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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes change in vision while on Sulfamethoxazole/Trimethoprim?

Answered by
Dr.
Dr. Klerida Shehu

Gastroenterologist

Practicing since :2006

Answered : 2265 Questions

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Posted on Tue, 7 Jun 2016 in Digestion and Bowels
Question: Went to local ER 3/31/16......diagnosis diverticulitis.....gave me two antibiotics. Had the same thing 18 months ago. Mitronidazole....no problem 18 months ago or this time. The other, Sulfameth/Trimethoprim 800/160 scares me a little. Two problems that may or may not be related to that antibiotic. 1) Had some vision changes last night with sensitivity to bright lights when I looked at them....they had a pattern to them.....went away in 5-10 minutes......later, my sugar dropped (I am diabetic) had to eat a lot of sugar but stabilized it.....this morning my sugar ran about 40+ points higher than normal after working out.....normally 125-142, it was 182.....but started coming down fairly soon thereafter. I read online that Sulfameth does not usually case glucose problems. Do you recommend changing the second antibiotic to Ciprofloxicin? Took that 18 moths ago and tolerated it well.
doctor
Answered by Dr. Klerida Shehu 8 hours later
Brief Answer:
Stop Sulfameth/Trimethoprim use ,,,,

Detailed Answer:
Hi and thank you for asking!
I read carefully all your concerns and I can say as follows:
1. You are reporting to have started to use Sulfameth/Trimethoprim and after that you have vision changes and lower blood sugar level.
Sulfameth/Trimethoprim can cause these side effects. It's use is associated with vision changes.
Also in diabetic patients Sulfameth/Trimethoprim use is associated with changes in blood sugar level. This is why in such cases like yours,in clinical practice I change the dose of diabetic treatment according to blood sugar level.
2. If I were your treating doctor since you have two side effects of Sulfameth/Trimethoprim use than I would prefere to stop it and start ciprofloxacin.
At your case there is no reason changing the dose of antidiabetic treatment since you have and another known side effect of Sulfameth/Trimethoprim like vision changes.
So please stop Sulfameth/Trimethoprim use and start ciprofloxacin twice per day.

Hope it was helpful to you!
Dr.Klerida
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Klerida Shehu 5 hours later
Since I wrote you.....I have taken two doses of sulfametn/trimeth........no vsion changes.......only that one time, maybe because my body was getting used to it. As far as sugar levels........since my diet has changed, temporarily, my sugar is fairly under control. Guess there is a readjusting period.

Was reading up on other antibiotics.....they all seem to have the same side affects to include vision changes. To date, my vision is fine and I have taken 5 total doses of the 20 prescribed of sulfameth/trimeth.

Appreciate your help. Thanks
doctor
Answered by Dr. Klerida Shehu 10 hours later
Brief Answer:
Please follow...

Detailed Answer:
Hi back,
I am glad to know that you are in good condition, without any side effect from the treatment.
Yes I agree with you that it may be an transitional period. It may happen that the side effects diaspear after some doses use and the organism started to better tolerate the drug.
Otherwise if these signs will repeat again I strongly suggest to shnage the medication.
Hope it was helpful to you.
Dr.Klerida
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Klerida Shehu 47 hours later
One more question:

I am on my 5th day of 2 antibiotics......NO PAIN.....feel great.......of course, my pain level prior was 1 to 2 and some times no pain.....had a light case of diverticulosis.

I was on a liquid diet for 2 1/2 days......have transitioned yesterday at 11AM and today to creme of chicken soup with a weenie and piece of XXXXXXX Cheese with followed by 1/3 cup of Fiber One Cereal (yesterday and today).

Bowel movement yesterday was just brown water and today just a little this morning.....WHEN will I have a regular bowel movement? Do I need a laxative or am I rushing it? I was always regular every morning for 15 years. Advice, please. Getting ready for a hamburg XXXXXXX
doctor
Answered by Dr. Klerida Shehu 24 hours later
Brief Answer:
Please follow...

Detailed Answer:
Hi back and sorry for my late.
There is no need to use laxatives at your case.
It will need near 10 -15 days ti have regular bowel movements.
Meantime continue to take care of your diet.
Dr.Klerida

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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