PYRIMETHAMINE AND TRIMETHOPRIM

Serious pancytopenia and megaloblastic anaemia have been described in patients given pyrimethamine and co-trimoxazole (which contains trimethoprim).
Caution should be used in prescribing the combination, especially in the presence of other drugs (e.g. methotrexate) or disease states that may also affect folate metabolism. When high-dose pyrimethamine is used for the treatment of toxoplasmosis, the manufacturer recommends that all patients should receive a folate supplement.
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