Sulfatrim Warnings and Precautions

There are several Sulfatrim warnings and precautions to be aware of before starting treatment with the medication. For example, make sure to tell your healthcare provider about any other medical conditions you may have, as well as any other medications you are taking (including vitamins and herbal supplements). Warnings also apply to people who have certain allergies and to women who are pregnant or breastfeeding.

What Should I Tell My Healthcare Provider Before Taking Sulfatrim?

You should talk with your healthcare provider prior to taking Sulfatrim® (sulfamethoxazole/trimethoprim) if you have:
  • 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
  • Anemia
  • Asthma
  • Glucose-6-phosphate dehydrogenase deficiency
  • Any other allergies, including allergies to foods, 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 any other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Sulfatrim Warnings and Precautions

Some warnings and precautions to be aware of with Sulfatrim include the following:
  • Rarely, Sulfatrim has caused deaths due to various problems, although it is generally a relatively safe antibiotic for most people.
  • Sulfatrim contains a sulfonamide (a "sulfa" drug). Do not take Sulfatrim if you have a sulfa allergy.
  • Stop taking Sulfatrim and contact your healthcare provider immediately if you develop a skin rash while taking Sulfatrim. 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, yellowing of the whites of the eyes or skin (jaundice), coughing, or shortness of breath while taking Sulfatrim. These may be signs of serious reactions to Sulfatrim.
  • Let your healthcare provider know if you experience bloody or watery diarrhea. While diarrhea is a common side effect of Sulfatrim, bloody or watery diarrhea may be a sign of a serious reaction to Sulfatrim that can occur when certain bacteria (Clostridium difficile) overgrow in the colon. This severe reaction can occur long after you stop taking Sulfatrim and can lead to life-threatening complications.
  • Check with your healthcare provider before taking Sulfatrim if you have glucose-6-phosphate dehydrogenase deficiency or severe asthma, as serious Sulfatrim side effects could occur.
  • Overuse of antibiotics (including Sulfatrim) 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.
  • Sulfatrim 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).
  • Make sure your healthcare provider knows if you have kidney or liver disease, as you may need a lower Sulfatrim dosage (or Sulfatrim may not be recommended, in severe cases).
  • There have been reports of low blood sugar (hypoglycemia), possibly due to Sulfatrim. While most common in people with diabetes, it has also been reported in non-diabetic individuals.
  • Sulfatrim may worsen certain thyroid disorders (especially hypothyroidism) or porphyria. If you have either of these problems, check with your healthcare provider before taking Sulfatrim.
  • Although Sulfatrim 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 Sulfatrim side effects. Your healthcare provider should carefully monitor you for side effects.
  • Sulfatrim 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 Sulfatrim exactly as prescribed. Skipping doses or stopping Sulfatrim too early (even if you feel better) can lead to bacterial resistance to Sulfatrim.
  • Sulfatrim can interact with many other medications (see Sulfatrim Drug Interactions).
  • Sulfatrim is considered a pregnancy Category D medication. This means that it is probably 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 this drug when pregnant (see Sulfatrim and Pregnancy for more information).
  • Sulfatrim passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, make sure to talk with your healthcare provider about using Sulfatrim (see Sulfatrim and Breastfeeding for more information).
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