Medication interaction hub

What Supplements Interact with Sulfamethoxazole, Trimethoprim?

Sulfamethoxazole, Trimethoprim brand names: Bactrim, Bactrim DS, Cotrim DS, Septra, Septra DS, and others. Every interaction below applies to the brands too.

174 Interactions 11 Major 139 Moderate 24 Minor
Curated & coded by · Clinical Pharmacist · Updated September 23, 2026

Drug–supplement interaction data sourced from Natural Medicines Pro, the licensed clinical database from TRC Healthcare / Therapeutic Research, with additional analysis by the HelloPharmacist Pharmacist Team. Our sources · Editorial policy

What is this page for?

One answer, for one medication: what supplements and herbal products interact with Sulfamethoxazole, Trimethoprim? Every vitamin, herb, and supplement ingredient we’ve checked against it is on this page, ranked by severity, each linking to the full report for that exact pair.

This page covers supplement interactions only — to check Sulfamethoxazole, Trimethoprim against your other medications, use the drug–drug interaction checker. Educational information from our licensed clinical databases, not medical advice. Our editorial policy

HelloPharmacist Bottom Line
Our Pharmacist Explains
What is this? The interaction data in the HelloPharmacist supplement database is licensed from Natural Medicines Pro by TRC Healthcare (Therapeutic Research). HelloPharmacist pharmacists often add our own analysis and context on top of that licensed data — such as this Bottom Line summary and the notes on individual interaction pages — and any such commentary is noted as ours.

The supplement I check first with sulfamethoxazole and trimethoprim (Bactrim, Septra) is PABA, because it feeds bacteria the exact compound this antibiotic works by blocking and can cancel the treatment outright. It is one of 11 major-rated entries among 174 supplements and herbs on file here, a count that calls for genuine care. The other serious entries mostly strain the heart's rhythm or the liver, and everyday items like grapefruit in quantity and alcohol from beer or wine sit on that shortlist.

The 139 moderate and 24 minor entries follow gentler patterns. Twenty ingredients add to the sun sensitivity this antibiotic already causes, dozens more share a liver-enzyme breakdown pathway with it, which can shift levels, and probiotics simply get killed off, so space those doses apart. Activated charcoal is the odd one out, rated major because it can pull the medication out of the gut before it is absorbed.

— , Clinical Pharmacist · July 18, 2026

Major 11 Moderate 139 Minor 24 No known interaction 1,278

This box checks one ingredient at a time (like turmeric or magnesium). Taking a supplement product with a whole label of ingredients? Search the product instead — we check every ingredient on it ↓

Most Viewed Ingredient Interactions

Sulfamethoxazole, Trimethoprim: Top Interactions at a Glance

The Sulfamethoxazole, Trimethoprim supplement & herbal interactions people checked most in the last 24 hours, colored by severity. Tap any ingredient to open the full report for that pair.

Showing the 12 highest-ranked of 174 interacting ingredients — plus 1,278 more checked with no known interaction. See the complete ranked list.

Start here

The Most-Checked Sulfamethoxazole, Trimethoprim Combinations Today

The Sulfamethoxazole, Trimethoprim + supplement pages people viewed most in the last 24 hours (resets at midnight). Open any card for the full report.

Major Likelihood Probable Grapefruit + Sulfamethoxazole, Trimethoprimi

Grapefruit or grapefruit juice, especially if consumed in large amounts, can cause additive QT interval prolongation when taken with QT interval-prolonging drug...

Read the full interaction Moderate Likelihood Possible Cannabis + Sulfamethoxazole, Trimethoprimi

Theoretically, drugs that are CYP2C9 inhibitors might increase the adverse effects of cannabis.

Read the full interaction Major Likelihood Probable Wine + Sulfamethoxazole, Trimethoprimi

Concomitant use of alcohol with hepatotoxic drugs may increase the risk of hepatotoxicity.

Read the full interaction Moderate Likelihood Possible Goldenseal + Sulfamethoxazole, Trimethoprimi

Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2C9.

Read the full interaction Moderate Likelihood Possible Licorice + Sulfamethoxazole, Trimethoprimi

Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP2C9.

Read the full interaction Major Likelihood Likely Para-aminobenzoic Acid (paba) + Sulfamethoxazole, Trimethoprimi

Theoretically, concomitant use of PABA and sulfonamide antibiotics inhibits the antibacterial effects of sulfonamide.

