Sulfamethoxazole and trimethoprim interactions

Sulfamethoxazole and trimethoprim (Bactrim, Septra), a sulfonamide has 219 documented interactions across the FDA labels and fact sheets we index: 34 major, 171 moderate, 12 minor, and 2 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.

Interactions from the label

Major interactions (34)

  • CONTRAINDICATIONS Atenolol and chlorthalidone is contraindicated in patients with: sinus bradycardia; heart block greater than first degree; cardiogenic shock; overt cardiac failure (See WARNINGS ); anuria; hypersensitivity to this product or to sulfonamide-derived drugs. (Atenolol and chlorthalidone label, Contraindications)

  • Lotensin HCT is also contraindicated in patients who are hypersensitive to benazepril, to any other ACE inhibitor, to hydrochlorothiazide, or to other sulfonamide-derived drugs. (Benazepril and hydrochlorothiazide label, Contraindications)

  • CONTRAINDICATIONS Bisoprolol fumarate and hydrochlorothiazide tablets are contraindicated in patients in cardiogenic shock, overt cardiac failure (see WARNINGS ), second or third degree AV block, marked sinus bradycardia, anuria, and hypersensitivity to either component of this product or to other sulfonamide-derived drugs. (Bisoprolol and hydrochlorothiazide label, Contraindications)

  • BosentanCYP3A4 inducerMajor

    Co-administration of such combinations of a CYP2C9 inhibitor plus a strong or moderate CYP3A inhibitor with TRACLEER is not recommended. (Bosentan label, Drug interactions)

  • Candesartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Major

    CONTRAINDICATIONS Candesartan cilexetil and hydrochlorothiazide tablets are contraindicated in patients who are hypersensitive to candesartan, to hydrochlorothiazide or to other sulfonamide-derived drugs. (Candesartan and hydrochlorothiazide label, Contraindications)

  • CelecoxibNSAIDMajor

    • In patients who have demonstrated allergic-type reactions to sulfonamides [ see Warnings and Precautions (5.7) ]. (Celecoxib label, Contraindications)

  • Chloroprocainelocal anestheticMajor

    Therefore, chloroprocaine should not be used in any condition in which a sulfonamide drug is being employed. (Chloroprocaine label, Precautions)

  • Chlorothiazidethiazide diureticMajor

    Hypersensitivity to this product or to other sulfonamide-derived drugs. (Chlorothiazide label, Contraindications)

  • Chlorthalidonethiazide diureticMajor

    THALITONE is contraindicated in patients with anuria or hypersensitivity to chlorthalidone or other sulfonamide-derived drugs. (Chlorthalidone label, Contraindications)

  • CidofovirantiviralMajor

    Cidofovir injection is contraindicated in patients with a history of clinically severe hypersensitivity to probenecid or other sulfa-containing medications. (Cidofovir label, Contraindications)

  • Dichlorphenamidecarbonic anhydrase inhibitorMajor

    KEVEYIS is contraindicated in the following circumstances: Hypersensitivity to dichlorphenamide or other sulfonamides [see Warnings and Precautions (5.1) ] Concomitant use of KEVEYIS and high dose aspirin [see Warnings and Precautions (5.2) and Drug Interactions (7.1) ] Severe pulmonary disease, limiting compensation to metabolic acidosis caused by KEVEYIS [see… (Dichlorphenamide label, Contraindications)

  • DofetilideantiarrhythmicMajor

    The concomitant use of verapamil or the cation transport system inhibitors cimetidine, trimethoprim (alone or in combination with sulfamethoxazole), or ketoconazole with dofetilide is contraindicated (see WARNINGS and PRECAUTIONS, Drug-Drug Interactions ), as each of these drugs cause a substantial increase in dofetilide plasma concentrations. (Dofetilide label, Contraindications)

  • Dutasteride and tamsulosin5-alpha reductase inhibitorMajor

    If a patient reports a serious or life-threatening sulfa allergy, caution is warranted when administering tamsulosin-containing products, including JALYN. (Dutasteride and tamsulosin label, Warnings and precautions)

  • Because of the hydrochlorothiazide component, this product is contraindicated in patients with anuria or hypersensitivity to other sulfonamide-derived drugs. (Enalapril and hydrochlorothiazide label, Contraindications)

  • Folic acid (folate)Vitamin and mineralMajor

    CONTRAINDICATIONS Sulfamethoxazole and trimethoprim is contraindicated in patients with a known hypersensitivity to trimethoprim or sulfonamides, in patients with a history of drug-induced immune thrombocytopenia with use of trimethoprim and/or sulfonamides, and in patients with documented megaloblastic anemia due to folate deficiency. (Sulfamethoxazole and trimethoprim label, Contraindications)

  • Fosinopril sodium and hydrochlorothiazide is also contraindicated in patients who are hypersensitive to fosinopril, to any other ACE inhibitor, to hydrochlorothiazide, or other sulfonamide-derived drugs, or any other ingredient or component in the formulation. (Fosinopril and hydrochlorothiazide label, Contraindications)

  • GlimepiridesulfonylureaMajor

    • Sulfonamide derivatives: Patients who have developed an allergic reaction to sulfonamide derivatives may develop an allergic reaction to glimepiride tablets.Do not use glimepiride tablets in patients who have a history of an allergic reaction to sulfonamide derivatives. (Glimepiride label, Contraindications)

  • GlipizidesulfonylureaMajor

    • Hypersensitivity to sulfonamide derivatives. ▪ Known hypersensitivity to glipizide or any of the product's ingredients ( 4 ). ▪ Hypersensitivity to sulfonamide derivatives ( 4 ). (Glipizide label, Contraindications)

