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No chromosomal effects were detected in peripheral lymphocytes of human subjects receiving 320 mg of Trimethoprim in combination with up to 1600 mg of sulfamethoxazole per day for as long as 112 weeks. Up to 20% of patients with AIDS who are given trimethoprim-sulfamethoxazole develop mild hyperkalemia due to the effect of trimethoprim, not sulfamethoxazole, on the kidney. Pneumocystis Pneumonia ProphylaxisBactrim, sulfamethoxazole/trimethoprim, Bactrim DS, Septra, Septra DS, More. HepaticCholestatic hepatitis associated with sulfamethoxazole therapy may present with other signs of hypersensitivity, such as rash, fever, and eosinophilia. Fulminant hepatic failure has occurred in a few patients treated with trimethoprim-sulfamethoxazole and is likely due to the sulfamethoxazole component. Nervous systemRare cases of aseptic meningitis associated with trimethoprim-sulfamethoxazole have been reported. Frequent monitoring of liver function tests during sulfamethoxazole therapy is recommended in patients with liver dysfunction. Cholestatic jaundice, thought to be due to hypersensitivity, has been reported with sulfamethoxazole alone. MetabolicMetabolic side effects have included hyperkalemia associated with sulfamethoxazole-trimethoprim in elderly patients, and hyponatremia. EndocrineSulfamethoxazole, like other sulfonamides, may induce hypoglycemia by stimulating pancreatic islet cells to secrete insulin. Frequent monitoring of serum creatinine and urinalysis is recommended during sulfamethoxazole therapy in patients with renal insufficiency. Serologic studies (flow cytometry) on a man with profound and symptomatic thrombocytopenia, associated with trimethoprim-sulfamethoxazole (TMP-SMX), revealed significant SMX-dependent platelet-reactive antibody. There is in vitro evidence for a sulfamethoxazole-associated antiplatelet antibody. Beba suficiente l