Read the full interaction
The complete list

Every Supplement Checked Against Sulfamethoxazole, Trimethoprim

All 1,452 ingredients in our database, ranked by severity — 174 with a Sulfamethoxazole, Trimethoprim interaction on file and 1,278 with none found. Filter by severity or search any ingredient; hover the for what each ingredient is.

Looking for an interaction with a specific supplement product? Search products instead ↓

Straight answers

Can You Take It With Sulfamethoxazole, Trimethoprim?

One-line answers, one card per combination — scroll through today’s 20 and tap any card for the full report. A different set rotates in daily until every combination has had its turn.

Can you take Grapefruit with Sulfamethoxazole, Trimethoprim?

Major Use real caution — this is a major-rated interaction, generally best avoided or used only under close supervision. Grapefruit or grapefruit juice, especially if consumed in large amounts, can cause additive QT interval prolongation when taken with QT inte...

Full Grapefruit + Sulfamethoxazole, Trimethoprim answer

Can you take Cannabis with Sulfamethoxazole, Trimethoprim?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, drugs that are CYP2C9 inhibitors might increase the adverse effects of cannabis.

Full Cannabis + Sulfamethoxazole, Trimethoprim answer

Can you take Wine with Sulfamethoxazole, Trimethoprim?

Major Use real caution — this is a major-rated interaction, generally best avoided or used only under close supervision. Concomitant use of alcohol with hepatotoxic drugs may increase the risk of hepatotoxicity.

Full Wine + Sulfamethoxazole, Trimethoprim answer

Can you take Goldenseal with Sulfamethoxazole, Trimethoprim?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, goldenseal might increase serum levels of drugs metabolized by CYP2C9.

Full Goldenseal + Sulfamethoxazole, Trimethoprim answer

Can you take Licorice with Sulfamethoxazole, Trimethoprim?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP2C9.

Full Licorice + Sulfamethoxazole, Trimethoprim answer

Can you take German Chamomile with Sulfamethoxazole, Trimethoprim?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, German chamomile might inhibit CYP2C9 and increase levels of drugs metabolized by these enzymes.

Full German Chamomile + Sulfamethoxazole, Trimethoprim answer

Can you take Ginkgo with Sulfamethoxazole, Trimethoprim?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, ginkgo might increase levels of drugs metabolized by CYP2C9.

Full Ginkgo + Sulfamethoxazole, Trimethoprim answer

Can you take Goji with Sulfamethoxazole, Trimethoprim?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, goji berry might inhibit CYP2C9 and reduce metabolism of CYP2C9 substrates.

Full Goji + Sulfamethoxazole, Trimethoprim answer

Can you take Gotu Kola with Sulfamethoxazole, Trimethoprim?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, taking gotu kola with hepatotoxic drugs might have additive adverse effects.

Full Gotu Kola + Sulfamethoxazole, Trimethoprim answer

Can you take Greater Celandine with Sulfamethoxazole, Trimethoprim?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. There is some concern that greater celandine can adversely affect the liver.

Full Greater Celandine + Sulfamethoxazole, Trimethoprim answer

Can you take Guar Gum with Sulfamethoxazole, Trimethoprim?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Guar gum might reduce the absorption of some oral drugs, potentially decreasing their effectiveness.

Full Guar Gum + Sulfamethoxazole, Trimethoprim answer

Can you take Gum Arabic with Sulfamethoxazole, Trimethoprim?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, gum arabic can alter the absorption of oral drugs due to its fiber content.

Full Gum Arabic + Sulfamethoxazole, Trimethoprim answer

Can you take Gymnema with Sulfamethoxazole, Trimethoprim?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, gymnema might increase or decrease levels of drugs metabolized by CYP2C9.

Full Gymnema + Sulfamethoxazole, Trimethoprim answer

Can you take Hemp Agrimony with Sulfamethoxazole, Trimethoprim?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Hemp agrimony contains hepatotoxic pyrrolizidine alkaloids (PA).

Full Hemp Agrimony + Sulfamethoxazole, Trimethoprim answer

Can you take Iboga with Sulfamethoxazole, Trimethoprim?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, iboga may have an additive effect with drugs that prolong the QT interval.

Full Iboga + Sulfamethoxazole, Trimethoprim answer

Can you take Ipriflavone with Sulfamethoxazole, Trimethoprim?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Ipriflavone is thought to competitively inhibit cytochrome P450 2C9 (CYP2C9).