  • Hydrochlorothiazidethiazide diureticMajor

    In patients with hypersensitivity to sulfonamide-derived drugs. (Hydrochlorothiazide label, Contraindications)

  • Indapamidethiazide diureticMajor

    Known hypersensitivity to indapamide or to other sulfonamide-derived drugs. (Indapamide label, Contraindications)

  • Irbesartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Major

    Because of the hydrochlorothiazide component, this product is contraindicated in patients with anuria or hypersensitivity to other sulfonamide-derived drugs. (Irbesartan and hydrochlorothiazide label, Contraindications)

  • Trimethoprim-Sulfamethoxazole Avoid concomitant use of VYKOURA with trimethoprim-sulfamethoxazole . (Leucovorin label, Drug interactions)

  • Because of the hydrochlorothiazide component, this product is contraindicated in patients with anuria or hypersensitivity to other sulfonamide-derived drugs. (Lisinopril and hydrochlorothiazide label, Contraindications)

  • Moderate dual CYP3A4 and CYP2C9 inhibitors (fluconazole, amiodarone) or use of combined CYP3A4 and CYP2C9 inhibitors may increase exposure to macitentan: avoid co-administration with OPSUMIT ( 7.3 , 12.3 ). (Macitentan label, Drug interactions)

  • MecamylamineantihypertensiveMajor

    Patients receiving antibiotics and sulfonamides should generally not be treated with ganglion blockers. (Mecamylamine label, Contraindications)

  • Anuria Hypersensitivity to metoprolol tartrate or hydrochlorothiazide or to other sulfonamide- derived drugs. (Metoprolol and hydrochlorothiazide label, Contraindications)

  • Olmesartan, amlodipine, and hydrochlorothiazideangiotensin II receptor blocker (ARB)Major

    Because of the hydrochlorothiazide component, olmesartan medoxomil, amlodipine and hydrochlorothiazide tablet is contraindicated in patients with anuria, hypersensitivity to any component, or hypersensitivity to other sulfonamide-derived drugs. (Olmesartan, amlodipine, and hydrochlorothiazide label, Contraindications)

  • Pioglitazone and glimepiridethiazolidinedioneMajor

    Use in patients with known history of an allergic reaction to sulfonamide derivatives. (Pioglitazone and glimepiride label, Contraindications)

  • Because of the hydrochlorothiazide components, this product is contraindicated in patients with anuria or hypersensitivity to other sulfonamide-derived drugs. (Quinapril and hydrochlorothiazide label, Contraindications)

  • Dihydrofolate Reductase (DHFR) Inhibitors : Avoid concomitant use (e.g., trimethoprim, methotrexate, trimetrexate, pemetrexed, pralatrexate, raltitrexed, or piritrexim). (Sepiapterin label, Drug interactions)

  • Spironolactone and hydrochlorothiazidealdosterone antagonistMajor

    CONTRAINDICATIONS Spironolactone and hydrochlorothiazide tablets are contraindicated in patients with anuria, acute renal insufficiency, significant impairment of renal excretory function, hypercalcemia, hyperkalemia, Addison's disease, and in patients who are allergic to thiazide diuretics or to other sulfonamide-derived drugs. (Spironolactone and hydrochlorothiazide label, Contraindications)

  • Tamsulosinalpha blockerMajor

    If a patient reports a serious or life-threatening sulfa allergy, caution is warranted when administering tamsulosin hydrochloride capsules. (Tamsulosin label, Warnings and precautions)

  • Triamterene and hydrochlorothiazidepotassium-sparing diureticMajor

    Hypersensitivity Hypersensitivity to either drug in the preparation or to other sulfonamide-derived drugs is a contraindication. (Triamterene and hydrochlorothiazide label, Contraindications)

  • Valsartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Major

    Because of the hydrochlorothiazide component, this product is contraindicated in patients with anuria or hypersensitivity to other sulfonamide-derived drugs. (Valsartan and hydrochlorothiazide label, Contraindications)

Moderate interactions (171)

  • AcarboseantidiabeticModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Acetazolamidecarbonic anhydrase inhibitorModerate

    Drug Interactions In elderly patients concurrently receiving certain diuretics, primarily thiazides, an increased incidence of thrombocytopenia with purpura has been reported. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • AlmotriptantriptanModerate

    Use with caution in patients with a known hypersensitivity to sulfonamides ( 5.8 ) (Almotriptan label, Warnings and precautions)

  • AlogliptinDPP-4 inhibitorModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Alogliptin and metforminDPP-4 inhibitorModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Amiloridepotassium-sparing diureticModerate

    Drug Interactions In elderly patients concurrently receiving certain diuretics, primarily thiazides, an increased incidence of thrombocytopenia with purpura has been reported. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Amitriptylinetricyclic antidepressantModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Amlodipine and benazeprildihydropyridine calcium channel blockerModerate

    In the literature, three cases of hyperkalemia in elderly patients have been reported after concomitant intake of sulfamethoxazole/trimethoprim and an angiotensin converting enzyme inhibitor. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Amoxapinetricyclic antidepressantModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • ApixabananticoagulantModerate

    It has been reported that sulfamethoxazole and trimethoprim may prolong the prothrombin time in patients who are receiving the anticoagulant warfarin. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • ArgatrobananticoagulantModerate

    It has been reported that sulfamethoxazole and trimethoprim may prolong the prothrombin time in patients who are receiving the anticoagulant warfarin. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Articaine and epinephrinelocal anestheticModerate

