Cotrimoxazole

Do not take cotrimoxazole if you: - Are allergic to sulfonamide drugs or trimethoprim - Have severe kidney or liver disease - Have porphyria (a rare metabolic disorder) - Are in the first trimester of pregnancy or near term (risk to newborn — discuss with doctor) - Are breastfeeding a newborn or premature infant - Have glucose-6-phosphate dehydrogenase (G6PD) deficiency — may cause haemolytic anaemia Important warnings: - Sulfonamide allergy cross-reaction: People allergic to other sulfa drugs (e.g., furosemide, hydrochlorothiazide in high doses) may react to cotrimoxazole — inform your doctor of all allergies - Skin reactions: Report any rash to your doctor immediately — even a mild rash can progress to a life-threatening skin condition - Folate deficiency: Long-term use can reduce folate levels — people on long-term therapy (e.g., HIV prophylaxis) may need folate supplementation - Kidney function: Monitor kidney function in people with pre-existing kidney disease — drink plenty of water - G6PD deficiency is more common in West Africans — screen where possible before long-term use