What are the main uses of Sulfamethoxazole-Trimethoprim. How does this antibiotic combination work. What are the most common side effects and drug interactions to be aware of. When should this medication be avoided.

Understanding Sulfamethoxazole-Trimethoprim: An Antibiotic Powerhouse

Sulfamethoxazole-trimethoprim, also known as co-trimoxazole, is a powerful antibiotic combination used to treat a wide range of bacterial infections. This medication pairs two antibiotics – sulfamethoxazole and trimethoprim – to create a synergistic effect against many types of bacteria. By understanding how this drug works, its common uses, potential side effects, and important interactions, patients can use it more safely and effectively.

The Mechanism of Action: How Sulfamethoxazole-Trimethoprim Fights Bacteria

How does this antibiotic combination work to combat infections? Sulfamethoxazole and trimethoprim target different steps in bacterial folate synthesis:

• Sulfamethoxazole inhibits dihydropteroate synthetase, preventing bacteria from using para-aminobenzoic acid (PABA) to produce folic acid
• Trimethoprim blocks dihydrofolate reductase, further disrupting folate metabolism

By interfering with folate production at multiple points, this combination prevents bacteria from synthesizing DNA and proteins essential for their survival and replication. This dual mechanism makes sulfamethoxazole-trimethoprim effective against a broad spectrum of bacterial pathogens.

Common Uses: When Is Sulfamethoxazole-Trimethoprim Prescribed?

This versatile antibiotic combination is used to treat various bacterial infections affecting different parts of the body. Some of the most common indications include:

• Urinary tract infections (UTIs)
• Respiratory tract infections like bronchitis and pneumonia
• Ear infections (otitis media)
• Intestinal infections
• Skin and soft tissue infections

Additionally, sulfamethoxazole-trimethoprim plays a crucial role in preventing and treating Pneumocystis jirovecii pneumonia, a serious fungal infection that often affects immunocompromised individuals, such as those with HIV/AIDS.

Special Considerations for Pediatric Use

Are there age restrictions for using this medication? Indeed, sulfamethoxazole-trimethoprim should not be given to infants younger than 2 months old due to the risk of serious side effects. For older children, dosing is typically based on weight to ensure safety and efficacy.

Potential Side Effects: What to Watch For

While sulfamethoxazole-trimethoprim is generally well-tolerated, it can cause various side effects. Common adverse reactions may include:

• Nausea and vomiting
• Diarrhea
• Loss of appetite
• Skin rash or itching
• Headache
• Dizziness

More serious side effects, though less common, can occur and require immediate medical attention. These may include:

• Severe skin reactions (e.g., Stevens-Johnson syndrome)
• Blood disorders (e.g., anemia, thrombocytopenia)
• Liver or kidney problems
• Allergic reactions

Monitoring for Adverse Reactions

How can patients and healthcare providers monitor for potential side effects? Regular check-ups and blood tests during treatment can help detect any developing issues early. Patients should report any unusual symptoms or changes in their health to their healthcare provider promptly.

Drug Interactions: Navigating Potential Risks

Sulfamethoxazole-trimethoprim can interact with numerous other medications, potentially altering their effectiveness or increasing the risk of side effects. According to the provided information, there are 402 known drug interactions, categorized as follows:

• 68 major interactions
• 133 moderate interactions
• 201 minor interactions

Some commonly used medications that may interact with sulfamethoxazole-trimethoprim include:

• Warfarin (increased risk of bleeding)
• Methotrexate (increased toxicity)
• ACE inhibitors (increased risk of hyperkalemia)
• Some diabetes medications (increased risk of hypoglycemia)

Managing Medication Interactions

How can patients safely manage potential drug interactions? It’s crucial to inform healthcare providers about all medications, supplements, and herbal products being taken. Doctors may need to adjust dosages, monitor certain parameters more closely, or choose alternative treatments to minimize risks.

Special Precautions: When to Avoid Sulfamethoxazole-Trimethoprim

Certain conditions may increase the risks associated with sulfamethoxazole-trimethoprim use. The medication should be used with caution or avoided in patients with:

• Kidney or liver disease
• Folate deficiency
• G6PD deficiency
• History of allergic reactions to sulfa drugs
• Pregnancy (especially in the third trimester) or breastfeeding

Additionally, the medication interacts with 12 specific disease states, including colitis, liver disease, and porphyria. Patients with these conditions should discuss the risks and benefits of treatment with their healthcare provider.

