Can a Massage During Bactrim Use Cause Hives
What is Bactrim (sulfamethoxazole and trimethoprim)?
Bactrim (sulfamethoxazole and trimethoprim) is a combination of antibiotics used to care for infections due to susceptible bacteria. Examples include urinary tract infections, flares of chronic bronchitis due to bacteria, middle ear infections, for prevention of infections due to pneumococcus in organ transplant recipients, for the treatment or prevention of Pneumocystis carinii pneumonia, chancroid, and prevention of toxoplasma encephalitis in patients with AIDS.
Sulfamethoxazole is an anti-bacterial sulfonamide (a "sulfa" drug) that disrupts the product of dihydrofolic acid, while trimethoprim disrupts the product of tetrahydrofolic acrid. Dihydrofolic acid and tetrahydrofolic acrid are forms of folic acid that bacteria and human cells use for producing proteins. Trimethoprim inhibits production of tetrahydrofolic acid by inhibiting the enzyme responsible for making tetrahydrofolic acid from dihydrofolic acid.
By combining both drugs, ii of import steps required in the production of bacterial proteins are interrupted, and the combination is more effective than either drug alone.
Mutual side furnishings of Bactrim include:
- dizziness,
- headache,
- languor,
- diarrhea,
- loss of ambition,
- nausea,
- vomiting, and
- rash.
Serious side effects of Bactrim include:
- liver harm,
- low white claret cell count,
- low platelet count (thrombocytopenia), and
- anemia.
Drug interactions of Bactrim include warfarin, because Bactrim enhances its blood-thinning effects, possibly leading to bleeding.
Sulfonamides such as sulfamethoxazole can add together to the kidney damage acquired past cyclosporines. All sulfonamides can crystallize in urine when the urine is acidic. Since methenamine causes an acidic urine, it should not be used with sulfonamides.
Blood levels of phenytoin may be increased by treatment with Bactrim and can lead to dizziness and reduced attention. Bactrim also may increase blood levels of digoxin and maybe lead to serious toxic furnishings.
Anemia can occur in persons receiving Bactrim in combination with divalproex, valproic acrid, methotrexate, pyrimethamine, triamterene, or trimetrexate.
Increased blood levels of potassium may occur when Bactrim is combined with ACE inhibitors.
Use of sulfonamides may cause bilirubin to be displaced from proteins in the infant's blood. Displacement of bilirubin can lead to jaundice and a dangerous condition called kernicterus in the infant. For this reason, Bactrim should not exist used most term (late in pregnancy) amongst women.
Bactrim should not be used by breastfeeding mothers because sulfamethoxazole is excreted in milk and can crusade kernicterus.
What are the important side furnishings of Bactrim (sulfamethoxazole and trimethoprim)?
Common side effects of sulfamethoxazole/trimethoprim are:
- dizziness,
- headache,
- lethargy,
- diarrhea,
- anorexia,
- nausea,
- vomiting, and
- rash.
Other side effects include:
- liver damage,
- depression white blood cell count,
- low platelet count (thrombocytopenia), and
- anemia.
Bactrim (sulfamethoxazole and trimethoprim) side furnishings list for healthcare professionals
The following serious adverse reactions are described elsewhere in the labeling:
- Embryo-fetal Toxicity
- Hypersensitivity and Other Fatal Reactions
- Thrombocytopenia
- Clostridium difficile-Associated Diarrhea
- Sulfite Sensitivity
- Risk Associated with Concurrent Use of Leucovorin for Pneumocystis jirovecii Pneumonia
- Infusion Reactions
- Hypoglycemia
- Electrolyte Abnormalities
Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot exist directly compared to rates in the clinical trials of some other drug and may not reflect the rates observed in practice.
The almost mutual agin reactions are gastrointestinal disturbances (nausea, vomiting, and anorexia) and allergic skin reactions (such equally rash and urticaria).
Local reaction, hurting and slight irritation on intravenous (Iv) administration are infrequent. Thrombophlebitis has been observed.
Table 3: Adverse Reactions Reported with Bactrim
| Body Arrangement | Adverse Reactions |
| Hematologic |
|
| Allergic Reactions |
|
| Gastrointestinal |
|
| Genitourinary |
|
| Metabolic and Nutritional |
|
| Neurologic |
|
| Psychiatric |
|
| Endocrine |
|
| Musculoskeletal |
|
| Respiratory |
|
| Miscellaneous |
|
| Eye Disorders |
|
Postmarketing Feel
The following agin reactions have been identified during postal service-blessing use of Bactrim. Because these reactions were reported voluntarily from a population of uncertain size, it is not possible to reliably approximate their frequency or constitute a causal relationship to drug exposure:
- Thrombotic thrombocytopenia purpura
- Idiopathic thrombocytopenic purpura
- QT prolongation resulting in ventricular tachycardia and torsade de pointes
What drugs collaborate with Bactrim (sulfamethoxazole and trimethoprim)?
Potential For Bactrim To Bear on Other Drugs
Trimethoprim is an inhibitor of CYP2C8 besides equally OCT2 transporter. Sulfamethoxazole is an inhibitor of CYP2C9. Avoid coadministration of Bactrim with drugs that are substrates of CYP2C8 and 2C9 or OCT2.
