PDRhealth on Bactrim

This page is material from a 1990s investigation and campaign in The Sunday Times of London over the risks of an antibiotic with many names, such as Bactrim, Septra, Septrin, Sulfatrim, and co-trimoxazole

Below is information on side-effects given by PDRhealth, a service of the authoritative Physician’s Desk Reference. You can read personal stories about the risks of drugs containing trimethoprim and sulfamethoxazole in letters to The Sunday Times and in emails to this website

BACTRIM/BACTRIM DS

Bactrim is the same as Septra and other branded and generic products containing sulfamethoxazole and trimethoprim. In its entry on Bactrim, PDRhealth says:

“the most important fact” about the drug is its risks.

Bactrim, is one of a group of drugs called sulfonamides, which prevent the growth of bacteria in the body. Rare but sometimes fatal reactions have occurred with use of sulfonamides. These reactions include Stevens-Johnson syndrome (severe eruptions around the mouth, anus, or eyes), progressive disintegration of the outer layer of the skin, sudden and severe liver damage, a severe blood disorder (agranulocytosis), and a lack of red and white blood cells because of a bone marrow disorder.

PDRhealth advises Bactrim users to notify your doctor “at the first sign of an adverse reaction such as skin rash, sore throat, fever, joint pain, cough, shortness of breath, abnormal skin paleness, reddish or purplish skin spots, or yellowing of the skin or whites of the eyes.” It says that “frequent blood counts by a doctor are recommended for patients taking sulfonamide drugs.”

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Bactrim. More common side effects may include: Hives, lack or loss of appetite, nausea, skin rash, vomiting. Less common or rare side effects may include: Abdominal pain, allergic reactions, anemia, chills, convulsions, depression, diarrhea, eye irritation, fatigue, fever, hallucinations, headache, hepatitis, inability to fall or stay asleep, inability to urinate, increased urination, inflammation of heart muscle, inflammation of the mouth and/or tongue, itching, joint pain, kidney failure, lack of feeling or concern, lack of muscle coordination, loss of appetite, low blood sugar, meningitis (inflammation of the brain or spinal cord), muscle pain, nausea, nervousness, red, raised rash, redness and swelling of the tongue, ringing in the ears, scaling of dead skin due to inflammation, sensitivity to light, severe skin welts or swelling, skin eruptions, skin peeling, vertigo, weakness, yellowing of eyes and skin.

PDRhealth advises that Bactrim should not be prescribed to anyone who is sensitive to or has ever had an allergic reaction to the drug’s components, or other sulfa drugs. Advise your doctor of any drug reactions you have experienced.

Unless you are directed to do so by your doctor, do not take this medication if you have been diagnosed as having megaloblastic anemia, which is a blood disorder due to a deficiency of folic acid. This drug should not be given to infants less than 2 months of age. Bactrim is not recommended for preventative or prolonged use in middle ear infections and should not be used in the treatment of streptococcal pharyngitis (strep throat) or certain other strep infections. You should not take Bactrim if you are pregnant or nursing a baby.

Make sure your doctor knows if you have impaired kidney or liver function, have a folic acid deficiency, are a chronic alcoholic, are taking anticonvulsants, have been diagnosed as having malabsorption syndrome (abnormal intestinal absorption), are in a state of poor nutrition, or have severe allergies or bronchial asthma. Bactrim should be used cautiously under these conditions.

If you develop severe diarrhea, call your doctor. This drug can cause a serious intestinal inflammation.

You can find more technical details on side-effects under sulfamethoxazole at this site