Bactrim, septra, sulfonamide antibiotics, sulfa -- yikes!

[Rachel]

Thank you thank you to all who have posted previously about how sulfa antibiotics can cause lows in our insulin-using kids!!!

My guy has a urinary tract infection and so was put on Septra suspension (generic form of Bactrim). When I voiced some concern about the meds, our ped (who is WONDERFUL) joked about how unless he had slept through a session at med school, he was quite sure that there should be no interaction between Bactrim and insulin / bg numbers. He then pulled out the handy-dandy PDA and looked up the Drug Interactions section on Bactrim, which mentioned nothing about bg, insulin, diabetes, or hypoglycemia.

Guess I'll be calling him tomorrow to raz him about his med school napping.

Thanks to CWD, particularly Emma's Mom, sammysmom, MelissaC, and madde, (and others ... sorry if I missed you), I found from previous posts it very much can be an issue.

Proof is in the pudding ... or in the 25 g of uncovered carbs at dinner (which is 20% of my guy's total carbs in a day) and a 50% basal for the past 6 hours . BG is 124 ... the highest # since the meds kicked in.

Just wanted again to thank all the previous posters for the heads up and to alert the many new people to this issue. The problem is that possible interaction is listed in the fine print of the insulin but not for Bactrim (which is why our ped, though diligent, found nothing about it.)

For example, from the Apidra insulin info: "The following are examples of substances that may increase the blood-glucose-lowering effect and susceptibility to hypoglycemia: oral antidiabetic products, ACE inhibitors, disopyramide, fibrates, fluoxetine, MAO inhibitors, pentoxifylline, propoxyphene, salicylates, sulfonamide antibiotics."
http://products.sanofi-aventis.us/apidra/apidra.html

I did finally find some info from the perspective of Bactrim here:
http://www.drugs.com/drug-interactio...im_d00124.html

If anyone has any more tips on how to deal with this, please share! (I am calling the ped and endo in the am to see what we should do, now that we clearly know that it does have an impact for my guy.)

[Jboudo01]

Wow! That's interesting. My DD just completed 10 days of Septra and she had one low (80) the entire time. She is honeymooning, but other than that, all other things have been normal.

[BrendaK]

Be sure and forward that info to your doctor, just so he'll actually believe you!!

[Rachel]

Originally Posted by Jboudo01

Wow! That's interesting. My DD just completed 10 days of Septra and she had one low (80) the entire time. She is honeymooning, but other than that, all other things have been normal.

Good to hear! Still not 100% what it is doing to my guy - and how much is the med and how much is the infection itself.

I just talked to one of our CDEs who said that people respond really differently to the med and they don't have a single answer about how to work with it ... she said just to watch for the patterns like you would for exercise and then adjust insulin/carbs as necessary.

I am still trying to figure out if it is impacting over-all insulin needs (insulin resistance?) or just boluses for food (delayed/reduced food absorption?)

Originally Posted by BrendaK

Be sure and forward that info to your doctor, just so he'll actually believe you!!

Thanks, Brenda. He'll be hearing from me.

[Abby-Dabby-Doo]

*I agree* THANK YOU to those of you who have posted about this in the past.
I called our pharmacy and had it marked on Abby's screen as a warning. So if I forget, or don't realize what the medication might contain, my wonderful pharmacist will let me know.