    Circulatory Shock Circulatory shock with fever, severe hypotension, and confusion requiring intravenous fluid resuscitation and vasopressors has occurred within minutes to hours of re-challenge with trimethoprim-sulfamethoxazole products in patients with history of recent (days to weeks) exposure to sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Warnings)

  • AvanafilPDE5 inhibitorModerate

    HIV Protease inhibitor — Ritonavir (600 mg twice daily), a strong CYP3A4 inhibitor, which also inhibits CYP2C9, increased avanafil 50 mg single-dose C max and AUC equal to approximately 2-fold and 13-fold, and prolonged the half-life of avanafil to approximately 9 hours in healthy volunteers. (Avanafil label, Drug interactions)

  • BenazeprilACE inhibitorModerate

    In the literature, three cases of hyperkalemia in elderly patients have been reported after concomitant intake of sulfamethoxazole/trimethoprim and an angiotensin converting enzyme inhibitor. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • BenzphetamineCNS stimulantModerate

    Circulatory Shock Circulatory shock with fever, severe hypotension, and confusion requiring intravenous fluid resuscitation and vasopressors has occurred within minutes to hours of re-challenge with trimethoprim-sulfamethoxazole products in patients with history of recent (days to weeks) exposure to sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Warnings)

  • BexagliflozinSGLT2 inhibitorModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • BivalirudinanticoagulantModerate

    It has been reported that sulfamethoxazole and trimethoprim may prolong the prothrombin time in patients who are receiving the anticoagulant warfarin. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Brinzolamidecarbonic anhydrase inhibitorModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Bromocriptinedopamine agonistModerate

    Therefore, CYCLOSET may increase the unbound fraction of other concomitantly used highly protein-bound therapies (e.g., salicylates, sulfonamides, chloramphenicol and probenecid), which may alter their effectiveness and risk for side effects. (Bromocriptine label, Drug interactions)

  • Circulatory Shock Circulatory shock with fever, severe hypotension, and confusion requiring intravenous fluid resuscitation and vasopressors has occurred within minutes to hours of re-challenge with trimethoprim-sulfamethoxazole products in patients with history of recent (days to weeks) exposure to sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Warnings)

  • Bumetanideloop diureticModerate

    Drug Interactions In elderly patients concurrently receiving certain diuretics, primarily thiazides, an increased incidence of thrombocytopenia with purpura has been reported. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Bupivacaine and epinephrinelocal anestheticModerate

    Circulatory Shock Circulatory shock with fever, severe hypotension, and confusion requiring intravenous fluid resuscitation and vasopressors has occurred within minutes to hours of re-challenge with trimethoprim-sulfamethoxazole products in patients with history of recent (days to weeks) exposure to sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Warnings)

  • BupropionantidepressantModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • CanagliflozinSGLT2 inhibitorModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • CaptoprilACE inhibitorModerate

    In the literature, three cases of hyperkalemia in elderly patients have been reported after concomitant intake of sulfamethoxazole/trimethoprim and an angiotensin converting enzyme inhibitor. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Carvedilolbeta blockerModerate

    Amiodarone Amiodarone and its metabolite desethyl amiodarone, inhibitors of CYP2C9, and P- glycoprotein increased concentrations of the S(-)-enantiomer of carvedilol by at least 2 fold [see Clinical Pharmacology (12.5) ]. (Carvedilol label, Drug interactions)

  • CitalopramSSRIModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Clomipraminetricyclic antidepressantModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • CyclosporineimmunosuppressantModerate

    There have been reports of marked but reversible nephrotoxicity with coadministration of sulfamethoxazole and trimethoprim and cyclosporine in renal transplant recipients. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • DabigatrananticoagulantModerate

    It has been reported that sulfamethoxazole and trimethoprim may prolong the prothrombin time in patients who are receiving the anticoagulant warfarin. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • DapagliflozinSGLT2 inhibitorModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Dapagliflozin and metforminSGLT2 inhibitorModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • DapsoneModerate

    However, an earlier report 2 also by Lee et al, in 78 HIV infected patients with acute Pneumocystis carinii pneumonia, receiving dapsone, 100 mg/day and higher trimethoprim dose, 20 mg/kg/day, demonstrated that the serum levels of dapsone were increased by 40% and trimethoprim levels were increased by 48% when the drugs were administered concurrently. (Dapsone label, Drug interactions)

  • DarunavirantiretroviralModerate

    Use with caution in patients with a known sulfonamide allergy. (Darunavir label, Warnings and precautions)

  • Darunavir and cobicistatantiretroviralModerate

    Monitor in patients with a known sulfonamide allergy. (Darunavir and cobicistat label, Warnings and precautions)

  • Desipraminetricyclic antidepressantModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • DesvenlafaxineSNRIModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • DiclofenacNSAIDModerate

    Co-administration of diclofenac with CYP2C9 inhibitors (e.g. voriconazole) may enhance the exposure and toxicity of diclofenac whereas co- administration with CYP2C9 inducers (e.g. rifampin) may lead to compromised efficacy of diclofenac. (Diclofenac label, Drug interactions)

  • Co-administration of diclofenac with CYP2C9 inhibitors (e.g., voriconazole) may enhance the exposure and toxicity of diclofenac [see Clinical Pharmacology (12.3) ] whereas co-administration with CYP2C9 inducers (e.g., rifampin) may lead to compromised efficacy of diclofenac. (Diclofenac and misoprostol label, Drug interactions)

