Trimethoprim toxicity

Trimethoprim toxicity is an adverse drug reaction or overdose state caused by exposure to trimethoprim, a dihydrofolate reductase inhibitor used alone or combined with sulfamethoxazole

Trimethoprim toxicity is an adverse drug reaction or overdose state caused by exposure to trimethoprim, a dihydrofolate reductase inhibitor used alone or combined with sulfamethoxazole Chronic overexposure or folate deficiency can also impair host DNA synthesis, leading to hematologic toxicities such as megaloblastic anemia, leukopenia, and thrombocytopenia

It predominantly affects the renal, metabolic, and hematologic systems, particularly in older adults, individuals with pre-existing renal impairment, or those receiving high doses

Pathophysiologically, trimethoprim blocks epithelial sodium channels in the distal nephron, inducing hyperkalemia and renal tubular acidosis, while competitively inhibiting tubular creatinine secretion to produce an isolated elevation in serum creatinine

Chronic overexposure or folate deficiency can also impair host DNA synthesis, leading to hematologic toxicities such as megaloblastic anemia, leukopenia, and thrombocytopenia