Full Ipriflavone + Sulfamethoxazole, Trimethoprim answer

Can you take Jambolan with Sulfamethoxazole, Trimethoprim?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. There is some in vitro evidence that jambolan can inhibit CYP2C9.

Full Jambolan + Sulfamethoxazole, Trimethoprim answer

Can you take K2/spice with Sulfamethoxazole, Trimethoprim?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, K2/spice might have an additive effect with drugs that prolong the QT interval and increase the risk of ventricular arrhythmi...

Full K2/spice + Sulfamethoxazole, Trimethoprim answer

Can you take Kava with Sulfamethoxazole, Trimethoprim?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, using kava with hepatotoxic drugs might increase the risk of liver damage.

Full Kava + Sulfamethoxazole, Trimethoprim answer

Can you take Khella with Sulfamethoxazole, Trimethoprim?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, concomitant use might result in increased photosensitivity.

Full Khella + Sulfamethoxazole, Trimethoprim answer
Read the list like a pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • Possible. Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each entry links to a full report with the clinical detail, likelihood, evidence level, and citations for that exact combination.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

How Does Our Interaction Checker Work?

Behind every verdict on this page is a category system. Our source database doesn’t document supplement interactions drug-by-drug — it documents them against groups of medications that behave the same way (for example, “drugs processed by the CYP3A4 liver enzyme” or “blood-thinning medications”).

So the check works in three steps: (1) Sulfamethoxazole, Trimethoprim is classified into the pharmacology categories it belongs to, (2) every supplement interaction documented against any of those categories is inherited by Sulfamethoxazole, Trimethoprim, and (3) each ingredient keeps its own severity, likelihood, and evidence grades from the underlying record. That’s why one supplement can carry several records for one drug — it may interact through more than one category.

Sulfamethoxazole, Trimethoprim sits in 9 interaction categories. Open any one to see what the group means:

Cytochrome P450 2C9 (Cyp2C9) Substrates 64 ingredients

A drug-metabolism group: these medications are processed by the named liver enzyme (a cytochrome P450). Supplements that speed this enzyme up or slow it down can lower or raise the medication's levels in your body.

64 of the supplement ingredients on this page reach Sulfamethoxazole, Trimethoprim through this category.

Hepatotoxic Drugs 38 ingredients

Medications with known liver considerations. Supplements that can stress the liver add to the load.

38 of the supplement ingredients on this page reach Sulfamethoxazole, Trimethoprim through this category.

Antibiotic Drugs 27 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

27 of the supplement ingredients on this page reach Sulfamethoxazole, Trimethoprim through this category.

Photosensitizing Drugs 20 ingredients

Medications that make skin more sun-sensitive. Supplements with the same property can compound it.

20 of the supplement ingredients on this page reach Sulfamethoxazole, Trimethoprim through this category.

Oral Drugs 17 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

17 of the supplement ingredients on this page reach Sulfamethoxazole, Trimethoprim through this category.

Qt Interval-Prolonging Drugs 13 ingredients

Medications that can affect the heart's electrical rhythm (the QT interval). Supplements with similar effects can add to that risk.

13 of the supplement ingredients on this page reach Sulfamethoxazole, Trimethoprim through this category.

Cytochrome P450 2C9 (Cyp2C9) Inhibitors 4 ingredients

A drug-metabolism group: these medications are processed by the named liver enzyme (a cytochrome P450). Supplements that speed this enzyme up or slow it down can lower or raise the medication's levels in your body.

4 of the supplement ingredients on this page reach Sulfamethoxazole, Trimethoprim through this category.

Sulfonamide Antibiotics 4 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

4 of the supplement ingredients on this page reach Sulfamethoxazole, Trimethoprim through this category.

Trimethoprim (Proloprim) 2 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

2 of the supplement ingredients on this page reach Sulfamethoxazole, Trimethoprim through this category.

Related: does Sulfamethoxazole, Trimethoprim deplete any nutrients?

Sulfamethoxazole, Trimethoprim has 120 reported nutrient associations in the research literature — see the Sulfamethoxazole, Trimethoprim nutrient depletion report.

Check a real product

Take a Supplement Product? Check the Whole Bottle Against Sulfamethoxazole, Trimethoprim

Most supplements are combination products — and the interaction may come from an ingredient you didn’t buy it for. Search any product below (or scan its label) and we’ll check every ingredient on it against Sulfamethoxazole, Trimethoprim.

