Table 1 Side effects linked to Sulfamethoxazole and Trimethoprim (Cotrimoxazole)

Sulfamethoxazole

• General side effects

Nausea, vomiting, anorexia, diarrhoea, hypoglycaemia, hypothyroidism,

neurological reactions including aseptic meningitis, ataxia, benign

intracranial hypertension, convulsions, dizziness. drowsiness, fatigue,

headache, insomnia, mental depression, peripheral or optic

neuropathies, psychoses, tinnitus, vertigo, and pancreatitis.

• Hypersensitivity reactions:

Skin: Exanthema, pruritus, photosensitivity reactions, exfoliative

dermatitis, SJS/TEN, erythema nodosum.

Systemic: DiHS (with involvement of various organs), Henoch Schönlein

purpura, interstitial nephritis (DD crystallisation); anaphylaxis/urticaria.

Blood: eosinophilia, agranulocytosis, aplastic anaemia,

thrombocytopenia, leucopenia, hypothrombinemia, acute haemolytic

anemia (glucose-6-phosphate dehydrogenase deficiency)

Trimethoprim

• General side effects

Nausea, vomiting, anorexia, diarrhea, thrombocytopenia, megaloblastic

anemia, hyperkalemia, rise in serum creatinine.

• Hypersensitivity reactions:

Drug-induced liver injury (cholestatic and hepatocellular hepatitis)

IgE-mediated anaphylaxis