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The safety and warning information for sulfamethoxazole/trimethoprim, an antibiotic medication, is essential for ensuring its proper use. Please read the following precautions and warnings carefully, and consult your healthcare provider if you have any questions or concerns.

• Pregnancy Warning: This medication is not recommended for use during pregnancy due to potential risks of severe developmental harm to the unborn child. Notify your healthcare provider if you are pregnant, planning to become pregnant, or if you become pregnant while taking this medication.

• Allergic and Skin Reactions: There is a risk of severe allergic reactions, including life-threatening conditions such as anaphylaxis and facial swelling. Serious skin reactions, such as Stevens-Johnson syndrome (SJS) and drug reaction with eosinophilia and systemic symptoms (DRESS), may also occur. These risks are heightened in individuals allergic to sulfa.

• Bleeding Risks: Sulfamethoxazole/trimethoprim can cause low platelet counts, increasing the risk of serious bleeding. This risk is particularly significant if taken with other medications that raise bleeding risk, such as aspirin or warfarin. Platelet counts usually normalize within a week after discontinuation.

• Infection-Related Diarrhea: The medication may increase the risk of infection with Clostridioides difficile, leading to severe diarrhea due to changes in gut bacteria.

• Electrolyte Imbalances: High doses of this medication can lead to elevated potassium levels and reduced sodium levels. Immediate medical attention is advised if symptoms such as weakness, numbness, headache, or confusion occur.

• Blood Cell Disorders: Certain individuals, especially those with conditions like glucose-6 phosphate dehydrogenase (G6PD) deficiency, older adults, or those with kidney, liver problems, or poor nutrition, may experience blood cell-related issues.

• Phenylketonuria (PKU) Advisory: Individuals with PKU should adhere to a low-protein diet while taking this medication, as it can interfere with processing phenylalanine.

Contraindications: This medication should not be used in the following conditions due to potential serious health risks:

• Sulfa allergy
• History of low platelet counts with sulfa or trimethoprim
• Megaloblastic anemia due to low folic acid
• Severe liver or kidney problems
• Children under 2 months old
• Concurrent use of dofetilide (Tikosyn)

Please ensure you discuss any of these conditions or concerns with your healthcare provider before starting this medication.

When taking this medication, it's common to experience mild side effects such as nausea, vomiting, diarrhea, and a loss of appetite. Skin reactions like rashes, hives, or increased sensitivity to sunlight may also occur. These effects are often manageable, but if they persist or worsen, consulting your healthcare provider is a good step.

There are other side effects that some individuals may encounter, including muscle and joint pain, fatigue, weakness, difficulty sleeping, and fluctuations in blood sugar levels. While these are generally less common, they should be discussed with your healthcare provider if they become bothersome.

More serious side effects, although rare, require immediate medical attention. These include severe allergic reactions characterized by hives, blisters, skin rash, and swelling of the lips or tongue, as well as difficulty breathing. Another serious condition, infectious diarrhea caused by C. difficile, presents with symptoms such as rapid heart rate, fever, and frequent, foul-smelling diarrhea. Other critical side effects involve high potassium levels leading to nausea and muscle cramps, or low sodium levels causing fatigue, headache, confusion, and seizures. Additionally, signs of kidney problems such as reduced urination or swelling in extremities, and unexplained weight gain, demand urgent care.

In rare cases, the medication can cause severe health issues like liver damage, blood disorders, or lung injury. Symptoms such as persistent sore throat, fever, cough, skin rash, and unusual tiredness should prompt immediate medical consultation. Always be attentive to any new or worsening symptoms and contact your healthcare provider for guidance.

Sulfamethoxazole/trimethoprim may interact with a variety of medications, so it's important to inform your doctor and pharmacist about all the drugs and supplements you are taking, including prescription, over-the-counter, vitamins, and herbal products.

Some medications should not be used with Sulfamethoxazole/trimethoprim, such as Dofetilide, levomethadyl, and Methenamine. Your doctor might decide against using Sulfamethoxazole/trimethoprim if you are taking these medications.

Other medications, including blood thinners like Warfarin and other drugs such as Methotrexate, may require careful monitoring or dosage adjustments if used together with Sulfamethoxazole/trimethoprim. This is to ensure safety and effectiveness, as the combination can affect how these drugs work or increase the risk of side effects.

Additionally, Sulfamethoxazole/trimethoprim might interfere with certain laboratory tests, potentially leading to incorrect results. It is crucial to inform lab personnel and your healthcare providers that you are using this medication to avoid misinterpretation of test results.