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Products that contain Sulfamethoxazole, Trimethoprim-interacting ingredients

Real supplements from the NIH label database that contain the top interacting ingredients on this page — each one is worth a full label check before combining with Sulfamethoxazole, Trimethoprim.

Zi Sheng Teapills by Plum Flower contains Siberian Cocklebur Cold Away by Health Concerns contains Siberian Cocklebur Sugar Coated Bi Yan Pian by Plum Flower contains Siberian Cocklebur Pe Min Kan Wan by Plum Flower contains Siberian Cocklebur
Pharmacist Counseling Corner

Sulfamethoxazole, Trimethoprim & Supplements: Common Questions

What supplements interact with Sulfamethoxazole, Trimethoprim?
In our interaction database, 174 supplement and herbal ingredients have an interaction with Sulfamethoxazole, Trimethoprim on file — 11 rated major, 139 moderate, and 24 minor. That number sounds scarier than it is: severity matters far more than the count, which is why the list on this page is ranked instead of alphabetical. Start at the top. The highest-ranked right now: Para-aminobenzoic Acid (paba), Siberian Cocklebur, Activated Charcoal.
Which Sulfamethoxazole, Trimethoprim supplement interactions are the most serious?
The 11 major-rated combinations — led by Para-aminobenzoic Acid (paba), Siberian Cocklebur, Activated Charcoal, Arsenic and Beer — deserve real caution: these are the ones generally best avoided, or used only with your prescriber watching. If you take any of them today, don't panic and don't stop anything abruptly — call your pharmacist first. Jump to the ranked list.
Can I take vitamins or supplements while on Sulfamethoxazole, Trimethoprim?
That depends entirely on which supplement. The honest answer for Sulfamethoxazole, Trimethoprim is in the ranked list above — and if what you take is a combination product with a dozen ingredients, don't check them one by one: photograph the label with our scanner and we'll check the whole thing at once. Try the label scanner or the interaction checker.
Do brands like Bactrim have the same supplement interactions as Sulfamethoxazole, Trimethoprim?
Yes — Bactrim, Bactrim DS, Cotrim DS, Septra, Septra DS and other brands all contain Sulfamethoxazole, Trimethoprim, so everything on this page applies to them equally. Interactions belong to the active drug, never to the brand on the box; the same is true of generics.
Where do these interaction ratings come from?
Every rating comes from the Natural Medicines database — the same evidence-graded reference pharmacists and hospitals use — and each interaction carries three separate grades: severity (how bad it can be), likelihood (how well it's documented in studies and case reports), and an evidence level. Our pharmacists review the content; we never let an AI decide an interaction. See how to read the ratings and our editorial policy.
Does Sulfamethoxazole, Trimethoprim deplete any vitamins or nutrients?
It might — Sulfamethoxazole, Trimethoprim has 120 reported nutrient-depletion associations in the research literature, which is a different question from interactions: instead of a supplement changing the drug, the drug may lower a nutrient over time. See the Sulfamethoxazole, Trimethoprim nutrient depletion report for the specifics and what to discuss with your pharmacist.
What about Sulfamethoxazole, Trimethoprim and my other medications?
This page covers Sulfamethoxazole, Trimethoprim against supplements and herbal ingredients. Checking Sulfamethoxazole, Trimethoprim against your other prescription or OTC medications is a different tool — our drug interaction checker covers that side. Head to the drug–drug interaction checker.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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Sourcing

Where This Data Comes From — and Why You Can Trust It

🧪 Licensed clinical database

Every interaction verdict on this page comes from Natural Medicines Pro (TRC Healthcare / Therapeutic Research) — the same evidence-graded reference used by pharmacists and hospitals. We license this data directly; we do not scrape it, and no AI invents an interaction.

🧑‍⚕️ Pharmacist review

This page is curated and coded by , Clinical Pharmacist, with additional analysis by the HelloPharmacist Pharmacist Team. Editorial commentary is ours; the licensed interaction records are shown as sourced.

🔄 Kept current

Our interaction database refreshes on a weekly cycle, and this page re-checks the live database every time it’s rebuilt — what you see reflects the database as of September 23, 2026.

🔍 Full transparency

How every dataset on this site is sourced, licensed, and updated is documented publicly: our data sources · editorial policy · how we use AI.

Educational information, not medical advice. An interaction being on file does not mean it will happen to you — and absence of one is not proof of safety. Never start or stop a medication or supplement without talking to your pharmacist or doctor.