Proper Usage and Adherence: Maximizing Treatment Effectiveness

To ensure the best possible outcomes when taking sulfamethoxazole-trimethoprim, patients should follow these guidelines:

1. Take the medication exactly as prescribed, usually twice daily
2. Complete the full course of treatment, even if symptoms improve before finishing
3. Stay well-hydrated to reduce the risk of kidney-related side effects
4. Take the medication with food if it causes stomach upset
5. Avoid prolonged sun exposure, as the medication can increase skin sensitivity

The Importance of Finishing the Prescribed Course

Why is it crucial to complete the entire antibiotic course? Stopping treatment early, even if symptoms have resolved, can lead to the survival of more resistant bacteria. This not only increases the risk of recurrent infection but also contributes to the broader issue of antibiotic resistance.

Antibiotic Stewardship: Using Sulfamethoxazole-Trimethoprim Responsibly

The responsible use of antibiotics like sulfamethoxazole-trimethoprim is crucial for maintaining their effectiveness and preventing the development of antibiotic-resistant bacteria. Here are some key principles of antibiotic stewardship:

• Use antibiotics only when necessary for bacterial infections
• Avoid using antibiotics for viral infections like the common cold or flu
• Follow prescribed dosages and treatment durations carefully
• Never share antibiotics or use leftover medications from previous treatments
• Dispose of unused antibiotics properly

By adhering to these principles, patients can help preserve the effectiveness of sulfamethoxazole-trimethoprim and other antibiotics for future use.

Monitoring and Follow-up: Ensuring Treatment Success

Regular monitoring during sulfamethoxazole-trimethoprim treatment is essential for detecting potential issues early and ensuring the infection is responding appropriately. This may involve:

• Follow-up appointments with healthcare providers
• Blood tests to check kidney and liver function
• Reassessment of symptoms to confirm infection clearance
• Adjusting treatment if necessary based on response or side effects

When to Seek Immediate Medical Attention

Which symptoms warrant urgent medical care during treatment? Patients should contact their healthcare provider immediately if they experience:

• Severe skin rashes or blistering
• Unusual bleeding or bruising
• Yellowing of the skin or eyes
• Severe diarrhea
• Signs of an allergic reaction (e.g., difficulty breathing, swelling of the face or throat)

Prompt attention to these symptoms can help prevent serious complications and ensure the best possible treatment outcomes.

Alternative Treatment Options: When Sulfamethoxazole-Trimethoprim Isn’t Suitable

In cases where sulfamethoxazole-trimethoprim is contraindicated or not well-tolerated, alternative antibiotics may be considered. The choice of alternative treatment depends on various factors, including:

• The specific type of infection
• Local patterns of antibiotic resistance
• Patient allergies and medical history
• Potential drug interactions with other medications

Some common alternatives to sulfamethoxazole-trimethoprim include:

• Fluoroquinolones (e.g., ciprofloxacin, levofloxacin)
• Beta-lactam antibiotics (e.g., amoxicillin, cephalosporins)
• Macrolides (e.g., azithromycin, clarithromycin)
• Tetracyclines (e.g., doxycycline)

Tailoring Treatment to Individual Needs

How do healthcare providers choose the most appropriate antibiotic? The selection process involves considering the patient’s specific infection, medical history, local antibiotic resistance patterns, and potential side effects or interactions. This personalized approach helps ensure the most effective and safe treatment for each individual.

In conclusion, sulfamethoxazole-trimethoprim is a valuable antibiotic combination that plays a crucial role in treating various bacterial infections. By understanding its uses, potential side effects, and important precautions, patients and healthcare providers can use this medication more effectively and safely. Regular monitoring, adherence to prescribed regimens, and awareness of potential interactions are key to maximizing the benefits of sulfamethoxazole-trimethoprim while minimizing risks. As with all antibiotics, responsible use is essential to preserve its effectiveness for future generations.

Sulfamethoxazole/trimethoprim Interactions – Drugs.com

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There are 402 drugs known to interact with
sulfamethoxazole/trimethoprim, along with
12 disease interactions, and 1 alcohol/food interaction.

Of the total drug interactions,
68 are major, 133 are moderate, and 201 are minor.

