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

From: Hypersensitivity reactions to non beta-lactam antimicrobial agents, a statement of the WAO special committee on drug allergy

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