PTCB Certified Pharmacy Technician (PTCE)Patient Safety and Quality AssuranceMedium

A pharmacy technician is reviewing a patient's medication profile and notes that the patient is prescribed both Warfarin (an anticoagulant) and Bactrim (sulfamethoxazole/trimethoprim, an antibiotic). What is the MOST significant concern regarding this combination?

  1. AIncreased risk of photosensitivity.
  2. BEnhanced anticoagulant effect, leading to increased bleeding risk.
  3. CPotential for severe constipation.
  4. DDecreased effectiveness of the antibiotic.
Show answer & explanation

Correct answer: B. Enhanced anticoagulant effect, leading to increased bleeding risk.

Bactrim (sulfamethoxazole/trimethoprim) is known to significantly inhibit the metabolism of Warfarin, leading to increased Warfarin levels and a heightened risk of bleeding. This is a critical drug-drug interaction.

Why the other options are wrong

  • A. Photosensitivity is a known side effect of Bactrim, but not the most significant concern when combined with Warfarin.
  • C. Constipation is not a primary or significant concern for this drug combination.
  • D. Bactrim's effectiveness is not decreased by Warfarin; rather, Warfarin's effect is enhanced.

Warfarin-Bactrim Interaction

The co-administration of Warfarin and Bactrim (sulfamethoxazole/trimethoprim) can lead to a significant increase in Warfarin's anticoagulant effect, greatly elevating the patient's risk of severe bleeding due to metabolic inhibition.

  • Bactrim inhibits Warfarin metabolism.
  • Leads to higher Warfarin levels in blood.
  • Increases risk of hemorrhage.
  • Requires close INR monitoring and possible Warfarin dose reduction.

Memory trick: Warfarin + Bactrim = Bleeding Risk, Be Aware!

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