Does sulfamethoxazole/trimethoprim interact with my other drugs?

Enter other medications to view a detailed report.

• View all 402 medications that may interact with sulfamethoxazole/trimethoprim
• View sulfamethoxazole/trimethoprim alcohol/food interactions (1)
• View sulfamethoxazole/trimethoprim disease interactions (12)

Most frequently checked interactions

View interaction reports for sulfamethoxazole / trimethoprim and the medicines listed below.

• Major
• Moderate
• Minor
• Unknown

• Aspirin Low Strength (aspirin)
• Azithromycin Dose Pack (azithromycin)
• Benadryl (diphenhydramine)
• Celebrex (celecoxib)
• Claritin (loratadine)
• CoQ10 (ubiquinone)
• Cymbalta (duloxetine)
• Eliquis (apixaban)
• Fish Oil (omega-3 polyunsaturated fatty acids)
• Flonase (fluticasone nasal)
• Lexapro (escitalopram)
• Lyrica (pregabalin)
• Metoprolol Succinate ER (metoprolol)
• Metoprolol Tartrate (metoprolol)
• MiraLAX (polyethylene glycol 3350)
• Norco (acetaminophen / hydrocodone)
• ProAir HFA (albuterol)
• Probiotic Formula (bifidobacterium infantis / lactobacillus acidophilus)
• Symbicort (budesonide / formoterol)
• Synthroid (levothyroxine)
• Tylenol (acetaminophen)
• Tylenol Extra Strength (acetaminophen)
• Vitamin B12 (cyanocobalamin)
• Vitamin C (ascorbic acid)
• Vitamin D2 (ergocalciferol)
• Vitamin D3 (cholecalciferol)
• Xanax (alprazolam)
• Zofran (ondansetron)
• Zoloft (sertraline)
• Zyrtec (cetirizine)

Sulfamethoxazole/trimethoprim alcohol/food interactions

There is 1 alcohol/food interaction with sulfamethoxazole / trimethoprim.

Sulfamethoxazole/trimethoprim disease interactions

There are 12 disease interactions with sulfamethoxazole / trimethoprim which include:

• colitis
• hematologic toxicity
• hypersensitivity reactions
• liver disease
• porphyria
• renal dysfunction
• folate deficiency
• crystalluria
• hemodialysis
• urinary obstruction
• dialysis
• renal dysfunction

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.

Major	Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate	Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor	Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown	No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Sulfamethoxazole-TMP DS Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Uses

This medication is a combination of two antibiotics: sulfamethoxazole and trimethoprim. It is used to treat a wide variety of bacterial infections (such as middle ear, urine, respiratory, and intestinal infections). It is also used to prevent and treat a certain type of pneumonia (pneumocystis-type).This medication should not be used by children less than 2 months of age due to the risk of serious side effects.This medication treats only certain types of infections. It will not work for viral infections (such as flu). Unnecessary use or misuse of any antibiotic can lead to its decreased effectiveness.

How to use Sulfamethoxazole-TMP DS Tablet

Take this medication by mouth, as directed by your doctor, with a full glass of water (8 ounces / 240 milliliters). If stomach upset occurs, take with food or milk. Drink plenty of fluids while taking this medication to lower the unlikely risk of kidney stones forming, unless your doctor advises you otherwise. Dosage is based on your medical condition and response to treatment.

For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same time(s) every day.

Continue to take this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping it too early may allow bacteria to continue to grow, which may result in a relapse of the infection.

Tell your doctor if your condition lasts or gets worse.

Side Effects

Nausea, vomiting, diarrhea, and loss of appetite may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: muscle weakness, mental/mood changes, signs of kidney problems (such as change in the amount of urine, blood in the urine), extreme drowsiness, signs of low blood sugar (such as sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness, or tingling hands/feet).

Get medical help right away if you have any very serious side effects, including: headache that doesn’t go away, neck stiffness, seizures, slow/irregular heartbeat.

This medication may rarely cause serious (possibly fatal) allergic reactions and other side effects such as a severe peeling skin rash (such as Stevens-Johnson syndrome), blood disorders (such as agranulocytosis, aplastic anemia), liver damage, or lung injury. If you notice any of the following, get medical help right away: sore throat or fever that doesn’t go away, cough that doesn’t go away, nausea/vomiting that doesn’t stop, skin rash/blisters, itching/swelling (especially of the face/tongue/throat), new or worsening lymph node swelling, paleness, joint pain/aches, trouble breathing, easy bleeding/bruising, yellowing eyes or skin, unusual fatigue, dark urine.

