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This drug safety and warning information is crucial for ensuring the safe use of sulfamethoxazole/trimethoprim. Please read the following details carefully and discuss any concerns with your healthcare provider.

• Pregnancy Warning: Sulfamethoxazole/trimethoprim is not advised during pregnancy due to the potential risk of severe developmental harm to the unborn child. Inform your healthcare provider if you are or plan to become pregnant before starting this medication. Contact your provider immediately if you become pregnant while using this drug to explore safer treatment alternatives.

• Allergic Reactions and Skin Conditions: Some individuals may experience serious allergic reactions, including anaphylaxis and facial swelling, which can be life-threatening. Rare but severe skin reactions, such as Stevens-Johnson syndrome (SJS) and DRESS syndrome, may also occur, particularly in those allergic to sulfa drugs.

• Thrombocytopenia and Bleeding Risk: This medication may lower platelet counts, increasing the risk of serious bleeding, especially when combined with other medications that elevate bleeding risk, such as aspirin or warfarin. Platelet counts typically return to normal within a week after discontinuing the drug.

• C. difficile Infection: There's an increased risk of infection with the bacterium Clostridioides difficile, leading to severe diarrhea, as antibiotics can disrupt the normal gut flora.

• Electrolyte Imbalances: High doses of sulfamethoxazole/trimethoprim can lead to elevated potassium levels and reduced sodium levels. Contact a healthcare professional immediately if you experience symptoms such as weakness, tingling, headache, confusion, or memory issues. Risks are higher in individuals with kidney problems.

• Blood Cell Disorders: Certain genetic conditions, like G6PD deficiency, can cause red blood cell damage when taking this medication. Risks are also heightened in older adults, those who consume alcohol regularly, or individuals with kidney or liver issues, or poor nutrition.

• Phenylketonuria (PKU) Considerations: Individuals with PKU should maintain a low-protein diet while using this drug, as it may exacerbate difficulties in processing phenylalanine.

Contraindications: Do not use sulfamethoxazole/trimethoprim if you have any of the following conditions, as they pose significant health risks:

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

Consult your healthcare provider if any of these conditions apply to you before starting this medication.

When taking this medication, you may experience some common side effects such as nausea, vomiting, diarrhea, and loss of appetite. In most cases, these effects are mild and temporary; however, if they persist or become bothersome, consult your healthcare provider for advice. Additionally, you might notice a rash, hives, or increased sensitivity to sunlight. These are generally not serious, but should be monitored.

Some users have reported other effects, including muscle or joint pain, fatigue, weakness, and trouble sleeping. These can occur occasionally and may require medical attention if they become severe. It is also possible to experience changes in blood sugar levels, which should be discussed with your healthcare provider.

There are some rare yet serious side effects that warrant immediate medical attention. These include severe allergic reactions characterized by hives, blistering skin, or swelling of the lips and tongue. Another severe condition is infectious diarrhea associated with C. difficile, which presents with rapid heart rate, fever, and frequent, foul-smelling diarrhea. High potassium levels could lead to nausea and muscle cramps, while low sodium levels might cause fatigue, headaches, confusion, or seizures. Kidney issues can manifest as reduced urination, swelling in the extremities, or unexpected weight gain.

In extremely rare cases, life-threatening reactions such as Stevens-Johnson syndrome, blood disorders, liver damage, or lung injury could occur, presenting symptoms like persistent sore throat, fever, unexplained bleeding, or yellowing of the skin or eyes. Always seek medical help if you encounter these severe symptoms. Remember, this is not an exhaustive list, and any new or unusual symptoms should be discussed with your healthcare provider.

When taking sulfamethoxazole/trimethoprim, it is important to be aware of potential interactions with other medications. Inform your doctor and pharmacist about all the medicines and supplements you are currently using, including prescriptions, over-the-counter drugs, vitamins, and herbal products.

Certain drugs should not be combined with sulfamethoxazole/trimethoprim. For example, Dofetilide, levomethadyl, and Methenamine are not recommended for use alongside this medication due to potential risks.

In some cases, other medications might be used with caution. These include Warfarin (a blood thinner), Methotrexate, and a wide range of others such as Amiodarone, Erythromycin, and Fluoxetine. If these are prescribed together, your doctor may adjust the dosages or the frequency of use to minimize risks.

Additionally, using sulfamethoxazole/trimethoprim with certain medicines may increase the likelihood of side effects. This might be necessary for your treatment, so your healthcare provider may modify how you take these drugs.

Lastly, this medication might alter some lab test results, leading to inaccuracies. Ensure that all your healthcare providers and lab technicians know you are taking this drug to avoid misinterpretation of test outcomes.