Sulfamethoxazole; Trimethoprim, SMX-TMP oral suspension

What is this medicine?

SULFAMETHOXAZOLE; TRIMETHOPRIM or SMX-TMP (suhl fuh meth OK suh zohl; trye METH oh prim) is a combination of a sulfonamide antibiotic and a second antibiotic, trimethoprim. It is used to treat or prevent certain kinds of bacterial infections.It will not work for colds, flu, or other viral infections.

How should I use this medicine?

Take this medicine by mouth. Follow the directions on the prescription label. Shake well before using. Use a specially marked oral syringe, spoon, or dropper to measure each dose. Ask your pharmacist if you do not have one. Household spoons are not accurate. Take your medicine at regular intervals. Do not take it more often than directed. Take all of your medicine as directed even if you think you are better. Do not skip doses or stop your medicine early.

Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for children as young as 2 months for selected conditions, precautions do apply.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions (skin rash, itching or hives; swelling of the face, lips, or tongue)

• bloody or watery diarrhea

• cough

• heartbeat rhythm changes (trouble breathing; chest pain; dizziness; fast, irregular heartbeat; feeling faint or lightheaded, falls,)

• fever

• high potassium levels (chest pain; fast, irregular heartbeat; muscle weakness)

• kidney injury (trouble passing urine or change in the amount of urine)

• liver injury (dark yellow or brown urine; general ill feeling or flu-like symptoms; loss of appetite, right upper belly pain; unusually weak or tired, yellowing of the eyes or skin)

• low blood pressure (dizziness; feeling faint or lightheaded, falls; unusually weak or tired)

• low blood sugar (feeling anxious; confusion; dizziness; increased hunger; unusually weak or tired; increased sweating; shakiness; cold, clammy skin; irritable; headache; blurred vision; fast heartbeat; loss of consciousness)

• low red blood cell counts (trouble breathing; feeling faint; lightheaded, falls; unusually weak or tired)

• rash, fever, and swollen lymph nodes

• redness, blistering, peeling, or loosening of the skin, including inside the mouth

• trouble breathing

• unusual bruising or bleeding

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• lack or loss of appetite

• nausea

• vomiting

What may interact with this medicine?

Do not take this medicine with any of the following medications:

• dofetilide

This medicine may also interact with the following medications:

• amantadine

• birth control pills

• certain medicines for blood pressure, heart disease

• certain medicines for depression, like amitriptyline

• certain medicines for diabetes, like glipizide or glyburide

• certain medicines that treat or prevent blood clots like warfarin

• cyclosporine

• digoxin

• diuretics

• indomethacin

• methotrexate

• phenytoin

• procainamide

• pyrimethamine

• zidovudine

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

Where should I keep my medicine?

Keep out of the reach of children.

Store between 15 and 25 degrees C (59 to 77 degrees F). Protect from light. Keep the container tightly closed. Throw away any unused drug after the expiration date.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• G6PD deficiency

• HIV or AIDS

• kidney disease

• liver disease

• low platelets

• low red blood cell counts

• poor nutrition

• stomach or intestine problems like colitis

• thyroid disease

• an unusual or allergic reaction to sulfamethoxazole, trimethoprim, sulfa drugs, other drugs, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

What should I watch for while using this medicine?

Tell your health care provider if your symptoms do not start to get better or if they get worse.

Do not treat diarrhea with over the counter products. Contact your health care provider if you have diarrhea that lasts more than 2 days or if it is severe and watery.

This drug may cause serious skin reactions. They can happen weeks to months after starting the drug. Contact your health care provider right away if you notice fevers or flu-like symptoms with a rash. The rash may be red or purple and then turn into blisters or peeling of the skin. Or, you might notice a red rash with swelling of the face, lips or lymph nodes in your neck or under your arms.

This drug can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and sunscreen. Do not use sun lamps or tanning beds/booths.

Be careful brushing or flossing your teeth or using a toothpick because you may get an infection or bleed more easily. If you have any dental work done, tell your dentist you are receiving this drug.