Predictions about the interaction can be made based on the metabolic pathways of both drugs. The risk for trimethoprim-associated hyperkalemia is greatest in patients with additional risk factors for hyperkalemia such as age greater than 65 years, those with underlying disorders of potassium metabolism, renal insufficiency, or those requiring high doses of trimethoprim. Ramipril: (Moderate) Monitor for hyperkalemia if concomitant use of an angiotensin-converting enzyme (ACE) inhibitor and trimethoprim is necessary. Amongst patients older than 65 years, concomitant use has been associated with a 2- to 7-fold increased risk of significant hyperkalemia compared to other antibiotics. Usual Adult Dose for: Pneumocystis Pneumonia Pneumocystis Pneumonia Prophylaxis Urinary Tract Infection Shigellosis Bronchitis Traveler's Diarrhea Cystitis Pyelonephritis Granuloma Inguinale Meningitis Toxoplasmosis Toxoplasmosis - Prophylaxis Protozoan Infection Usual Pediatric Dose for: Otitis Media Urinary Tract Infection Shigellosis Concomitant administration of rifabutin and sulfamethoxazole; trimethoprim, SMX-TMP, cotrimoxazole (double-strength) in 12 HIV-infected patients decreased the AUC of SMX-TMP by about 15 to 20%. Trimethoprim increases the plasma concentrations of procainamide and its active N-acetyl metabolite (NAPA). Levomefolate: (Minor) L-methylfolate and trimethoprim should be used together cautiously. Antituberculous drugs (e.g., rifampin) were the only agents associated with OC failure and pregnancy. Concurrent use can cause hyperkalemia, especially in elderly patients or patients with impaired renal function. Avoid concomitant use and consider alternative antibiotic therapy in patients with additional risk factors for hyperkalemia, including patients older than 65 years, those with underlying disorders of potassium metabolism, renal insufficiency, or those requiring high doses of trimethoprim. Usual Adult Dose for Urinary Tract Infection 100 mg orally every 12 hours or 200 mg orally every 24 hours Duration of therapy: 10 days Avoid concomitant use and consider alternative antibiotic therapy in patients with additional risk factors for hyperkalemia, including patients older than 65 years, those with underlying disorders of potassium metabolism, renal insufficiency, or those requiring high doses of trimethoprim. If coadministration is necessary, use caution and monitor for increased paclitaxel side effects, including myelosuppression and peripheral neuropathy. Data regarding progestin-only contraceptives or for newer combined contraceptive deliveries (e.g., patches, rings) are not available. Almost all antibacterial agents, including trimethoprim, have been associated with pseudomembranous colitis or C. difficile-associated diarrhea (CDAD) which may range in severity from mild to life-threatening. Leucovorin has been recommended to offset the hematologic toxicity of trimethoprim without affecting its antibacterial effects. One retrospective study reviewed the literature to determine the effects of oral antibiotics on the pharmacokinetics of contraceptive estrogens and progestins, and also examined clinical studies in which the incidence of pregnancy with OCs and antibiotics was reported. Data regarding progestin-only contraceptives or for newer combined contraceptive deliveries (e.g., patches, rings) are not available. Potassium Citrate; Citric Acid: (Moderate) Monitor serum potassium concentrations closely if potassium supplements and trimethoprim are used together. Drugs & Medications Trimethoprim Trimethoprim - Uses, Side Effects, and More Common Brand (S): Primsol, Proloprim, Trimpex Generic Name (S): trimethoprim View Free Coupon Uses. Another review concurred with these data, but noted that individual patients have been identified who experienced significant decreases in plasma concentrations of combined OC components and who appeared to ovulate; the agents most often associated with these changes were rifampin, tetracyclines, and penicillin derivatives. Because trimethoprim may interfere with folate metabolism, use caution when trimethoprim is administered to breast-feeding woman. 6 to 11 months: 10 mg/kg/day PO is FDA-approved maximum dosage; however, doses up to 15 mg/kg/day PO have been used off-label for PCP in HIV-infected patients.1 to 5 months: Safety and efficacy have not been established; however, doses up to 15 mg/kg/day PO have been used off-label for PCP in HIV-infected patients. Rifabutin decreased the AUC and Cmax of trimethoprim by 14% and 6%, respectively, when rifabutin was given with trimethoprim alone. These authors concluded that because females most at risk for OC failure or noncompliance may not be easily identified and the true incidence of such events may be under-reported, and given the serious consequence of unwanted pregnancy, that recommending an additional method of contraception during short-term antibiotic use may be justified. Drospirenone; Estradiol: (Moderate) It would be prudent to recommend alternative or additional contraception when oral contraceptives (OCs) are used in conjunction with antibiotics. Data regarding