Sulfamethoxazole and Trimethoprim

This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Bactrim; Bactrim DS; Sulfatrim Pediatric

Brand Names: Canada

Septra; Sulfatrim; Sulfatrim DS; Sulfatrim Pediatric; TEVA-Trimel DS [DSC]; TEVA-Trimel [DSC]

What is this drug used for?

  • It is used to treat or prevent bacterial infections.

What do I need to tell the doctor BEFORE my child takes this drug?

  • If your child is allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell the doctor about the allergy and what signs your child had.
  • If your child has anemia caused by a lack of folic acid.
  • If your child has any of these health problems: Kidney disease or liver disease.
  • If your child has any of these health problems: Asthma, porphyria, thyroid disease, not enough folate in the body, poor absorption, or poor nutrition.
  • If your child has been drinking alcohol for a long time or is taking a drug for seizures.
  • If your child has ever had a low platelet count when using trimethoprim or a sulfa (sulfonamide) drug.
  • If your child is taking any of these drugs: Amantadine, cyclosporine, dofetilide, indomethacin, leucovorin, methotrexate, pyrimethamine, or a water pill.
  • If your child is taking or has recently taken any of these drugs: Benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, or trandolapril.
  • If your child is younger than 2 months of age. Do not give this drug to an infant younger than 2 months of age.

This is not a list of all drugs or health problems that interact with this drug.

Tell the doctor and pharmacist about all of your child’s drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe to give this drug with all of your child’s other drugs and health problems. Do not start, stop, or change the dose of any drug your child takes without checking with the doctor.

What are some things I need to know or do while my child takes this drug?

All products:

  • Tell all of your child’s health care providers that your child is taking this drug. This includes your child’s doctors, nurses, pharmacists, and dentists.
  • Have your child’s blood work and other lab tests checked as you have been told by the doctor.
  • This drug may affect certain lab tests. Tell all of your child’s health care providers and lab workers that your child takes this drug.
  • Do not give to your child longer than you have been told. A second infection may happen.
  • Be careful if your child has low levels of an enzyme called G6PD. Anemia may happen. Low levels of G6PD may be more likely in patients of African, South Asian, Middle Eastern, and Mediterranean descent.
  • If your child has high blood sugar (diabetes), you will need to watch your child’s blood sugar closely.
  • Alcohol may interact with this drug. Be sure your child does not drink alcohol.
  • This drug may make your child sunburn more easily. Use care if your child will be in the sun. Tell your child’s doctor if your child sunburns easily while taking this drug.
  • A severe and sometimes deadly reaction has happened. Most of the time, this reaction has signs like fever, rash, or swollen glands with problems in body organs like the liver, kidney, blood, heart, muscles and joints, or lungs. If you have questions, talk with the doctor.

If your child is pregnant or breast-feeding a baby:

  • This drug may cause harm to the unborn baby if your child takes it during pregnancy. If your child is pregnant or gets pregnant while taking this drug, call the doctor right away.
  • Tell the doctor if your child is breast-feeding a baby. You will need to talk about any risks to the baby.

Injection:

  • If your child is allergic to sulfites, talk with your child’s doctor. Some products have sulfites in them.
  • This drug has propylene glycol in it. Too much propylene glycol may lead to very bad health problems like nervous system problems, kidney problems, or other organ problems. If you have questions, talk with the doctor.
  • Some products have benzyl alcohol. If possible, avoid products with benzyl alcohol in newborns or infants. Serious side effects can happen in these children with some doses of benzyl alcohol, including if given with other drugs that have benzyl alcohol. Talk with the doctor to see if this product has benzyl alcohol in it.

