Sulfamethoxazole and trimethoprim interactions
Sulfamethoxazole and trimethoprim (Bactrim, Septra), a sulfonamide has 135 documented interactions across the FDA labels and fact sheets we index: 17 major, 109 moderate, 8 minor, and 1 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.
Major interactions (17)
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)
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)
• In patients who have demonstrated allergic-type reactions to sulfonamides [ see Warnings and Precautions (5.7) ]. (Celecoxib label, Contraindications)
THALITONE is contraindicated in patients with anuria or hypersensitivity to chlorthalidone or other sulfonamide-derived drugs. (Chlorthalidone label, Contraindications)
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)
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)
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)
• 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)
• Hypersensitivity to sulfonamide derivatives. ▪ Known hypersensitivity to glipizide or any of the product's ingredients ( 4 ). ▪ Hypersensitivity to sulfonamide derivatives ( 4 ). (Glipizide label, Contraindications)
In patients with hypersensitivity to sulfonamide-derived drugs. (Hydrochlorothiazide label, Contraindications)
Known hypersensitivity to indapamide or to other sulfonamide-derived drugs. (Indapamide label, Contraindications)
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)
- MacitentanMajor
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)
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)
If a patient reports a serious or life-threatening sulfa allergy, caution is warranted when administering tamsulosin hydrochloride capsules. (Tamsulosin label, Warnings and precautions)
Hypersensitivity Hypersensitivity to either drug in the preparation or to other sulfonamide-derived drugs is a contraindication. (Triamterene and hydrochlorothiazide label, Contraindications)
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 (109)
Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)
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)
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)
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)
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)
- 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)
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)
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)
The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (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)
- 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)
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)
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)
Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (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)
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)
Increased digoxin blood levels can occur with concomitant sulfamethoxazole and trimethoprim therapy, especially in elderly patients. (Sulfamethoxazole and trimethoprim label, Drug interactions)
- 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)
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)
Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)
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)
- Elexacaftor, tezacaftor, and ivacaftorModerate
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)
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)
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)
- 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)
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)
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)
- 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)
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)
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)
Increased sulfamethoxazole blood levels may occur in patients who are also receiving indomethacin. (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)
- 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)
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)
- Insulin regular (human)insulinModerate
Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)
- 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)
- LevomilnacipranSNRIModerate
The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (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)
Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)
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)
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)
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)
Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)
Trimethoprim/sulfamethoxazole has been reported to increase bone marrow suppression in patients receiving methotrexate. (Methotrexate label, Drug interactions)
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)
- 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)
The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim 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)
- 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 MYHIBBIN… (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)
The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)
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)
- PhenelzineMAO inhibitorModerate
The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim 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)
- 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)
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)
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)
- Polymyxin B and trimethoprim ophthalmicantibioticModerate
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)
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)
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)
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)
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)
Rosuvastatin plasma levels can be significantly increased with concomitant administration of inhibitors of CYP2C9 and transporters. (Rosuvastatin label, Drug interactions)
Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)
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)
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)
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)
- SulfasalazinesulfonamideModerate
Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)
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)
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)
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)
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)
The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)
The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)
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)
Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)
Minor mentions (8)
- 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)
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)
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)
- 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)
- 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 (1)
…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)
Check Sulfamethoxazole and trimethoprim against everything you take. Add your full list; every pair is checked at once.
Open in the checkerNot 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.