progestin-only contraceptives or for newer combined contraceptive deliveries (e.g., patches, rings) are not available. Administration of indinavir and sulfamethoxazole; trimethoprim, SMX-TMP significantly increased the AUC of trimethoprim. Another review concurred with these data, but noted that individual patients have been identified who experienced significant decreases in plasma concentrations of combined OC components and who appeared to ovulate; the agents most often associated with these changes were rifampin, tetracyclines, and penicillin derivatives. Based on the study results, these authors recommended that back-up contraception may not be necessary if OCs are used reliably during oral antibiotic use. Norethindrone Acetate; Ethinyl Estradiol; Ferrous fumarate: (Moderate) It would be prudent to recommend alternative or additional contraception when oral contraceptives (OCs) are used in conjunction with antibiotics. Amlodipine; Olmesartan: (Moderate) Monitor for hyperkalemia if concomitant use of an angiotensin II receptor antagonist and trimethoprim is necessary. Higher doses as a single dose are also effective in treating uncomplicated urine infections. The reductions in tolbutamide clearance are relatively small. Based on the study results, these authors recommended that back-up contraception may not be necessary if OCs are used reliably during oral antibiotic use. Data regarding progestin-only contraceptives or for newer combined contraceptive deliveries (e.g., patches, rings) are not available. Drospirenone; Ethinyl Estradiol; Levomefolate: (Moderate) It would be prudent to recommend alternative or additional contraception when oral contraceptives (OCs) are used in conjunction with antibiotics. The usual oral adult dosage is 100 mg of Trimethoprim every 12 hours or 200 mg of Trimethoprim every 24 hours, each for 10 days. Fosinopril; Hydrochlorothiazide, HCTZ: (Moderate) Monitor for hyperkalemia if concomitant use of an angiotensin-converting enzyme (ACE) inhibitor and trimethoprim is necessary. Trimethoprim has a potassium-sparing effect on the distal nephron and may induce hyperkalemia, especially in patients with preexisting risk factors (e.g., renal disease, elderly patients). Sodium Sulfate; Magnesium Sulfate; Potassium Chloride: (Moderate) Monitor serum potassium concentrations closely if potassium supplements and trimethoprim are used together. In general, dose selection for a geriatric patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal or cardiac function, and of concomitant disease or other drug therapy. Another review concurred with these data, but noted that individual patients have been identified who experienced significant decreases in plasma concentrations of combined OC components and who appeared to ovulate; the agents most often associated with these changes were rifampin, tetracyclines, and penicillin derivatives. Amongst patients older than 65 years, concomitant use has been associated with a 2- to 7-fold increased risk of significant hyperkalemia compared to other antibiotics. During long-term antibiotic administration, the risk for drug interaction with OCs is less clear, but alternative or additional contraception may be advisable in selected circumstances. It was concluded that the antibiotics ampicillin, ciprofloxacin, clarithromycin, doxycycline, metronidazole, ofloxacin, roxithromycin, temafloxacin, and tetracycline did not alter plasma concentrations of OCs. Indinavir: (Minor) Concomitant administration of indinavir and trimethoprim should be done with caution. Data regarding progestin-only contraceptives or for newer combined contraceptive deliveries (e.g., patches, rings) are not available. Atovaquone; Proguanil: (Moderate) Concomitant administration of atovaquone with an oral combination of trimethoprim and sulfamethoxazole lead to a minor decreases in TMP and SMX AUCs by 16% and 10%, respectively, in a small number of HIV-positive subjects. Adults1 tablet (DS tablet) of 800 milligrams (mg) of sulfamethoxazole and 160 mg of trimethoprim, 2 tablets of 400 mg of sulfamethoxazole and 80 mg of trimethoprim, or 4 teaspoonfuls or 20 milliliters (mL) of oral liquid every 12 hours for 14 days. Serum half-life is 810 hours in patients with normal renal function. One retrospective study reviewed the literature to determine the effects of oral antibiotics on the pharmacokinetics of contraceptive estrogens and progestins, and also examined clinical studies in which the incidence of pregnancy with OCs and antibiotics was reported. Another review concurred with these data, but noted that individual patients have been identified who experienced significant decreases in plasma concentrations of combined OC components and who appeared to ovulate; the agents most often associated with these changes were rifampin, tetracyclines, and penicillin derivatives. During long-term antibiotic administration, the risk for drug interaction with OCs is less clear, but alternative or additional contraception may be advisable in selected circumstances. It was concluded that the antibiotics