  • DiethylpropionCNS stimulantModerate

    Circulatory Shock Circulatory shock with fever, severe hypotension, and confusion requiring intravenous fluid resuscitation and vasopressors has occurred within minutes to hours of re-challenge with trimethoprim-sulfamethoxazole products in patients with history of recent (days to weeks) exposure to sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Warnings)

  • Digoxindigitalis glycosideModerate

    Increased digoxin blood levels can occur with concomitant sulfamethoxazole and trimethoprim therapy, especially in elderly patients. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • DobutaminesympathomimeticModerate

    Circulatory Shock Circulatory shock with fever, severe hypotension, and confusion requiring intravenous fluid resuscitation and vasopressors has occurred within minutes to hours of re-challenge with trimethoprim-sulfamethoxazole products in patients with history of recent (days to weeks) exposure to sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Warnings)

  • Dorzolamidecarbonic anhydrase inhibitorModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Dorzolamide and timololcarbonic anhydrase inhibitorModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Doxepintricyclic antidepressantModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • DronabinolcannabinoidModerate

    Monitor for increased dronabinol-related adverse reactions when dronabinol oral solution is co-administered with inhibitors of CYP2C9 (e.g., amiodarone, fluconazole) and inhibitors of CYP3A4 enzymes (e.g., ketoconazole, itraconazole, clarithromycin, ritonavir, erythromycin, grapefruit juice). (Dronabinol label, Drug interactions)

  • DroxidopasympathomimeticModerate

    Circulatory Shock Circulatory shock with fever, severe hypotension, and confusion requiring intravenous fluid resuscitation and vasopressors has occurred within minutes to hours of re-challenge with trimethoprim-sulfamethoxazole products in patients with history of recent (days to weeks) exposure to sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Warnings)

  • DulaglutideGLP-1 receptor agonistModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • DuloxetineSNRIModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • EdoxabananticoagulantModerate

    It has been reported that sulfamethoxazole and trimethoprim may prolong the prothrombin time in patients who are receiving the anticoagulant warfarin. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • The possibility of interactions with other drugs administered concurrently should be considered, particularly when their main route of elimination is active renal secretion via the organic cationic transport system (e.g., trimethoprim) [see Clinical Pharmacology (12.3) ] . (Efavirenz, lamivudine, and tenofovir label, Drug interactions)

  • Effect of TRIKAFTA on Other Drugs CYP2C9 Substrates Ivacaftor may inhibit CYP2C9; therefore, monitoring of the international normalized ratio (INR) during concomitant use of TRIKAFTA with warfarin is recommended. (Elexacaftor, tezacaftor, and ivacaftor label, Drug interactions)

  • EmpagliflozinSGLT2 inhibitorModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Empagliflozin and metforminSGLT2 inhibitorModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • EnalaprilACE inhibitorModerate

    In the literature, three cases of hyperkalemia in elderly patients have been reported after concomitant intake of sulfamethoxazole/trimethoprim and an angiotensin converting enzyme inhibitor. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • EnalaprilatACE inhibitorModerate

    In the literature, three cases of hyperkalemia in elderly patients have been reported after concomitant intake of sulfamethoxazole/trimethoprim and an angiotensin converting enzyme inhibitor. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • EnoxaparinanticoagulantModerate

    It has been reported that sulfamethoxazole and trimethoprim may prolong the prothrombin time in patients who are receiving the anticoagulant warfarin. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • EphedrinesympathomimeticModerate

    Circulatory Shock Circulatory shock with fever, severe hypotension, and confusion requiring intravenous fluid resuscitation and vasopressors has occurred within minutes to hours of re-challenge with trimethoprim-sulfamethoxazole products in patients with history of recent (days to weeks) exposure to sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Warnings)

  • EpinephrinesympathomimeticModerate

    Circulatory Shock Circulatory shock with fever, severe hypotension, and confusion requiring intravenous fluid resuscitation and vasopressors has occurred within minutes to hours of re-challenge with trimethoprim-sulfamethoxazole products in patients with history of recent (days to weeks) exposure to sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Warnings)

  • Eplerenonealdosterone antagonistModerate

    Drug Interactions In elderly patients concurrently receiving certain diuretics, primarily thiazides, an increased incidence of thrombocytopenia with purpura has been reported. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • EscitalopramSSRIModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Ethacrynic acidloop diureticModerate

    Drug Interactions In elderly patients concurrently receiving certain diuretics, primarily thiazides, an increased incidence of thrombocytopenia with purpura has been reported. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • ExenatideGLP-1 receptor agonistModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • FenoprofenNSAIDModerate

    Intervention: Patients receiving hydantoins, sulfonamides, or sulfonylureas should be observed for increased activity of these drugs and, therefore, signs of toxicity from these drugs. (Fenoprofen label, Drug interactions)

  • FluoxetineSSRIModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • FluvoxamineSSRIModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • FondaparinuxanticoagulantModerate

    It has been reported that sulfamethoxazole and trimethoprim may prolong the prothrombin time in patients who are receiving the anticoagulant warfarin. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • FosamprenavirantiretroviralModerate

    Fosamprenavir calcium should be used with caution in patients with a known sulfonamide allergy. (Fosamprenavir label, Warnings and precautions)

  • FosinoprilACE inhibitorModerate

    In the literature, three cases of hyperkalemia in elderly patients have been reported after concomitant intake of sulfamethoxazole/trimethoprim and an angiotensin converting enzyme inhibitor. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • FosphenytoinanticonvulsantModerate

