Bactrim (Trimethoprim and Sulfamethoxazole) Drug Information: Overdosage and Contraindications

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May 25, 2012

Bactrim

Travelers' Diarrhea »

Travelers' diarrhea facts

Travelers' diarrhea is a gastrointestinal illness that occurs in travelers.
Travelers' diarrhea usually is caused by eating food contaminated with bacteria or, less commonly, with parasites or viruses.
The treatment of travelers' diarrhea is usually plenty of oral liquids as well as over-the-counter medications that control diarrhea and cramps.
Antibiotic prophylaxis (prevention) for travelers' diarrhea is available but is not recommended generally.
The prognosis of travelers' diarrhea is good. It is rarely fatal, and most cases resolve within a week.

What is travelers' diarrhea?

Travelers' diarrhea is defined by most experts as three or more unformed stools in a 24 hour time period, passed by a person who is traveling. Travelers' diarrhea is commonly accompanied by abdominal cramps, nausea, and bloating. Travelers' diarrhea is a general term and does...

Read the Travelers' Diarrhea article »

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OVERDOSE

Acute: The amount of a single dose of BACTRIM (trimethoprim and sulfamethoxazole) that is either associated with symptoms of overdosage or is likely to be life-threatening has not been reported. Signs and symptoms of overdosage reported with sulfonamides include anorexia, colic, nausea, vomiting, dizziness, headache, drowsiness and unconsciousness. Pyrexia, hematuria and crystalluria may be noted. Blood dyscrasias and jaundice are potential late manifestations of overdosage.

Signs of acute overdosage with trimethoprim include nausea, vomiting, dizziness, headache, mental depression, confusion and bone marrow depression.

General principles of treatment include the institution of gastric lavage or emesis, forcing oral fluids, and the administration of intravenous fluids if urine output is low and renal function is normal. Acidification of the urine will increase renal elimination of trimethoprim. The patient should be monitored with blood counts and appropriate blood chemistries, including electrolytes. If a significant blood dyscrasia or jaundice occurs, specific therapy should be instituted for these complications. Peritoneal dialysis is not effective and hemodialysis is only moderately effective in eliminating sulfamethoxazole and trimethoprim.

Chronic: Use of BACTRIM (trimethoprim and sulfamethoxazole) at high doses and/or for extended periods of time may cause bone marrow depression manifested as thrombocytopenia, leukopenia and/or megaloblastic anemia. If signs of bone marrow depression occur, the patient should be given leucovorin 5 to 15 mg daily until normal hematopoiesis is restored.

CONTRAINDICATIONS

BACTRIM (trimethoprim and sulfamethoxazole) 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. BACTRIM (trimethoprim and sulfamethoxazole) is also contraindicated in pregnant patients and nursing mothers, because sulfonamides pass the placenta and are excreted in the milk and may cause kernicterus. BACTRIM (trimethoprim and sulfamethoxazole) is contraindicated in pediatric patients less than 2 months of age. BACTRIM (trimethoprim and sulfamethoxazole) is also contraindicated in patients with marked hepatic damage or with severe renal insufficiency when renal function status cannot be monitored.

Last reviewed on RxList: 1/24/2011
This monograph has been modified to include the generic and brand name in many instances.