ampicillin, ciprofloxacin, clarithromycin, doxycycline, metronidazole, ofloxacin, roxithromycin, temafloxacin, and tetracycline did not alter plasma concentrations of OCs. It was concluded that the antibiotics ampicillin, ciprofloxacin, clarithromycin, doxycycline, metronidazole, ofloxacin, roxithromycin, temafloxacin, and tetracycline did not alter plasma concentrations of OCs. It was previously thought that antibiotics may decrease the effectiveness of OCs containing estrogens due to stimulation of metabolism or a reduction in enterohepatic circulation via changes in GI flora. It was concluded that the antibiotics ampicillin, ciprofloxacin, clarithromycin, doxycycline, metronidazole, ofloxacin, roxithromycin, temafloxacin, and tetracycline did not alter plasma concentrations of OCs. Norgestimate; Ethinyl Estradiol: (Moderate) It would be prudent to recommend alternative or additional contraception when oral contraceptives (OCs) are used in conjunction with antibiotics. Data regarding progestin-only contraceptives or for newer combined contraceptive deliveries (e.g., patches, rings) are not available. Low blood platelet count (thrombocytopenia) Low blood sodium (hyponatremia) Low white blood cell count ( leukopenia, neutropenia) Maculopapular rash (3-7% at 200 mg/day; incidence higher with larger daily doses) Megaloblastic anemia. 100 mg PO every 24 hours. Data regarding progestin-only contraceptives or for newer combined contraceptive deliveries (e.g., patches, rings) are not available. A pharmacokinetic effect on the combination has been reported with another rifamycin. Antituberculous drugs (e.g., rifampin) were the only agents associated with OC failure and pregnancy. Repaglinide: (Major) Coadministration of trimethoprim and repaglinide increases the AUC of repaglinide by 61%; if coadministration is necessary, consider a dose reduction of repaglinide and increased frequency of glucose monitoring. . During long-term antibiotic administration, the risk for drug interaction with OCs is less clear, but alternative or additional contraception may be advisable in selected circumstances. Based on the study results, these authors recommended that back-up contraception may not be necessary if OCs are used reliably during oral antibiotic use. Use caution and monitor for hematologic toxicity during concurrent use. Antituberculous drugs (e.g., rifampin) were the only agents associated with OC failure and pregnancy. Data regarding progestin-only contraceptives or for newer combined contraceptive deliveries (e.g., patches, rings) are not available. One retrospective study reviewed the literature to determine the effects of oral antibiotics on the pharmacokinetics of contraceptive estrogens and progestins, and also examined clinical studies in which the incidence of pregnancy with OCs and antibiotics was reported. Trimethoprim may be taken on an empty stomach or, if it upsets your stomach, it may be taken with food. Antituberculous drugs (e.g., rifampin) were the only agents associated with OC failure and pregnancy. Coadministration can be expected to increase exposure to selexipag and its active metabolite. Avoid concomitant use and consider alternative antibiotic therapy in patients with additional risk factors for hyperkalemia, including patients older than 65 years, those with underlying disorders of potassium metabolism, renal insufficiency, or those requiring high doses of trimethoprim. Based on the study results, these authors recommended that back-up contraception may not be necessary if OCs are used reliably during oral antibiotic use. Avoid concomitant use and consider alternative antibiotic therapy in patients with additional risk factors for hyperkalemia, including patients older than 65 years, those with underlying disorders of potassium metabolism, renal insufficiency, or those requiring high doses of trimethoprim. Avoid concomitant use and consider alternative antibiotic therapy in patients with additional risk factors for hyperkalemia, including patients older than 65 years, those with underlying disorders of potassium metabolism, renal insufficiency, or those requiring high doses of trimethoprim. Reports suggest that patients receiving pyrimethamine as malaria prophylaxis in doses more than 25 mg/week may develop megaloblastic anemia with concurrent sulfamethoxazole; trimethoprim. One retrospective study reviewed the literature to determine the effects of oral antibiotics on the pharmacokinetics of contraceptive estrogens and progestins, and also examined clinical studies in which the incidence of pregnancy with OCs and antibiotics was reported. Patients should be monitored for changes in glycemic control if any CYP2C8 inhibitors are coadministered with rosiglitazone. Concurrent administration of dapsone with trimethoprim increases the plasma concentrations of both drugs. Trimethoprim has a potassium-sparing effect on the distal nephron and may induce hyperkalemia, especially in those with pre-existing risk factors. Data regarding progestin-only contraceptives or for newer combined contraceptive deliveries (e.g., patches, rings) are not available. Moraxella catarrhalis isolates were found to be consistently