This medication may rarely cause a severe intestinal condition due to a bacteria called C. difficile. This condition may occur during treatment or weeks to months after treatment has stopped. Tell your doctor right away if you develop: diarrhea that doesn’t stop, abdominal or stomach pain/cramping, blood/mucus in your stool.

If you have these symptoms, do not use anti-diarrhea or opioid products because they may make symptoms worse.

Use of this medication for prolonged or repeated periods may result in oral thrush or a new yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking this medication, tell your doctor or pharmacist if you are allergic to sulfamethoxazole or trimethoprim; or to sulfa medications; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease, certain blood disorders (such as porphyria, anemia due to folate vitamin deficiency), history of blood disorders caused by trimethoprim or sulfa medications, vitamin deficiency (folate or folic acid), severe allergies, asthma, decreased bone marrow function (bone marrow suppression), a certain metabolic disorder (G6PD deficiency), underactive thyroid, mineral imbalances (such as high level of potassium or low level of sodium in the blood).

This medication may cause live bacterial vaccines (such as typhoid vaccine) to not work well. Tell your health care professional that you are using this medication before having any immunizations/vaccinations.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Get medical help right away if you get sunburned or have skin blisters/redness.

If you have diabetes, this product may affect your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Tell your doctor right away if you have symptoms of low blood sugar (see Side Effects section). Your doctor may need to adjust your diabetes medication, exercise program, or diet.

Older adults may be more sensitive to the side effects of this drug, especially skin reactions, blood disorders, easy bleeding/bruising, and a high potassium blood level.

Patients with AIDS may be more sensitive to the side effects of this drug, especially skin reactions, fever, and blood disorders.

Tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while using sulfamethoxazole/trimethoprim. This medication may harm an unborn baby. If you become pregnant, talk to your doctor right away about the risks and benefits of this medication.

This drug passes into breast milk. While there have been no reports of harm to healthy infants, this drug may have undesirable effects on infants who are ill or premature or have certain disorders (jaundice, high blood levels of bilirubin, G6PD deficiency). Breast-feeding is not recommended for infants with these conditions. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug include: “blood thinners” (such as warfarin), dofetilide, methenamine, methotrexate.

This product may interfere with certain laboratory tests, possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this product.

Does Sulfamethoxazole-TMP DS Tablet interact with other drugs you are taking?

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Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe nausea/vomiting/diarrhea, severe dizziness or drowsiness, mental/mood changes.

Do not share this medication with others.

This medication has been prescribed for your current condition only. Do not use it later for another infection unless your doctor tells you to.

If taking this medication for a long time, lab and/or medical tests (such as complete blood count, kidney function, potassium blood level, cultures) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Use of sulfamethoxazole/trimethoprim in the treatment of children with cancer

Antibiotic

Brand names:

Bactrim®, Septra®, Sulfatrim®

Other names:

SMX-TMP, Co-trimoxazole

Often used for:

Infections

Sulfamethoxazole/trimethoprim is an antibiotic; its action is aimed at the destruction of bacteria that cause infections. Some patients are given this drug to prevent pneumonia during chemotherapy. This drug may also be used to treat infections. Follow dosage instructions carefully.

You may need to have blood tests while taking this drug.

Oral tablets

Oral liquid form

Administered intravenously (through a drip) in liquid form

• Nausea and vomiting
• Rash
  
• Sun sensitivity
  
• Loss of appetite
• Diarrhea
• Pain in the abdomen
• Low blood counts

These side effects may not occur in all patients treated with sulfamethoxazole/trimethoprim. The most common side effects are highlighted in bold, but others are not excluded. Report all possible side effects to your doctor or pharmacist.

Be sure to discuss these and other recommendations with your doctor or pharmacist.

• It is important to drink plenty of fluids while taking this medicine. It is necessary to drink the amount of liquid recommended by the doctor.
• The drug may interfere with the results of some laboratory tests.
• Alcoholic beverages should be avoided while taking this drug.
• Patients should protect their skin from sunlight during treatment with this drug.
• Pregnant, planning pregnancy or breastfeeding patients should notify the attending physician.
• The course of taking the drug must be completed completely in accordance with the recommendations of the attending physician or pharmacist.

