Rasuvo and Sulfamethoxazole Trimethoprim Oral Suspension

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.

Methotrexate can cause impaired bone marrow function resulting in low numbers of different types of blood cells, and using it with trimethoprim can increase the risk. You may be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the interaction, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should contact your doctor if you develop paleness, fatigue, dizziness, fainting, unusual bruising or bleeding, fever, chills, diarrhea, sore throat, muscle aches, shortness of breath, blood in phlegm, weight loss, red or inflamed skin, body sores, and pain or burning during urination. 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: Coadministration of methotrexate with trimethoprim may increase the risk of severe myelosuppression and megaloblastic anemia due to potential additive effects resulting from inhibition of dihydrofolate reductase by both drugs. The interaction has been reported primarily with sulfamethoxazole-trimethoprim, but has also occurred with trimethoprim alone. Most cases involved the elderly, often in association with renal impairment. Some were fatal. In one report, an 81-year-old woman receiving low-dose methotrexate (7.5 mg/week) for rheumatoid arthritis developed fatal pancytopenia following the addition of trimethoprim. The dosage of trimethoprim had been 100 mg/day for nearly two months, but was increased to 200 mg/day due to suspected urinary tract infection one week before admission to hospital. The patient's bone marrow failed to recover despite treatment with calcium folinate and granulocyte colony stimulating factor, and she died of bronchopneumonia one week after admission. Likewise, concomitant use of sulfamethoxazole-trimethoprim was identified as a risk factor for pancytopenia associated with low-dose methotrexate use over a 10-year period in a regional survey conducted by a group of investigators in Ottawa.

MANAGEMENT: Concomitant use of methotrexate with trimethoprim should be avoided if possible. Some clinicians consider the use of methotrexate with low-dose sulfamethoxazole-trimethoprim (e.g., for the prophylaxis of Pneumocystis jiroveci pneumonia) to be acceptable; however, close monitoring for hematologic toxicity is recommended, particularly in the elderly. Complete blood counts, liver enzymes, and serum creatinine levels should be performed at baseline and periodically during treatment. Folate supplementation may be required in some cases. Patients should be advised to notify their doctor if they experience signs and symptoms of bone marrow depression or anemia such as fever, chills, sore throat, easy bruising or bleeding, pallor, dizziness, fatigue, lethargy, sore mouth or tongue, and tingling in hands or feet.

Rasuvo

Generic Name: methotrexate

Brand name: Methotrexate Sodium, Preservative Free, Otrexup, Rasuvo, Rheumatrex Dose Pack, Trexall, Xatmep

Synonyms: Rasuvo (injection), Rasuvo Injection

What is Rasuvo?

Sulfamethoxazole Trimethoprim Oral Suspension

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: Sulfamethoxazole and trimethoprim, Sulfamethoxazole and Trimethoprim

What is Sulfamethoxazole Trimethoprim Oral Suspension?