Can You Crush Bactrim DS (SMZ/TMP)?

In our latest question and answer, the pharmacist discusses whether or not Bactrim DS can be crushed.

Question

I can’t swallow pills at all, but I’m taking Bactrim DS for 10 days and the pills are massive! I tried cutting them in half, but I still can’t swallow it. Can I crush it up and mix it with apple sauce?

Asked by Alexis On Sep 02, 2021

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Sep 02, 2021
Last updated Mar 28, 2024

Key points

  • Bactrim DS (Sulfamethoxazole/Trimethoprim) can be safely crushed, cut, or split.
  • An alternative to crushing the pills is to ask your doctor about switching to the oral suspension form of the drug.

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Safe To Crush?

Bactrim DS (Sulfamethoxazole/Trimethoprim) tablets are very large and a common complaint among individuals is difficulty swallowing the tablets whole.

Fortunately, Bactrim DS (Sulfamethoxazole/Trimethoprim) tablets may be safely cut, split, and crushed to ease administration. In fact, most manufacturers of the drug produce the tablet with a score mark down the middle, making them easy to break in half.

In terms of taking crushed Bactrim DS tablets, they can be mixed with food or a thick liquid to ensure the entire dose is consumed. Applesauce is certainly a good choice, or a viscous liquid such as a syrup works as well.

Several studies have shown that extemporaneously compounded Bactrim solutions, made by crushing the tablets and mixing with suspending agents, are stable for at least 90 days.

Alternatives To Crushing Tablets

It is important to note that Bactrim DS does have a somewhat disagreeable taste (they aren't sweetened or flavored), making it non-palatable for many.

If this is the case in your situation, it may be prudent to ask your doctor or pharmacist about the possibility of switching to the oral suspension form of the drug.

The oral suspension comes in a strength of 200mg-40mg/5ml. It would therefore take 20 ml of the suspension to equal one Bactrim DS tablet.

Lastly, Bactrim DS may be administered without regard to meals.

Food will have no effect on the effectiveness of the medication. In fact, when Bactrim DS is administered with food, water, or milk, stomach irritation is often minimized.

References

  • Bactrim DS Prescribing Information, AccessFDA
  • Nasoduodenal feeding tubes: prevention of occlusion, PubMed
  • Stability of Extemporaneously Compounded Suspensions of Trimethoprim and Sulfamethoxazole in Amber Plastic Bottles and Amber Plastic Syringes, PubMed

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at [email protected]! You can also connect with Dr. Brian Staiger on LinkedIn.

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