risk of Bactrim side effects. Your healthcare provider should carefully monitor you for Bactrim side effects.
 
  • Bactrim can cause electrolyte problems, such as high potassium or low sodium levels in the blood. If you already have electrolyte problems or if you have kidney problems, your electrolytes should be monitored using blood tests while taking this medication.
 
  • It is very important to take Bactrim exactly as prescribed. Skipping doses or stopping Bactrim too early (even if you feel better) can lead to bacterial resistance to Bactrim.
     
  • Bactrim can interact with many other medications (see Bactrim Drug Interactions).
     
  • Bactrim is considered a pregnancy Category D medication. This means that it probably is not safe for use during pregnancy, although the full risks are not known. Talk to your healthcare provider about the risks and benefits of using Bactrim during pregnancy (see Bactrim and Pregnancy for more information).
     
  • Bactrim passes through breast milk. Therefore, if you are breastfeeding or plan to start, be sure to talk with your healthcare provider about using Bactrim (see Bactrim and Breastfeeding for more information).
     
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