    …Antidepressants Fluoxetine, fluvoxamine, sertraline Gastric acid reducing agents H 2 antagonists (cimetidine), omeprazole Sulfonamides Sulfamethizole, sulfaphenazole, sulfadiazine, sulfamethoxazole-trimethoprim Other Acute alcohol intake, amiodarone, chloramphenicol, chlordiazepoxide, disulfiram, estrogen, fluvastatin, isoniazid, methylphenidate, phenothiazines,… (Fosphenytoin label, Drug interactions)

  • Furosemideloop diureticModerate

    Drug Interactions In elderly patients concurrently receiving certain diuretics, primarily thiazides, an increased incidence of thrombocytopenia with purpura has been reported. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • GanciclovirantiviralModerate

    Other drugs associated with myelosuppression or nephrotoxicity (e.g., dapsone, doxorubicin, flucytosine, hydroxyurea, pentamidine, tacrolimus, trimethoprim/ sulfamethoxazole, vinblastine, vincristine and zidovudine) Unknown Because of potential for higher toxicity, coadministration with Ganciclovir should be considered only if the potential benefits are judged… (Ganciclovir label, Drug interactions)

  • Glipizide and metforminsulfonylureaModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • GlyburidesulfonylureaModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Glyburide and metforminsulfonylureaModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • HeparinanticoagulantModerate

    It has been reported that sulfamethoxazole and trimethoprim may prolong the prothrombin time in patients who are receiving the anticoagulant warfarin. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Imipraminetricyclic antidepressantModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • IndomethacinNSAIDModerate

    Increased sulfamethoxazole blood levels may occur in patients who are also receiving indomethacin. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Insulin aspartinsulinModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Insulin degludecinsulinModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Insulin detemirinsulinModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Insulin glargineinsulinModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Insulin lisproinsulinModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Isoproterenolbeta-adrenergic agonistModerate

    Circulatory Shock Circulatory shock with fever, severe hypotension, and confusion requiring intravenous fluid resuscitation and vasopressors has occurred within minutes to hours of re-challenge with trimethoprim-sulfamethoxazole products in patients with history of recent (days to weeks) exposure to sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Warnings)

  • LacosamideanticonvulsantModerate

    Strong CYP3A4 or CYP2C9 Inhibitors Patients with renal or hepatic impairment who are taking strong inhibitors of CYP3A4 and CYP2C9 may have a significant increase in exposure to VIMPAT. (Lacosamide label, Drug interactions)

  • LamivudineantiretroviralModerate

    The possibility of interactions with other drugs administered concurrently should be considered, particularly when their main route of elimination is active renal secretion via the organic cationic transport system (e.g., trimethoprim) [see Clinical Pharmacology (12.3)]. (Lamivudine label, Drug interactions)

  • Drug Interaction with Trimethoprim-Sulfamethoxazole : Increased rates of treatment failure and morbidity with concomitant use of d, l -leucovorin with trimethoprim-sulfamethoxazole for Pneumocystis jiroveci pneumonia in patients with HIV. (Levoleucovorin label, Warnings and precautions)

  • LevomilnacipranSNRIModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Lidocaine and epinephrinelocal anestheticModerate

    Circulatory Shock Circulatory shock with fever, severe hypotension, and confusion requiring intravenous fluid resuscitation and vasopressors has occurred within minutes to hours of re-challenge with trimethoprim-sulfamethoxazole products in patients with history of recent (days to weeks) exposure to sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Warnings)

  • LinagliptinDPP-4 inhibitorModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Linagliptin and metforminDPP-4 inhibitorModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • LiraglutideGLP-1 receptor agonistModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • LisinoprilACE inhibitorModerate

    In the literature, three cases of hyperkalemia in elderly patients have been reported after concomitant intake of sulfamethoxazole/trimethoprim and an angiotensin converting enzyme inhibitor. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • LoperamideQT-prolonging drugModerate

    CYP2C8 Inhibitors Gemfibrozil When a single 4 mg dose of loperamide hydrochloride was coadministered with 600 mg gemfibrozil, a strong inhibitor of CYP2C8, on day 3 of a 5-day treatment with gemfibrozil twice daily, the mean peak plasma concentration and the systemic exposure to loperamide was increased by 1.6-fold and 2.2-fold, respectively. (Loperamide label, Drug interactions)

  • Losartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate

    Drug Interactions In elderly patients concurrently receiving certain diuretics, primarily thiazides, an increased incidence of thrombocytopenia with purpura has been reported. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • MeloxicamNSAIDModerate

    Thus concomitant usage of CYP2C9 inhibitors (such as amiodarone, fluconazole, and sulphaphenazole) may lead to abnormally high plasma levels of meloxicam due to reduced metabolic clearance [ see Use in Specific Populations ( 8.8 ); and Clinical Pharmacology ( 12.3 , 12.5 ) ]. (Meloxicam label, Drug interactions)

  • Mepivacainelocal anestheticModerate

    …procaine, ropivacaine, tetracaine Antineoplastic agents cyclophosphamide, flutamide, hydroxyurea, ifosfamide, rasburicase Antibiotics dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamides Antimalarials chloroquine, primaquine Anticonvulsants phenobarbital, phenytoin, sodium valproate Other drugs acetaminophen, metoclopramide, quinine, sulfasalazine (Mepivacaine label, Drug interactions)

  • MercaptopurineantimetaboliteModerate

    Enhanced myelosuppression has been noted in some patients also receiving trimethoprim-sulfamethoxazole. (Mercaptopurine label, Drug interactions)

  • MetforminbiguanideModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • MethamphetamineCNS stimulantModerate

