Natural Health Research

Naturopathic Medicine
Health Quizzes
Trimethoprim, Trimethoprim-Sulfamethazone, TMP-SMZ, Bactrim, Cotrim, Septra


Trimethoprim-Sulfamethazone is an antibiotic combination that interferes with folate metabolism


antibiotic combination, interfere with folate


Side Effects

agranulocytosis, anorexia, aplastic anemia, bullous rash, crystalluria, diarrhea, dizziness, elevated hepatic enzymes, erythema nodosum, glossitis, headache, hematuria, hemolytic anemia, hepatic necrosis, hepatitis, hyperkalemia, interstitial nephritis, jaundice, leukopenia, maculopapular rash, methemoglobinemia, nausea/vomiting, neutropenia, pancreatitis, pancytopenia, photosensitivity, purpura, renal tubular necrosis, Stevens-Johnson syndrome, stomatitis, toxic epidermal necrolysis, urticaria,

Drug-Vitamin-Herb Interactions

Negative interactions:

PABA isused by bacteria to make folate. TMP-SMZ blocks bacterial folate production.

TMP-SMZ may increase potassium levels which may cause hyperkalemia.

St JohnÕs Wort and Dong Quai
St JohnÕs Wort and Dong Quai can cause sensitivity to sunlight adding to drug side effects.

Positive interactions:

Lactobacillus acidophilus
Probiotics replace normal intestinal bacteria, which may reduce the side effect of diarrhea associated with antibiotics.

Sacchromyces boulardii
Sacchromyces boulardii may prevent antibiotic-related diarrhea.

Vitamin K
Antibiotics may cause vitamin K deficiency by destroying the beneficial bacteria that produce it.

TMP-SMZ blocks bacterial folate production, folate may be helpful if taken long-term.

N-Acetyl cysteine
N-Acetyl cysteine may help prevent side effects caused by long term use of TMP-SMZ.




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