Bactrim interactions: Alcohol, medications, and other factors

Bactrim interactions with other medications  

Before you start treatment with Bactrim, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Bactrim interacts with supplements, herbs, or vitamins, see the “Bactrim and other interactions” section.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Bactrim. Keep in mind that this table doesn’t include all drugs that may interact with Bactrim. Some of these interactions are described in detail in “Drug interactions in depth.”

When to avoid Bactrim

In some cases, factors or conditions could prevent your doctor from prescribing Bactrim due to the risk of harm. These are known as contraindications. The contraindications of Bactrim include:

Being younger than age 2 months

Doctors typically won’t prescribe Bactrim for children younger than age 2 months. It isn’t known whether the drug is safe or effective for children of this age.

Doctors will prescribe a treatment other than Bactrim for children younger than age 2 months. If you have questions about treatment options for your child, talk with their doctor.

Having a certain type of anemia

Doctors typically won’t prescribe Bactrim for people with megaloblastic anemia caused by folate (vitamin B9) deficiency. With this condition, having a low level of folate causes the body to make red blood cells that don’t function as they should. Bactrim may lower folate levels in the body, which could worsen this condition.

If you have this type of anemia, talk with your doctor before taking Bactrim. They’ll likely prescribe a treatment other than Bactrim for your condition.

Having severe liver damage

Doctors typically won’t prescribe Bactrim for people with severe liver damage. This is because Bactrim may cause liver problems, which can worsen this condition.

If you have severe liver damage, talk with your doctor before taking Bactrim. They’ll likely prescribe a treatment other than Bactrim for your condition.

Having severe kidney damage

Doctors typically will not prescribe Bactrim for people with severe kidney damage when their kidney function cannot be monitored often. This is because Bactrim may cause kidney problems, which can worsen this condition.

If you have severe kidney damage, talk with your doctor before taking Bactrim. They may monitor your kidney function more often than usual or prescribe a different treatment instead.

Having had a low platelet count with Bactrim or similar drugs

Doctors typically will not prescribe Bactrim for people who’ve had immune thrombocytopenia after taking Bactrim or similar drugs. This condition occurs when an overactive immune system attacks platelets, which can lead to a low platelet count.

Taking Bactrim could cause this reaction to occur again. You can ask your doctor about other treatments that may be better choices for you.

Taking dofetilide

Doctors typically will not prescribe Bactrim in combination with dofetilide (Tikosyn), which is used to treat atrial fibrillation and atrial flutter.

Taking these drugs together can raise the level of dofetilide in your system. This can increase your risk of serious and possibly life threatening side effects from dofetilide. These include long QT syndrome and torsades de pointes.

Before you start treatment with Bactrim, it’s important to tell your doctor if you take dofetilide. They’ll likely prescribe a treatment other than Bactrim for your condition.

Having had an allergic reaction to Bactrim or any of its ingredients

If you have had an allergic reaction to Bactrim or any of its ingredients, your doctor will likely not prescribe Bactrim. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Bactrim, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe Bactrim.

Bactrim interactions with alcohol

There aren’t any known interactions between Bactrim and alcohol. However, drinking alcohol while taking the drug may worsen some of Bactrim’s side effects. For example, you may experience worsening nausea, vomiting, or fatigue.

In addition, consuming large amounts of alcohol can cause liver damage. Bactrim may also cause liver damage as a side effect. This means that drinking alcohol during Bactrim treatment may increase the risk of this side effect.

If you have questions about drinking alcohol while taking Bactrim, talk with your doctor.

Drug interactions in depth

Here’s a closer look at certain drug interactions of Bactrim.

Diabetes drugs

Diabetes drugs are prescribed to help manage blood sugar levels in people with diabetes.

Interaction result:Taking Bactrim with a diabetes drug may increase the risk of low blood sugar.

Interaction explained:Both Bactrim and diabetes drugs can lower blood sugar when taken individually. Taking them together may lower your blood sugar further.

Examples of diabetes drugs: Here are some diabetes drugs that may interact with Bactrim:

• glipizide (Glucotrol XL)
• glyburide (Diabeta, Glynase)
• metformin (Fortamet, Glumetza)
• pioglitazone (Actos)

Steps you or your doctor may take:Before starting Bactrim treatment, tell your doctor if you take a diabetes drug. They can recommend whether it’s safe to take these medications together.

If your doctor prescribes Bactrim with a diabetes drug, watch for symptoms of low blood sugar. These may include dizziness, sweating, and headache. Your doctor can recommend how to manage these symptoms.

For example, they may advise you to eat at least 15 grams (g) of carbohydrates to raise your blood sugar level. Sources of carbohydrates include fruit juice, hard candies, non-diet soda, and glucose tablets.