    Circulatory Shock Circulatory shock with fever, severe hypotension, and confusion requiring intravenous fluid resuscitation and vasopressors has occurred within minutes to hours of re-challenge with trimethoprim-sulfamethoxazole products in patients with history of recent (days to weeks) exposure to sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Warnings)

  • Methazolamidecarbonic anhydrase inhibitorModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • MethotrexateimmunosuppressantModerate

    Trimethoprim/sulfamethoxazole has been reported to increase bone marrow suppression in patients receiving methotrexate. (Methotrexate label, Drug interactions)

  • Metolazonethiazide diureticModerate

    Drug Interactions In elderly patients concurrently receiving certain diuretics, primarily thiazides, an increased incidence of thrombocytopenia with purpura has been reported. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Midodrinealpha-adrenergic agonistModerate

    Circulatory Shock Circulatory shock with fever, severe hypotension, and confusion requiring intravenous fluid resuscitation and vasopressors has occurred within minutes to hours of re-challenge with trimethoprim-sulfamethoxazole products in patients with history of recent (days to weeks) exposure to sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Warnings)

  • MifepristoneCYP3A4 inhibitorModerate

    Drugs Metabolized by CYP2C8/2C9 Because mifepristone is an inhibitor of CYP2C8/2C9, concurrent use of mifepristone with a drug whose metabolism is largely or solely mediated by CYP2C8/2C9 is likely to result in increased plasma concentrations of the drug. (Mifepristone label, Drug interactions)

  • MiglitolantidiabeticModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Mirabegronbeta-adrenergic agonistModerate

    Circulatory Shock Circulatory shock with fever, severe hypotension, and confusion requiring intravenous fluid resuscitation and vasopressors has occurred within minutes to hours of re-challenge with trimethoprim-sulfamethoxazole products in patients with history of recent (days to weeks) exposure to sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Warnings)

  • MirtazapineantidepressantModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • ModafinilCNS stimulantModerate

    Circulatory Shock Circulatory shock with fever, severe hypotension, and confusion requiring intravenous fluid resuscitation and vasopressors has occurred within minutes to hours of re-challenge with trimethoprim-sulfamethoxazole products in patients with history of recent (days to weeks) exposure to sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Warnings)

  • MoexiprilACE inhibitorModerate

    In the literature, three cases of hyperkalemia in elderly patients have been reported after concomitant intake of sulfamethoxazole/trimethoprim and an angiotensin converting enzyme inhibitor. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • MycophenolateimmunosuppressantModerate

    Examples Cyclosporine A, trimethoprim/sulfamethoxazole, bile acid sequestrants (cholestyramine), rifampin as well as aminoglycoside, cephalosporin, fluoroquinolone and penicillin classes of antimicrobials Drugs Modulating Glucuronidation Clinical Impact Concomitant use with drugs inducing glucuronidation decreases MPA systemic exposure, potentially reducing mycophenolate… (Mycophenolate label, Drug interactions)

  • Naltrexone and bupropionopioid antagonistModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • NateglinidemeglitinideModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • NefazodoneantidepressantModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Nortriptylinetricyclic antidepressantModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Olanzapine and fluoxetineantipsychoticModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Olmesartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate

    Drug Interactions In elderly patients concurrently receiving certain diuretics, primarily thiazides, an increased incidence of thrombocytopenia with purpura has been reported. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • OxymetazolinedecongestantModerate

    Circulatory Shock Circulatory shock with fever, severe hypotension, and confusion requiring intravenous fluid resuscitation and vasopressors has occurred within minutes to hours of re-challenge with trimethoprim-sulfamethoxazole products in patients with history of recent (days to weeks) exposure to sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Warnings)

  • ParoxetineSSRIModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • PerindoprilACE inhibitorModerate

    In the literature, three cases of hyperkalemia in elderly patients have been reported after concomitant intake of sulfamethoxazole/trimethoprim and an angiotensin converting enzyme inhibitor. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • PhendimetrazineCNS stimulantModerate

    Circulatory Shock Circulatory shock with fever, severe hypotension, and confusion requiring intravenous fluid resuscitation and vasopressors has occurred within minutes to hours of re-challenge with trimethoprim-sulfamethoxazole products in patients with history of recent (days to weeks) exposure to sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Warnings)

  • PhenelzineMAO inhibitorModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • PhentermineCNS stimulantModerate

    Circulatory Shock Circulatory shock with fever, severe hypotension, and confusion requiring intravenous fluid resuscitation and vasopressors has occurred within minutes to hours of re-challenge with trimethoprim-sulfamethoxazole products in patients with history of recent (days to weeks) exposure to sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Warnings)

  • PhenylephrinedecongestantModerate

    Circulatory Shock Circulatory shock with fever, severe hypotension, and confusion requiring intravenous fluid resuscitation and vasopressors has occurred within minutes to hours of re-challenge with trimethoprim-sulfamethoxazole products in patients with history of recent (days to weeks) exposure to sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Warnings)

  • PhenytoinanticonvulsantModerate

    Sulfamethoxazole and trimethoprim, given at a common clinical dosage, increased the phenytoin half-life by 39% and decreased the phenytoin metabolic clearance rate by 27%. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • PioglitazonethiazolidinedioneModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Pioglitazone and metforminthiazolidinedioneModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • In a separate survey, Brumfitt and Pursell also found no congenital abnormalities in 35 children whose mothers had received oral trimethoprim and sulfamethoxazole at the time of conception or shortly thereafter. (Polymyxin B and trimethoprim ophthalmic label, Precautions)

