Medical Editor: John P. Cunha, DO, FACOEP
What Is Bactrim?
Bactrim (sulfamethoxazole and trimethoprim) DS is a combination of two antibiotics used to treat urinary tract infections, acute otitis media, bronchitis, Shigellosis, Pneumocystis pneumonia, traveler's diarrhea, methicillin-resistant Staphylococcus aureus (MRSA), and other bacterial infections susceptible to this antibiotic. Bactrim is available as a generic drug.
What Are Side Effects of Bactrim?
Common side effects of Bactrim include:
- loss of appetite,
- nausea,
- vomiting,
- painful or swollen tongue,
- dizziness,
- spinning sensation,
- ringing in your ears,
- tiredness, or
- sleep problems (insomnia).
Tell your doctor if you experience serious side effects of Bactrim including:
- bruising or bleeding,
- aplastic anemia,
- jaundice,
- hepatic necrosis,
- mouth sores,
- joint aches,
- severe skin rashes,
- itching, and
- sore throat.
Dosage for Bactrim
Bactrim is available in tablets in two strengths; 400 mg sulfamethoxazole and 80 mg trimethoprim and the "DS" form which means double strength, 800 mg sulfamethoxazole and 160 mg trimethoprim. Patients should follow their doctor's instructions and take all of the Bactrim prescribed. Patients allergic to sulfa compounds should not take Bactrim.
What Drugs, Substances, or Supplements Interact with Bactrim?
Bactrim may interact with many drugs; the patient and prescribing doctor should be aware of any potential interactions.
Bactrim During Pregnancy and Breastfeeding
Bactrim should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus; the same situation exists for women who are breastfeeding and their neonates.
Additional Information
Our Bactrim DS Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

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Get emergency medical help if you have signs of an allergic reaction (hives, cough, chest pain, shortness of breath, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).
Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, joint pain, muscle aches, severe weakness, pale skin, unusual bruising, or yellowing of your skin or eyes.
Call your doctor at once if you have:
- severe stomach pain, diarrhea that is watery or bloody (even if it occurs months after your last dose);
- any skin rash, no matter how mild;
- yellowing of your skin or eyes;
- a seizure;
- new or unusual joint pain;
- increased or decreased urination;
- swelling, bruising, or irritation around the IV needle;
- increased thirst, dry mouth, fruity breath odor;
- new or worsening cough, fever, trouble breathing;
- high blood potassium--nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement;
- low blood sodium--headache, confusion, problems with thinking or memory, weakness, feeling unsteady; or
- low blood cell counts--fever, chills, mouth sores, skin sores, easy bruising, unusual bleeding, pale skin, cold hands and feet, feeling light-headed or short of breath.
Common side effects may include:
- nausea, vomiting, loss of appetite; or
- skin rash.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

QUESTION
COPD (chronic obstructive pulmonary disease) is the same as adult-onset asthma. See AnswerSIDE EFFECTS
The following serious adverse reactions are described elsewhere in the labeling:
- Embryo-fetal Toxicity [see WARNINGS AND PRECAUTIONS]
- Hypersensitivity and Other Fatal Reactions [see WARNINGS AND PRECAUTIONS]
- Thrombocytopenia [see WARNINGS AND PRECAUTIONS]
- Clostridioides difficile-Associated Diarrhea [see WARNINGS AND PRECAUTIONS]
- Sulfite Sensitivity [see WARNINGS AND PRECAUTIONS]
- Risk Associated with Concurrent Use of Leucovorin for Pneumocystis jirovecii Pneumonia [see WARNINGS AND PRECAUTIONS]
- Propylene Glycol Toxicity [see WARNINGS AND PRECAUTIONS, ADVERSE REACTIONS]
- Infusion Reactions [see WARNINGS AND PRECAUTIONS]
- Hypoglycemia [see WARNINGS AND PRECAUTIONS]
- Electrolyte Abnormalities [see WARNINGS AND PRECAUTIONS]
Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.
The most common adverse reactions are gastrointestinal disturbances (nausea, vomiting, and anorexia) and allergic skin reactions (such as rash and urticaria).
Local reaction, pain and slight irritation on intravenous (IV) administration are infrequent. Thrombophlebitis has been observed.
Table 3: Adverse Reactions Reported with BACTRIM
Body System | Adverse Reactions |
Hematologic |
|
Allergic Reactions |
|
Gastrointestinal | |
Genitourinary |
|
Metabolic and Nutritional |
|
Neurologic |
|
Psychiatric |
|
Endocrine |
|
Musculoskeletal | |
Respiratory |
|
Miscellaneous |
|
Eye Disorders |
Postmarketing Experience
The following adverse reactions have been identified during post-approval use of BACTRIM. Because these reactions were reported voluntarily from a population of uncertain size, it is not possible to reliably estimate their frequency or establish a causal relationship to drug exposure:
- Thrombotic thrombocytopenia purpura
- Idiopathic thrombocytopenic purpura
- QT prolongation resulting in ventricular tachycardia and torsade de pointes
- Metabolic acidosis
Read the entire FDA prescribing information for Bactrim (Trimethoprim and Sulfamethoxazole)
© Bactrim Patient Information is supplied by Cerner Multum, Inc. and Bactrim Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.
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