resistant to trimethoprim in vitro.Resistance to trimethoprim occurs through several mechanisms. It was concluded that the antibiotics ampicillin, ciprofloxacin, clarithromycin, doxycycline, metronidazole, ofloxacin, roxithromycin, temafloxacin, and tetracycline did not alter plasma concentrations of OCs. Perindopril; Amlodipine: (Moderate) Monitor for hyperkalemia if concomitant use of an angiotensin-converting enzyme (ACE) inhibitor and trimethoprim is necessary. Sodium picosulfate; Magnesium oxide; Anhydrous citric acid: (Major) Prior or concomitant use of antibiotics with sodium picosulfate; magnesium oxide; anhydrous citric acid may reduce efficacy of the bowel preparation as conversion of sodium picosulfate to its active metabolite bis-(p-hydroxy-phenyl)-pyridyl-2-methane (BHPM) is mediated by colonic bacteria. Concomitant use may increase the risk of hyperkalemia. Procainamide: (Moderate) Monitor procainamide plasma concentrations, if available, and for clinical and ECG signs of procainamide toxicity with concomitant trimethoprim use. Trimethoprim has a potassium-sparing effect on the distal nephron and may induce hyperkalemia, especially in those with pre-existing risk factors. Primsol:- Protect from light- Store between 59 to 77 degrees FProloprim:- Protect from light- Protect from moisture- Store between 68 to 77 degrees F, excursions permitted 59 to 86 degrees FTRIMPEX:- Protect from light- Store between 59 to 77 degrees F. Trimethoprim use is contraindicated in folate deficiency megaloblastic anemia. Potassium Citrate: (Moderate) Monitor serum potassium concentrations closely if potassium supplements and trimethoprim are used together. Amitriptyline: (Moderate) Monitor therapeutic response and adjust the tricyclic antidepressant dose, if needed, when use sulfamethoxazole; trimethoprim concomitantly. [48707] If trimethoprim is used during pregnancy, administer supplemental multivitamins. These authors concluded that because females most at risk for OC failure or noncompliance may not be easily identified and the true incidence of such events may be under-reported, and given the serious consequence of unwanted pregnancy, that recommending an additional method of contraception during short-term antibiotic use may be justified. Nab-paclitaxel is a CYP2C8 substrate and trimethoprim is a weak CYP2C8 inhibitor. Trimethoprim is a CYP2C8 inhibitor and repaglinide is a CYP2C8 substrate. COMMON BRAND NAMES Primsol, Proloprim, TRIMPEX HOW SUPPLIED Primsol/TRIMPEX Oral Sol: 5mL, 50mg Trimethoprim has a potassium-sparing effect on the distal nephron and may induce hyperkalemia, especially in those with pre-existing risk factors. It was concluded that the antibiotics ampicillin, ciprofloxacin, clarithromycin, doxycycline, metronidazole, ofloxacin, roxithromycin, temafloxacin, and tetracycline did not alter plasma concentrations of OCs. The efficacy of tricyclic antidepressants can decrease when administered with sulfamethoxazole; trimethoprim. These authors concluded that because females most at risk for OC failure or noncompliance may not be easily identified and the true incidence of such events may be under-reported, and given the serious consequence of unwanted pregnancy, that recommending an additional method of contraception during short-term antibiotic use may be justified. Dose advice: How to use Alprim Before you take Alprim When you must not take it Based on the study results, these authors recommended that back-up contraception may not be necessary if OCs are used reliably during oral antibiotic use. It was concluded that the antibiotics ampicillin, ciprofloxacin, clarithromycin, doxycycline, metronidazole, ofloxacin, roxithromycin, temafloxacin, and tetracycline did not alter plasma concentrations of OCs. During long-term antibiotic administration, the risk for drug interaction with OCs is less clear, but alternative or additional contraception may be advisable in selected circumstances. Antituberculous drugs (e.g., rifampin) were the only agents associated with OC failure and pregnancy. Avoid concomitant use and consider alternative antibiotic therapy in patients with additional risk factors for hyperkalemia, including patients older than 65 years, those with underlying disorders of potassium metabolism, renal insufficiency, or those requiring high doses of trimethoprim. Avoid concomitant use and consider alternative antibiotic therapy in patients with additional risk factors for hyperkalemia, including patients older than 65 years, those with underlying disorders of potassium metabolism, renal insufficiency, or those requiring high doses of trimethoprim. Trimethoprim is administered orally. Concomitant use may increase the risk of hyperkalemia. These authors concluded that because females most at risk for OC failure or noncompliance may not be easily identified and the true incidence of such events may be under-reported, and given the serious consequence of unwanted pregnancy, that recommending an additional method of contraception during short-term antibiotic use may be justified. Based on the study results, these authors recommended that