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

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May 27, 2012

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Ear Infection (Otitis Media) »

Ear infection or inflammation (otitis media) facts

Otitis media (ear infection or inflammation) is the most common diagnosis in sick children in the U.S.
Otitis media features fever, ear pain, and a feeling of fullness in the ear; as well as fussiness and feeding problems in young children.
Otitis media is usually an infection and/or inflammation of the middle ear.
Ear infection or inflammation causes fluid buildup in the middle ear.
A cold or other respiratory infection can lead to ear infections or inflammation.
Exposure to other children's colds as often occurs in daycare centers, raises the risk of contracting otitis media (ear infection or inflammation).
Bottlefeeding increases the risk of ear infection or inflammation in babies.
Middle ear pus causes pain and temporary hearing loss.
Rupture of the eardrum allows the pus to drain into the ear canal.
Otitis ...

Read the Ear Infection (Otitis Media) article »

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OVERDOSE

Acute

The amount of a single dose of SEPTRA (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 trimethoprim and sulfamethoxazole.

Chronic

Use of SEPTRA (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 leucovorin daily has been recommended by some investigators.

CONTRAINDICATIONS

SEPTRA (trimethoprim and sulfamethoxazole) is contraindicated in patients with a known hypersensitivity to trimethoprim or sulfonamides and in patients with documented megaloblastic anemia due to folate deficiency. SEPTRA (trimethoprim and sulfamethoxazole) is also contraindicated in pregnant patients at term and in nursing mothers, because sulfonamides pass the placenta and are excreted in the milk and may cause kernicterus. SEPTRA (trimethoprim and sulfamethoxazole) is contraindicated in pediatric patients less than 2 months of age.

Last reviewed on RxList: 10/19/2010
This monograph has been modified to include the generic and brand name in many instances.