Home use of sulfamethoxazole/trimethoprim:

• The drug should be taken at the same time every day.
• This drug can be taken with or without food. If the drug causes stomach upset, it must be taken with food.
• It is recommended to take the drug with a full glass of water.
• In liquid form: shake well before use, measure dosage using the measuring device included.
• Store at room temperature. Avoid exposure to direct sunlight.
• Take your dose as soon as possible if you miss it. Do not do this only if there is little time left until the next appointment. In no case do not double the dose at the next dose!
• Do not use an expired drug.
• Follow instructions for safe storage and disposal of the drug.

Learn more about sulfamethoxazole/trimethoprim

ERIPRIM CONCENTRATE – instructions, description

ERIPRIM CONCENTRATE
Water-soluble powder for oral administration. Contains as active ingredients macrolide antibiotic tylosin – 5%, sulfanilamide sulfamethoxazole – 17.5%, trimethoprim – 3.5%, polypeptide antibiotic colistin – 1.5%, as well as auxiliary components. The drug is a white powder soluble in water.

Purpose
Used for therapeutic purposes in bacterial infections of poultry.

Biological properties
Tylosin is a bacteriostatic macrolide antibiotic. Tylosin penetrates into the bacterial cell through passive diffusion, where it blocks protein synthesis by binding to the 50S ribosomal subunit. The spectrum of action of tylosin covers gram-positive bacteria, as well as mycoplasmas. Sulfamethoxazole is a synthetic chemotherapeutic agent from the group of sulfonamides, the mechanism of action of which is to block the synthesis of folic acid in bacteria, which leads to a stop in the synthesis of bacterial nucleic acids. Trimethoprim is a synthetic chemotherapeutic agent derived from diaminopyrimidines. In combination, sulfamethoxazole with trimethoprim has a synergistic effect and is effective against many gram-positive and gram-negative microorganisms. Colistin belongs to polypeptide antibiotics and acts on gram-negative bacteria by replacing lipids and proteins of the bacterial cell wall. The components of the drug are distributed differently in the body. Tylosin is rapidly absorbed from the gastrointestinal tract and remains at therapeutic concentrations in the organs and tissues of the body for 15-20 hours. The highest concentrations are achieved in the lungs, liver and kidneys. Excretion occurs mainly with bile. Sulfamethoxazole after oral administration is consistently absorbed and distributed in the tissues and body fluids of the bird. Transforms in the liver into acetylated and hydroxylated derivatives. Excreted from the body by the kidneys. When administered orally, trimethoprim is consistently absorbed, reaching peak plasma concentrations 2 to 4 hours after administration. The highest concentrations are achieved in the lungs, liver and kidneys. Plasma concentrations are usually lower than tissue concentrations. Excretion occurs by the kidneys and to a small extent – with bile. Colistin is absorbed very slowly from the gastrointestinal tract. Plasma concentrations are practically not determined. It stands out mainly with litter. Eriprim Concentrate belongs to drugs with low toxicity for poultry.

Dosage and route of administration
The drug is administered orally mixed with water at a daily dose of 1 g/l of water for 3-5 days. During treatment, the bird should receive only water containing Eriprim Concentrate.

Contraindications
Do not use in commercial laying hens.

Product form
Eriprim Concentrate is produced in sealed three-layer bags of 0.5 and 1 kg, packed in cardboard boxes of 10 pcs, as well as in 5 kg bags, packed in cardboard drums of 1 pc. List B. Store in a dry place out of direct sunlight at a temperature of 5 to 25 ° C. The shelf life of the drug is 2 years. Manufacturer s.p. veterinaria, s.a., RIUDOMS (Tarragona), Spain

Notes
Poultry may be slaughtered for meat 28 days after the last use of the preparation. Poultry meat, forced to be killed before the expiration of the specified period, can be used for feeding fur-bearing animals or for the production of meat and bone meal.

Side effects
Not observed at recommended doses. In some individuals, the use of the drug can cause dysbacteriosis. With prolonged use, dysbacteriosis may occur, leading to digestive disorders. In these cases, stop the administration of the drug and apply symptomatic treatment.