back-up contraception may not be necessary if OCs are used reliably during oral antibiotic use. If stomach upset occurs, take with food or milk. Based on the study results, these authors recommended that back-up contraception may not be necessary if OCs are used reliably during oral antibiotic use. Eprosartan: (Moderate) Monitor for hyperkalemia if concomitant use of an angiotensin II receptor antagonist and trimethoprim is necessary. Rifabutin decreased the AUC and Cmax of trimethoprim by 14% and 6%, respectively, when rifabutin was given with trimethoprim alone. Based on the study results, these authors recommended that back-up contraception may not be necessary if OCs are used reliably during oral antibiotic use. Fluorouracil, 5-FU: (Major) Use of other folate antagonists should be avoided during therapy with trimethoprim. Benazepril: (Moderate) Monitor for hyperkalemia if concomitant use of an angiotensin-converting enzyme (ACE) inhibitor and trimethoprim is necessary. Antituberculous drugs (e.g., rifampin) were the only agents associated with OC failure and pregnancy. Taking these drugs together may increase velpatasvir plasma concentrations, potentially resulting in adverse events. Taking these drugs together may increase velpatasvir plasma concentrations, potentially resulting in adverse events. Another review concurred with these data, but noted that individual patients have been identified who experienced significant decreases in plasma concentrations of combined OC components and who appeared to ovulate; the agents most often associated with these changes were rifampin, tetracyclines, and penicillin derivatives. Trimethoprim should be used with caution in patients with hepatic disease. Amongst patients older than 65 years, concomitant use has been associated with a 2- to 7-fold increased risk of significant hyperkalemia compared to other antibiotics. Monitor serum potassium concentrations at periodic intervals. Concomitant use may increase the risk of hyperkalemia. Leucovorin: (Minor) Racemic leucovorin may be used to offset the toxicity of folate antagonists such as trimethoprim; however, the concomitant use of leucovorin with sulfamethoxazole; trimethoprim for the acute treatment of Pneumocystis carinii pneumonia in patients with HIV infection was associated with an increased risk of treatment failure and morbidity. The efficacy of tricyclic antidepressants can decrease when administered with sulfamethoxazole; trimethoprim. Monitor patients for decreased efficacy of L-methylfolate if these agents are used together. Concomitant use may increase phenytoin concentrations. Amongst patients older than 65 years, concomitant use has been associated with a 2- to 7-fold increased risk of significant hyperkalemia compared to other antibiotics. Antituberculous drugs (e.g., rifampin) were the only agents associated with OC failure and pregnancy. During long-term antibiotic administration, the risk for drug interaction with OCs is less clear, but alternative or additional contraception may be advisable in selected circumstances. Trimethoprim has a potassium-sparing effect on the distal nephron and may induce hyperkalemia, especially in those with pre-existing risk factors. Amongst patients older than 65 years, concomitant use has been associated with a 2- to 7-fold increased risk of significant hyperkalemia compared to other antibiotics. It was previously thought that antibiotics may decrease the effectiveness of OCs containing estrogens due to stimulation of metabolism or a reduction in enterohepatic circulation via changes in GI flora. Spironolactone; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum potassium concentrations if trimethoprim and a potassium-sparing diuretic are used together. Data regarding progestin-only contraceptives or for newer combined contraceptive deliveries (e.g., patches, rings) are not available. These authors concluded that because females most at risk for OC failure or noncompliance may not be easily identified and the true incidence of such events may be under-reported, and given the serious consequence of unwanted pregnancy, that recommending an additional method of contraception during short-term antibiotic use may be justified. Metformin; Rosiglitazone: (Moderate) It is possible that an increase in the exposure of rosiglitazone may occur when coadministered with drugs that inhibit CYP2C8 such as trimethoprim. These authors concluded that because females most at risk for OC failure or noncompliance may not be easily identified and the true incidence of such events may be under-reported, and given the serious consequence of unwanted pregnancy, that recommending an additional method of contraception during short-term antibiotic use may be justified. Can be made based on the metabolic pathways of both drugs Cmax of without... 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[ 48707 ] if trimethoprim is necessary, use caution and Monitor for increased side! An angiotensin-converting enzyme ( ACE ) inhibitor and repaglinide is a weak CYP2C8 inhibitor and repaglinide a...
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