See also Antibiotics (General)
Trimethoprim (Proloprim, Trimpex) is commonly combined with sulfamethoxazole (Gantanol) for an antibiotic combination that gives a one-two punch against bacteria.
Supplementation Likely Helpful
Both trimethoprim and sulfamethoxazole interfere with folate: The sulfamethoxazole makes it hard for invading bacteria to manufacture folate, and the trimethoprim makes it hard for bacteria to use the folate. The net effect is to starve the bacteria of this necessary vitamin.
Humans and other mammals are much less affected by these antibiotics than are bacteria, due to the different way we process folate. However, trimethoprim can still interfere to some extent in your body's ability to utilize this essential nutrient. Folate supplementation may be helpful if you take this antibiotic for a long period of time (to prevent urinary tract infections, for example).1
Possible Negative Interaction
The herb white willow contains substances very similar to aspirin. On this basis, it might not be advisable to combine white willow with trimethoprim or sulfamethoxazole.
1. Kahn SB, et al. Effects of trimethoprim on folate metabolism in man. Clin PharmacolTherap 9: 550–560, 1968.
2. Degowin RL, Eppes RB, Carson PE, et al. The effects of diaphenylsulfone (DDS) against chloroquine-resistant Plasmodium falciparum.Bull World Health Organ 34: 671–681, 1966.
3. Vinnicombe HG, Derrick JP. Dihydropteroate synthase from Streptococcus pneumoniae: characterization of substrate binding order and sulfonamide inhibition. Biochem Biophys Res Commun 258: 752–757, 1999.
4. Alappan R, Perazella MA, and Buller GK. Hyperkalemia in hospitalized patients treated with trimethoprim-sulfamethoxazole. Ann Intern Med 124: 316–320, 1996.
Last reviewed August 2013 by EBSCO CAM Review Board
Last Updated: 8/22/2013
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