Montelukast and Trimethoprim: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Montelukast
Trimethoprim
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased exposure of CYP2C8 substrates
Interaction Deep Dive
Concurrent administration of trimethoprim (a CYP2C8 inhibitor) together with a CYP2C8 substrate may increase the exposure of the CYP2C8 substrate. Use caution if coadministration is required1.
Why it happens (mechanism)
Inhibition of CYP2C8-mediated metabolism by trimethoprim
Common questions
Can I take Montelukast and Trimethoprim together?
Increased exposure of CYP2C8 substrates Always confirm with your pharmacist or prescriber before making any change.
How serious is the Montelukast and Trimethoprim interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Montelukast or Trimethoprim need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (1)
- Product Information: BACTRIM(TM) oral tablets oral double strength tablets, sulfamethoxazole trimethoprim oral tablets oral double strength tablets. AR Scientific, Inc. (per FDA), Philadelphia, PA, 2013. DailyMed
Keep reading about Montelukast
Keep reading about Trimethoprim
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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