Table 4: Drug Interactions with Bactrim
| Drug(s) | Recommendation | Comments |
| Diuretics | Avoid concurrent use | In elderly patients concurrently receiving certain diuretics, primarily thiazides, an increased incidence of thrombocytopenia with purpura has been reported. |
| Warfarin | Monitor prothrombin time and INR | It has been reported that Bactrim may prolong the prothrombin time in patients who are receiving the anticoagulant warfarin (a CYP2C9 substrate). This interaction should be kept in mind when Bactrim is given to patients already on anticoagulant therapy, and the coagulation time should be reassessed. |
| Phenytoin | Monitor serum phenytoin levels | Bactrim may inhibit the hepatic metabolism of phenytoin (a CYP2C9 substrate). Bactrim, given at a mutual clinical dosage, increased the phenytoin half-life by 39% and decreased the phenytoin metabolic clearance rate past 27%. When administering these drugs concurrently, ane should be alert for possible excessive phenytoin upshot. |
| Methotrexate | Avoid concurrent use | Sulfonamides can too readapt methotrexate from plasma protein binding sites and can compete with the renal transport of methotrexate, thus increasing costless methotrexate concentrations. |
| Cyclosporine | Avoid concurrent apply | There have been reports of marked just reversible nephrotoxicity with coadministration of Bactrim and cyclosporine in renal transplant recipients. |
| Digoxin | Monitor serum digoxin levels | Increased digoxin claret levels can occur with concomitant Bactrim therapy, especially in elderly patients |
| Indomethacin | Avoid concurrent use | Increased sulfamethoxazole blood levels may occur in patients who are also receiving indomethacin. |
| Pyrimethamine | Avoid concurrent utilize | Occasional reports suggest that patients receiving pyrimethamine equally malaria prophylaxis in doses exceeding 25 mg weekly may develop megaloblastic anemia if Bactrim is prescribed. |
| Tricyclic Antidepressants (TCAs) | Monitor therapeutic response and accommodate dose of TCA appropriately | The efficacy of tricyclic antidepressants tin decrease when coadministered with Bactrim. |
| Oral hypoglycemics | Monitor blood glucose more ofttimes | Like other sulfonamide-containing drugs, Bactrim potentiates the effect of oral hypoglycemic that are metabolized by CYP2C8 (due east.g., pioglitazone, repaglinide, and rosiglitazone) or CYP2C9 (e.g., glipizide and glyburide) or eliminated renally via OCT2 (e.g., metformin). Boosted monitoring of claret glucose may be warranted. |
| Amantadine | Avoid concurrent utilise | In the literature, a unmarried case of toxic delirium has been reported subsequently concomitant intake of Bactrim and amantadine (an OCT2 substrate). Cases of interactions with other OCT2 substrates, memantine and metformin, accept also been reported. |
| Angiotensin Converting Enzyme Inhibitors | Avoid concurrent use | In the literature, three cases of hyperkalemia in elderly patients have been reported after concomitant intake of Bactrim and an angiotensin converting enzyme inhibitor.6,7 |
| Zidovudine | Monitor for hematologic toxicity | Zidovudine and Bactrim are known to induce hematological abnormalities. Hence, there is potential for an additive myelotoxicity when coadministered.8 |
| Dofetilide | Concurrent assistants is contraindicated | Elevated plasma concentrations of dofetilide have been reported post-obit concurrent administration of trimethoprim and dofetilide. Increased plasma concentrations of dofetilide may cause serious ventricular arrhythmias associated with QT interval prolongation, including torsade de pointes.ii,3 |
| Procainamide | Closely monitor for clinical and ECG signs of procainamide toxicity and/or procainamide plasma concentration if available | Trimethoprim increases the plasma concentrations of procainamide and its active Northward-acetyl metabolite (NAPA) when trimethoprim and procainamide are coadministered. The increased procainamide and NAPA plasma concentrations that resulted from the pharmacokinetic interaction with trimethoprim are associated with further prolongation of the QTc interval.9 |
Interactions With Laboratory Or Diagnostic Testing
Bactrim, specifically the trimethoprim component, can interfere with a serum methotrexate assay as determined by the competitive binding poly peptide technique (CBPA) when a bacterial dihydrofolate reductase is used as the bounden poly peptide. No interference occurs, however, if methotrexate is measured by a radioimmunoassay (RIA).
The presence of Bactrim may also interfere with the Jaffé alkaline picrate reaction assay for creatinine, resulting in overestimations of about 10% in the range of normal values.
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Treatment & Diagnosis
Medications & Supplements
Written report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call one-800-FDA-1088.
Medically Reviewed on 5/8/2020
References
FDA Prescribing Information
Professional person side effects and drug interactions sections courtesy of the U.South. Food and Drug Assistants.
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5. London NJ, Garg SJ, Moorthy RS, Cunningham ET. Drug-induced uveitis. J Ophthalmic Inflamm Infect. 2013;three:43.
vi. Marinella MA. Trimethoprim-induced hyperkalemia: An assay of reported cases. Gerontol. 1999;45:209–212.
seven. Margassery Due south, Bastani B. Life threatening hyperkalemia and acidosis secondary to trimethoprimsulfamethoxazole treatment. J. Nephrol. 2001;14(5):410-414.
8. Moh R, et al. Haematological changes in adults receiving a zidovudine-containing HAART regimen in combination with cotrimoxazole in Côte d'Ivoire. Antivir Ther. 2005;ten(5):615-24.
9. Kosoglou T, Rocci ML Jr, Vlasses PH. Trimethoprim alters the disposition of procainamide and Nacetylprocainamide. Clin Pharmacol Ther. Oct 1988;44(4):467-77.
Source: https://www.medicinenet.com/side_effects_of_bactrim/side-effects.htm
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