Sulfonamides

BRAND NAMES: Bactrim; Septra

Cotrimoxazole is a combination of sulfamethoxazole and trimethoprim in a ratio of 5:1 or 1:2. Trimethoprim and sulfamethoxazole both block the production of folic acid, a necessary chemical for both bacteria and humans, and each is an effective antibiotic when used alone. For more information on the individual drugs, please visit their respective sites in the Pharmacy section. Cotrimoxazole was approved by the FDA in 1973.

Cotrimoxazole is used for urinary tract infections, respiratory tract infections, middle ear infections, for prevention of infections due to pneumococcus in transplant recipients, for the treatment or prevention of Pneumocystis carinii pneumonia, chancroid, and prevention of toxoplasma encephalitis in patients with AIDS.

The effects of the sulfonamide class of antibiotics, including sulfamethoxazole, on the fetus have not been adequately studied. Physicians may elect to use cotrimoxazole if its benefits are deemed to outweigh potential risks. On the other hand, use of sulfonamides near term (that is, by the ninth month) may cause bilirubin to be displaced from proteins in the infant's blood. Displacement of bilirubin can lead to jaundice and a dangerous condition called kernicterus in the infant. For this reason, cotrimoxazole should not be used near term in pregnant women.

Sulfamethoxazole

BRAND NAME: Gantanol

DRUG CLASS AND MECHANISM: Sulfamethoxazole is an anti- bacterial sulfonamide. It prevents the formation of dihydrofolic acid, a compound that bacteria must be able to make in order to survive. Although it was once a very useful antibiotic, it is almost obsolete as a single agent today due to the development of bacterial resistance to its effects. Sulfamethoxazole is now used primarily in combination with trimethoprim, a combination product known as Bactrim or Septra. Sulfamethoxazole was approved by the FDA in 1961.

Sulfamethoxazole can enhance the blood-thinning effects of warfarin (Coumadin), possibly leading to bleeding. Sulfonamides such as sulfamethoxazole can increase the metabolism (break-down and elimination) of cyclosporine (causing loss of effectiveness of cyclosporine), and can add to the kidney damage caused by cyclosporine. All sulfonamides can crystallize in urine when the urine is acidic. Since methenamine causes an acidic urine, it should not be used with sulfonamides.

Sulfamethoxazole may cause dizziness, headache, lethargy, diarrhea, anorexia, nausea, vomiting, and rash. Sulfamethoxazole should be stopped at the first appearance of a skin rash since the rash may become severe. Serious rashes include Stevens-Johnson syndrome (aching joints and muscles; redness, blistering, and peeling of the skin); toxic epidermal necrolysis (difficulty in swallowing; peeling, redness, loosening, and blistering of the skin). Sulfamethoxazole therapy also can cause extensive sunburn, following exposure to sunlight. Patients receiving sulfamethoxazole should avoid excessive exposure to sunlight and should wear sunscreen.

Other rare side effects include liver damage, low white blood cell count, low platelet count, and anemia.

Sulfamethoxazole may form crystals in the urine which may damage the kidney and cause bleeding into the urine. It is important to drink additional liquids during sulfonamide therapy to prevent these side effects. Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor. This information is meant only as a guideline - always consult a physician or pharmacist for complete information about prescription medications.

On behalf of learning, and use as teaching tools for those of us who need to know about our disease, I have tried to supply you with as much information as I could find on all of the drugs, treatments and disorders associated with Inflammatory Bowel Diseases. I have tried to blend all facts supported by research and also from personal experiences of other IBD sufferers into one readable webpage, and any and all information presented here is not entirely from one source. Most information contained within these pages is found in the public domain. At times you may find information used from another site, and as with all copyrighted materials you may find on these pages, I claim fair use under sections 107 through 118 of the Copyright Act (title 17, U.S. Code). Click here for more info

• Achieve health, fitness, relaxation, and balance with
  Wai Lana Yoga