Severely low blood sugar may lead to loss of consciousness. For this or other severe symptoms, you or a bystander should call 911 or a local emergency number right away.

If you have questions about taking Bactrim and diabetes drugs, talk with your doctor or pharmacist.

Birth control pills

Birth control pills are prescribed to help prevent pregnancy.

Interaction result: Taking Bactrim with birth control pills could make the birth control less effective.

Interaction explained: Taking Bactrim with birth control pills may cause your body to break down the birth control drug more quickly than usual. This may lower the level of the birth control drug in your body, making it less effective for preventing pregnancy.

Examples of birth control: Here are some birth control pills that may interact with Bactrim:

• desogestrel/ethinyl estradiol (Kariva, Viorele, others)
• drospirenone/ethinyl estradiol (Yasmin, Yaz, others)
• drospirenone/estetrol (Nextstellis)
• levonorgestrel/ethinyl estradiol (Seasonale, Seasonique, others)

Steps you or your doctor may take: If you take birth control pills, talk with your doctor before starting Bactrim treatment. They’ll likely advise you to keep taking your birth control as it has been prescribed.

In addition, your doctor may suggest using a backup method of birth control during Bactrim treatment. Examples include using a condom or diaphragm.

If you have questions about taking Bactrim and birth control pills, talk with your doctor or pharmacist.

Warfarin

Warfarin (Jantoven) is prescribed to treat and help prevent blood clots.

Interaction result: Taking Bactrim with warfarin may increase the risk of bleeding.

Interaction explained: Taking Bactrim with warfarin may cause your body to break down warfarin more slowly than is typical. This may raise the level of warfarin in your system, increasing your risk of bleeding as a side effect.

Steps you or your doctor may take: Before starting Bactrim treatment, tell your doctor if you’re taking warfarin. They can advise whether it’s safe to take these medications together.

If you’re prescribed Bactrim with warfarin, your doctor may recommend certain blood tests to check the time it takes your blood to clot. They may use these blood test results to temporarily adjust your warfarin dosage. Doing so may help reduce the risk of bleeding while you’re taking Bactrim.

If you have questions about taking Bactrim and warfarin, talk with your doctor or pharmacist.

Bactrim and other interactions

Bactrim may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Bactrim.

Bactrim interactions with supplements

Bactrim may interact with potassium supplements. Some people take these supplements to raise the potassium level in the body.

Bactrim may cause high blood potassium levels as a side effect. Taking the drug with potassium supplements further increases this risk.

Before taking Bactrim with a potassium supplement, talk with your doctor. They can tell you whether it’s safe to take them together. If you take Bactrim with potassium, your doctor may check your blood potassium levels more frequently than usual while you take both medications.

Before you start treatment with Bactrim, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Bactrim and herbs

There are no specific reports of herbs interacting with Bactrim. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Bactrim treatment.

Bactrim interactions with vitamins

Bactrim may interact with folic acid, which is a human-made form of folate (vitamin B9). Some people take folic acid to treat and help prevent low folate levels in the body.

Bactrim may lower folate levels in the body, which could make folic acid less effective. This risk may be greater for people taking Bactrim at higher doses or long-term.

Before you start treatment with Bactrim, tell your doctor and pharmacist which vitamins you take. They can advise you on whether Bactrim may interact with any of them.

Bactrim and food

Although potassium supplements may interact with Bactrim, there were no reports of food interactions with the drug. The amount of potassium in food, such as bananas, is usually much less than what’s in a potassium supplement.

If you have additional questions or want more information about eating certain foods during Bactrim treatment, talk with your doctor.

Bactrim interactions with vaccines

Bactrim has been reported to interact with vaccines for cholera and typhoid. Receiving these vaccines while taking Bactrim could make them less effective.

Before starting Bactrim, talk with your doctor or pharmacist about any vaccines you may need. They may advise you to wait until at least 2 weeks after you’ve stopped Bactrim treatment to receive vaccines for cholera or typhoid. Your doctor or pharmacist can recommend whether it’s safe to receive other vaccines during Bactrim treatment.

Bactrim interactions with lab tests

Bactrim may interact with certain lab tests used to measure levels of creatinine and methotrexate in your body. Doctors may test creatinine levels to check . Methotrexate is a drug prescribed for certain autoimmune conditions, including rheumatoid arthritis.

If you’re prescribed Bactrim, your doctor will recommend different tests to gather this information.

BACTRIM INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have been reported to interact with Bactrim. Taking Bactrim with cannabis products may increase the risk of side effects from cannabis.

Before you start treatment with Bactrim, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many U.S. states to varying degrees.