  • Prilocaine and epinephrinelocal anestheticModerate

    Circulatory Shock Circulatory shock with fever, severe hypotension, and confusion requiring intravenous fluid resuscitation and vasopressors has occurred within minutes to hours of re-challenge with trimethoprim-sulfamethoxazole products in patients with history of recent (days to weeks) exposure to sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Warnings)

  • ProbenecidModerate

    Probenecid produces an insignificant increase in free sulfonamide plasma concentrations but a significant increase in total sulfonamide plasma levels. (Probenecid label, Drug interactions)

  • Probenecid produces an insignificant increase in free sulfonamide plasma concentrations but a significant increase in total sulfonamide plasma levels. (Probenecid and colchicine label, Drug interactions)

  • Protriptylinetricyclic antidepressantModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • PseudoephedrinedecongestantModerate

    Circulatory Shock Circulatory shock with fever, severe hypotension, and confusion requiring intravenous fluid resuscitation and vasopressors has occurred within minutes to hours of re-challenge with trimethoprim-sulfamethoxazole products in patients with history of recent (days to weeks) exposure to sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Warnings)

  • PyrimethamineantimalarialModerate

    Occasional reports suggest that patients receiving pyrimethamine as malaria prophylaxis in doses exceeding 25 mg weekly may develop megaloblastic anemia if sulfamethoxazole and trimethoprim is prescribed. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • QuinaprilACE inhibitorModerate

    In the literature, three cases of hyperkalemia in elderly patients have been reported after concomitant intake of sulfamethoxazole/trimethoprim and an angiotensin converting enzyme inhibitor. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Ramelteonsedative-hypnoticModerate

    Fluconazole (strong CYP2C9 inhibitor): Increases systemic exposure of ramelteon; administer with caution. (Ramelteon label, Drug interactions)

  • RamiprilACE inhibitorModerate

    In the literature, three cases of hyperkalemia in elderly patients have been reported after concomitant intake of sulfamethoxazole/trimethoprim and an angiotensin converting enzyme inhibitor. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • RepaglinidemeglitinideModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • RifabutinantibioticModerate

    ND ↓ AUC by 27 – 40% Sulfamethoxazole-Trimethoprim 800/160 mg 300 mg once a day HIV-infected patients (12) ↔ ↓ AUC by 15–20% ANTI-MAC (Mycobacterium avium intracellulare complex) Azithromycin 500 mg once a day for 1 day, then 250 mg once a day for 9 days 300 mg once a day Healthy subjects (6) ↔ ↔ Clarithromycin 500 mg twice a day 300 mg once a day HIV-infected… (Rifabutin label, Drug interactions)

  • RivaroxabananticoagulantModerate

    It has been reported that sulfamethoxazole and trimethoprim may prolong the prothrombin time in patients who are receiving the anticoagulant warfarin. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Ropivacainelocal anestheticModerate

    …procaine, ropivacaine, tetracaine Antineoplastic agents cyclophosphamide, flutamide, hydroxyurea, ifosfamide, rasburicase Antibiotics dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamides Antimalarials chloroquine, primaquine Anticonvulsants Phenobarbital, phenytoin, sodium valproate Other drugs acetaminophen, metoclopramide, quinine, sulfasalazine NAROPIN… (Ropivacaine label, Drug interactions)

  • RosuvastatinstatinModerate

    Rosuvastatin plasma levels can be significantly increased with concomitant administration of inhibitors of CYP2C9 and transporters. (Rosuvastatin label, Drug interactions)

  • SapropterinModerate

    Inhibitors of Folate Synthesis (e.g., methotrexate, valproic acid, phenobarbital, trimethoprim) Clinical Impact In vitro and in vivo nonclinical data suggest that drugs that inhibit folate synthesis may decrease the bioavailability of endogenous BH4 by inhibiting the enzyme dihydrofolate reductase, which is involved in the recycling (regeneration) of BH4. (Sapropterin label, Drug interactions)

  • SaxagliptinDPP-4 inhibitorModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Saxagliptin and metforminDPP-4 inhibitorModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • SemaglutideGLP-1 receptor agonistModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • SertralineSSRIModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Silver sulfadiazinesulfonamideModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • SitagliptinDPP-4 inhibitorModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Sitagliptin and metforminDPP-4 inhibitorModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Spironolactonealdosterone antagonistModerate

    Drug Interactions In elderly patients concurrently receiving certain diuretics, primarily thiazides, an increased incidence of thrombocytopenia with purpura has been reported. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • SulfadiazinesulfonamideModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • SulfasalazinesulfonamideModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Telmisartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate

    Drug Interactions In elderly patients concurrently receiving certain diuretics, primarily thiazides, an increased incidence of thrombocytopenia with purpura has been reported. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • TerbinafineantifungalModerate

    The influence of terbinafine on the pharmacokinetics of fluconazole, cotrimoxazole (trimethoprim and sulfamethoxazole), zidovudine or theophylline was not considered to be clinically significant. (Terbinafine label, Drug interactions)

  • TirzepatideGLP-1 receptor agonistModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Torsemideloop diureticModerate

    Drug Interactions In elderly patients concurrently receiving certain diuretics, primarily thiazides, an increased incidence of thrombocytopenia with purpura has been reported. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • TrandolaprilACE inhibitorModerate

    In the literature, three cases of hyperkalemia in elderly patients have been reported after concomitant intake of sulfamethoxazole/trimethoprim and an angiotensin converting enzyme inhibitor. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • TranylcypromineMAO inhibitorModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • TrazodoneantidepressantModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Triamterenepotassium-sparing diureticModerate

