Can You Crush Bactrim DS (SMZ/TMP)?
In our latest question and answer, the pharmacist discusses whether or not Bactrim DS can be crushed.
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?
Sep 02, 2021- Bactrim DS tablets can be safely crushed, cut, or split and mixed with food like applesauce or thick liquids to make them easier to take. If you find the taste unpleasant after crushing, ask your pharmacist about switching to the liquid suspension form instead. Taking Bactrim DS with food or milk can help reduce stomach irritation without affecting how well the medication works.
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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 & sources
Glossary — Terms in This Answer
- Sulfonamides
- A class of antibiotics containing sulfonamide compounds used to treat bacterial infections.
- Co-trimoxazole
- A combination antibiotic medication made up of two drugs: trimethoprim and sulfamethoxazole.
- Trimethoprim
- An antibiotic drug that is one of the two active ingredients in co-trimoxazole.
- Sulfamethoxazole
- An antibiotic drug that is one of the two active ingredients in co-trimoxazole.
- Extemporaneously compounded
- A medication that is specially prepared or mixed on an individual basis, typically by a pharmacist.
- Suspending agents
- Substances added to medications to help keep solid particles evenly distributed throughout a liquid.
- Oral suspension
- A liquid form of medication meant to be taken by mouth, in which the active drug is mixed throughout the liquid.
- Palatable
- Pleasant or acceptable to taste.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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