Bactrim and health-related interactions

Certain medical conditions and other factors may increase the risk of interactions with Bactrim. Before you take this drug, be sure to talk with your doctor about your health history. Bactrim may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Bactrim include:

A certain type of anemia: Doctors typically won’t prescribe Bactrim for people with megaloblastic anemia caused by folate (vitamin B9) deficiency. For details, see the “When to avoid Bactrim” section.

Liver damage: If you have liver damage, talk with your doctor before taking Bactrim. This condition may increase your risk of side effects from Bactrim. Examples include high blood potassium levels and low blood sugar. Your doctor can recommend whether Bactrim is a safe treatment option.

Keep in mind doctors typically won’t prescribe Bactrim for people with severe liver damage. For details about this, see the “When to avoid Bactrim” section.

Kidney damage: If you have kidney damage, talk with your doctor before starting Bactrim treatment. This condition may increase your risk of side effects from Bactrim, including high blood potassium and low blood sugar. To reduce this risk, your doctor may prescribe a lower Bactrim dosage than is typical.

Keep in mind doctors typically will not prescribe Bactrim for people with severe kidney damage when their kidney function cannot be monitored often. For details about this, see the “When to avoid Bactrim” section.

Low platelet count: Doctors typically will not prescribe Bactrim for people who’ve had immune thrombocytopenia after taking Bactrim or similar drugs. For details about this, see the “When to avoid Bactrim” section.

Thyroid problems: If you have a thyroid problem, talk with your doctor before taking Bactrim. Taking the drug could cause your thyroid to become underactive, which may affect how well your thyroid problem is managed. Your doctor may prescribe a treatment other than Bactrim.

Porphyria: If you have porphyria, talk with your doctor before taking Bactrim. Taking the drug could result in a sudden worsening of this condition. Doctors may prescribe a treatment other than Bactrim for people with porphyria.

Folate deficiency: If you have folate (vitamin B9) deficiency, talk with your doctor before starting Bactrim treatment. Bactrim may lower folate levels in the body, which could worsen this condition. Your doctor can determine whether Bactrim is a safe treatment option.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency: If you have an inherited condition called G6PD deficiency, talk with your doctor before taking Bactrim. This condition may lead to low levels of red blood cells. Taking Bactrim further increases this risk. Your doctor can recommend whether Bactrim is a safe treatment option.

Allergic reaction: If you’ve had an allergic reaction to Bactrim or any of its ingredients, your doctor will likely not prescribe Bactrim. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Breastfeeding: It may not be safe to take Bactrim while breastfeeding. The drug passes into breast milk and may cause side effects in certain children who are breastfed. If you’re breastfeeding or planning to, talk with your doctor before using Bactrim. They can discuss treatment options and ways to feed your child.

Pregnancy: It may not be safe to take Bactrim while pregnant. Some reports suggest that the drug may cause congenital anomalies (commonly known as birth defects). If you’re pregnant or planning to become pregnant, tell your doctor before starting Bactrim. They can advise you on the right treatment plan for you.

FAQs about Bactrim and interactions

Here are some frequently asked questions about Bactrim and possible interactions.

Does my Bactrim dosage affect my risk of interactions?

Yes, certain other drugs and health conditions can increase the risk of dose-related side effects from Bactrim.

For example, taking a higher dose of Bactrim may increase the risk of high blood potassium levels. This risk is greater if you take Bactrim with an angiotensin converting enzyme inhibitor or if you have kidney or liver problems.

Higher doses of Bactrim may also increase the risk of low blood sugar, especially if you take it with diabetes drugs or have liver or kidney problems.

In addition, taking a higher Bactrim dosage can increase the risk of low red blood cell or platelet levels. This risk may be greater for the following people:

• older adults who take thiazide diuretics
• those with an inherited condition called G6PD deficiency

If you have questions about how your Bactrim dosage may affect your risk of interactions, talk with your doctor or pharmacist.

Are there any interactions that increase the risk of Bactrim’s side effects in older adults?

Yes, it’s possible. Certain drug and health-related interactions can increase the risk of side effects from Bactrim in older adults (ages 65 years and older).

For example, taking Bactrim with a thiazide diuretic may increase the risk of a low platelet count with bruise-like rashes in older adults.

Older adults are also more likely to have folate (vitamin B9) deficiency, liver problems, or kidney problems. Bactrim may lower folate levels in the body, which can worsen folate deficiency. Having liver or kidney problems can also increase the risk of side effects from Bactrim, including high blood potassium levels and low blood sugar.

If you have questions about how your age may affect your risk of interactions with Bactrim, talk with your doctor or pharmacist.

Preventing interactions

You can take certain steps to help prevent interactions with Bactrim. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Bactrim label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Bactrim doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Bactrim by taking it exactly as your doctor prescribes.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.