Leucovorin Oral, Intravenous, Injection and Sulfatrim Pediatric

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Ask your doctor before using trimethoprim together with leucovorin. Using these medications together has been associated with increased rates of treatment failure. If your doctor prescribes these medications together, you may need a dose adjustment or special tests to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

GENERALLY AVOID: Concomitant use of leucovorin with sulfamethoxazole-trimethoprim (SMX-TMP) for the acute treatment of Pneumocystis jiroveci pneumonia (formerly known as Pneumocystis carinii pneumonia, or PCP) has been associated with increased rates of treatment failure and morbidity. In a randomized, double-blind, placebo-controlled study consisting of 92 AIDS patients with PCP, a higher rate of both therapeutic failure (15% vs. 0%) and death (11% vs. 0%) was observed in subjects receiving SMX-TMP and leucovorin compared to subjects receiving SMX-TMP alone. The time to therapeutic failure was shorter and probability of death greater in patients receiving leucovorin, even after adjusting for baseline arterial oxygen pressure, serum lactate dehydrogenase, respiratory rate, CD4 cell count, and peak serum level of SMX or TMP. Although the incidence of neutropenia was lower in patients receiving leucovorin (23% vs. 47%), there was no significant difference in time to occurrence. Isolated case reports have also described treatment failure when SMX-TMP was administered in combination with leucovorin, both in AIDS patients and in renal transplant patients. The actual efficacy of leucovorin in mitigating adverse effects of SMX-TMP is questionable. In one study, investigators found that leucovorin use did not improve tolerance for chronic SMX-TMP prophylaxis in AIDS, even among patients taking the medication daily. In another study, leucovorin therapy did not abolish the cytopenia associated with SMX-TMP in 12 patients with PCP, and the authors recommended that leucovorin not be routinely prescribed for this purpose.

MANAGEMENT: The use of leucovorin in immunosuppressed patients receiving SMX-TMP for treatment of Pneumocystis jiroveci pneumonia should be avoided unless benefits are anticipated to outweigh the risks.

Leucovorin Oral, Intravenous, Injection

Generic Name: leucovorin

Brand name: Wellcovorin

Synonyms: Leucovorin

What is Leucovorin Oral, Intravenous, Injection?

Sulfatrim Pediatric

Generic Name: sulfamethoxazole / trimethoprim

Brand name: Bactrim, Bactrim DS, Bactrim IV, Septra IV, SMZ-TMP DS, Sulfatrim Pediatric, Septra, Sulfatrim, Bethaprim, Cotrim, Uroplus, Uroplus DS, Cotrim DS, Bactrim Pediatric, Bethaprim Pediatric, Sulfatrim Suspension, Cotrim Pediatric, Septra DS

Synonyms: Sulfatrim Pediatric (Oral)

What is Sulfatrim Pediatric?