Potential Drug Interactions with Levactrim (Sulfamethoxazole-Trimethoprim)

Major Drug Interactions

• The American Geriatrics Society and European Journal of Heart Failure recommend monitoring for hyperkalemia when combining ACE inhibitors or ARBs with Levactrim, especially in patients with reduced kidney function 1, 2

Special Populations at Risk

• The American Geriatrics Society identifies TMP-SMX as a medication requiring caution in older adults, particularly when combined with ACE inhibitors or ARBs due to hyperkalemia risk 1
• The Centers for Disease Control and Prevention (CDC) reports a higher incidence of severe adverse events in elderly patients taking Levactrim 3, 4
• The CDC contraindicates Levactrim in pregnant women near term, nursing mothers, and infants <2 months due to risk of kernicterus 3, 4

Monitoring Recommendations

• The American Geriatrics Society and European Journal of Heart Failure recommend monitoring electrolytes for hyperkalemia, especially when combining Levactrim with ACE inhibitors or ARBs 1, 2

Severe Adverse Reactions

• The American Academy of Dermatology reports severe dermatologic reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis, associated with Levactrim use 5
• The European Journal of Heart Failure reports metabolic disturbances, including hyperkalemia, associated with Levactrim use 2