What are some side effects that I need to call my child’s doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your child’s doctor or get medical help right away if your child has any of the following signs or symptoms that may be related to a very bad side effect:

All products:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of high potassium levels like a heartbeat that does not feel normal; feeling confused; feeling weak, lightheaded, or dizzy; feeling like passing out; numbness or tingling; or shortness of breath.
  • Signs of low blood sugar like dizziness, headache, feeling sleepy, feeling weak, shaking, a fast heartbeat, confusion, hunger, or sweating.
  • Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
  • Signs of low sodium levels like headache, trouble focusing, memory problems, feeling confused, weakness, seizures, or change in balance.
  • Signs of lung or breathing problems like shortness of breath or other trouble breathing, cough, or fever.
  • Muscle or joint pain.
  • Purple patches on the skin or mouth.
  • Hallucinations (seeing or hearing things that are not there).
  • Depression or other mood changes.
  • A burning, numbness, or tingling feeling that is not normal.
  • Ringing in ears.
  • Swollen gland.
  • Chest pain.
  • Very bad dizziness or passing out.
  • Diarrhea is common with antibiotics. Rarely, a severe form called C diff–associated diarrhea (CDAD) may happen. Sometimes, this has led to a deadly bowel problem. CDAD may happen during or a few months after taking antibiotics. Call your child’s doctor right away if your child has stomach pain, cramps, or very loose, watery, or bloody stools. Check with your child’s doctor before treating diarrhea.
  • Rarely, severe effects have happened with sulfa drugs. Sometimes, these have been deadly. These effects have included liver problems, blood problems, and severe skin reactions (Stevens-Johnson syndrome/toxic epidermal necrolysis). Call the doctor right away if your child has a rash; red, swollen, blistered, or peeling skin; red or irritated eyes; sores in the mouth, throat, nose, or eyes; fever, chills, or sore throat; cough that is new or worse; feeling very tired or weak; any bruising or bleeding; or signs of liver problems like dark urine, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
  • This drug may raise the chance of a very bad brain problem called aseptic meningitis. Call the doctor right away if your child has a headache, fever, chills, very upset stomach or throwing up, stiff neck, rash, bright lights bother the eyes, feeling sleepy, or feeling confused.

Injection:

  • This drug may irritate the vein. If the drug leaks from the vein, it may also cause irritation around that area. Tell your child’s nurse if your child has any redness, burning, pain, swelling, or leaking of fluid where the drug is going into your child’s body.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your child’s doctor or get medical help if any of these side effects or any other side effects bother your child or do not go away:

  • Diarrhea, upset stomach, or throwing up.
  • Decreased appetite.

These are not all of the side effects that may occur. If you have questions about side effects, call your child’s doctor. Call your child’s doctor for medical advice about side effects.

You may report side effects to your national health agency.

How is this drug best given?

Give this drug as ordered by your child’s doctor. Read all information given to you. Follow all instructions closely.

All oral products:

  • Give this drug with or without food. Give with food if it causes an upset stomach.
  • Give this drug with a full glass of water.
  • Give this drug at the same time of day.
  • Keep giving this drug to your child as you have been told by your child’s doctor or other health care provider, even if your child feels well.
  • Have your child drink lots of noncaffeine liquids every day unless told to drink less liquid by your child’s doctor.

Liquid (suspension):

  • Shake well before use.
  • Measure liquid doses carefully. Use the measuring device that comes with this drug. If there is none, ask the pharmacist for a device to measure this drug.

Injection:

  • It is given as an infusion into a vein over a period of time.
  • Have your child drink lots of noncaffeine liquids every day unless told to drink less liquid by your child’s doctor.

What do I do if my child misses a dose?

All oral products:

  • Give a missed dose as soon as you think about it.
  • If it is close to the time for your child’s next dose, skip the missed dose and go back to your child’s normal time.
  • Do not give 2 doses at the same time or extra doses.

Injection:

  • Call your child’s doctor to find out what to do.

How do I store and/or throw out this drug?

All oral products:

  • Store at room temperature protected from light. Store in a dry place. Do not store in a bathroom.

Injection:

  • If you need to store this drug at home, talk with your child’s doctor, nurse, or pharmacist about how to store it.

All products:

  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts

  • If your child’s symptoms or health problems do not get better or if they become worse, call your child’s doctor.
  • Do not share your child’s drug with others and do not give anyone else’s drug to your child.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your child’s doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2021-05-12

Copyright

© 2024 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.

Last Updated

Monday, December 12, 2022