    Drug Interactions In elderly patients concurrently receiving certain diuretics, primarily thiazides, an increased incidence of thrombocytopenia with purpura has been reported. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Trimipraminetricyclic antidepressantModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • ValganciclovirantiviralModerate

    Other drugs associated with myelosuppression or nephrotoxicity (e.g., adriamycin, dapsone, doxorubicin, flucytosine, hydroxyurea, pentamidine, tacrolimus, trimethoprim/ sulfamethoxazole, vinblastine, vincristine, and zidovudine) Unknown Because of potential for higher toxicity, coadministration with valganciclovir hydrochloride should be considered only if the… (Valganciclovir label, Drug interactions)

  • VenlafaxineSNRIModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Vibegronbeta-adrenergic agonistModerate

    Circulatory Shock Circulatory shock with fever, severe hypotension, and confusion requiring intravenous fluid resuscitation and vasopressors has occurred within minutes to hours of re-challenge with trimethoprim-sulfamethoxazole products in patients with history of recent (days to weeks) exposure to sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Warnings)

  • VilazodoneSSRIModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • VortioxetineantidepressantModerate

    The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • WarfarinanticoagulantModerate

    It has been reported that sulfamethoxazole and trimethoprim may prolong the prothrombin time in patients who are receiving the anticoagulant warfarin. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Zafirlukastleukotriene receptor antagonistModerate

    Zafirlukast exposure is likely to be increased by other moderate and strong CYP2C9 inhibitors. (Zafirlukast label, Precautions)

  • ZonisamideanticonvulsantModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

Minor mentions (12)

  • AmantadineanticholinergicMinor

    In the literature, a single case of toxic delirium has been reported after concomitant intake of sulfamethoxazole/trimethoprim and amantadine. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Amoxicillinpenicillin antibioticMinor

    Other Antibacterials Chloramphenicol, macrolides, sulfonamides, and tetracyclines may interfere with the bactericidal effects of penicillin. (Amoxicillin label, Drug interactions)

  • Ampicillinpenicillin antibioticMinor

    Bacteriostatic Antibiotics : Chloramphenicol, erythromycins, sulfonamides, or tetracyclines may interfere with the bactericidal effect of penicillins. (Ampicillin label, Drug interactions)

  • AtazanavirantiretroviralMinor

    Atazanavir is a weak inhibitor of CYP2C8. (Atazanavir label, Drug interactions)

  • Clopidogrelantiplatelet agentMinor

    However, at high concentrations in vitro , clopidogrel inhibits CYP2C9. (Clopidogrel label, Drug interactions)

  • LeflunomideimmunosuppressantMinor

    Effect on CYP2C8 Substrates Teriflunomide is an inhibitor of CYP2C8 in vivo . (Leflunomide label, Drug interactions)

  • Lopinavir and ritonavirantiretroviralMinor

    Based on known metabolic profiles, clinically significant drug interactions are not expected between KALETRA and dapsone, trimethoprim/sulfamethoxazole, azithromycin, erythromycin, or fluconazole. (Lopinavir and ritonavir label, Drug interactions)

  • Methylene blueMAO inhibitorMinor

    Lack of Effectiveness Methemoglobinemia may not resolve or may rebound after response to treatment with PROVAYBLUE in patients with methemoglobinemia due to aryl amines such as aniline or sulfa drugs such as dapsone. (Methylene blue label, Warnings and precautions)

  • Penicillin Gpenicillin antibioticMinor

    Drug Interactions Bacteriostatic antibacterials ( i.e. , chloramphenicol, erythromycins, sulfonamides or tetracyclines) may antagonize the bactericidal effect of penicillin, and concurrent use of these drugs should be avoided. (Penicillin G label, Drug interactions)

  • TeriflunomideimmunosuppressantMinor

    Effect of AUBAGIO on CYP2C8 Substrates Teriflunomide is an inhibitor of CYP2C8 in vivo . (Teriflunomide label, Drug interactions)

  • Toremifeneselective estrogen receptor modulatorMinor

    Toremifene is a weak inhibitor of CYP2C9. (Toremifene label, Drug interactions)

  • VardenafilPDE5 inhibitorMinor

    The interaction is a consequence of blocking hepatic metabolism of vardenafil by ritonavir, a HIV protease inhibitor and a highly strong CYP3A4 inhibitor, which also inhibits CYP2C9. (Vardenafil label, Drug interactions)

No significant interaction reported (2)

  • AminophyllinemethylxanthineNo interaction

    …table. albuterol, systemic and inhaled amoxicillin ampicillin, with or without sulbactam atenolol azithromycin caffeine, dietary ingestion cefaclor co-trimoxazole (trimethoprim and sulfamethoxazole) diltiazem dirithromycin enflurane famotidine felodipine finasteride hydrocortisone isoflurane isoniazid isradipine influenza vaccine ketoconazole lomefloxacin mebendazole… (Aminophylline label, Drug interactions)

  • TheophyllinemethylxanthineNo interaction

    …without methylprednisolone sulbactam metronidazole atenolol metoprolol azithromycin nadolol caffeine, dietary ingestion nifedipine cefaclor nizatidine co-trimoxazole (trimethoprim and sulfamethoxazole) norfloxacin ofloxacin diltiazem omeprazole dirithromycin prednisone, prednisolone enflurane ranitidine famotidine rifabutin felodipine roxithromycin finasteride Sorbitol… (Theophylline label, Drug interactions)

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Not medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.