Re: Septra in First Trimester

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I was diagnosed with a UTI and I am 6 weeks pregnant. The doctor prescribed Septra. Is this safe. Should I take extra folic acid? What affects could this have on the fetus/pregnancy?

Dear Kai, Septra is a "Sulfa" drug and if you have had an allergic reaction to any medication, especially Sulfa drugs, antibiotics, you need to use caution taking this medication as it may cause serious adverse drug reactions or anemia. So you need to learn what the signs of reaction are so that if they ocur you can report them immediatly. The risk to fetus during 1st trimester is related to folate metabolism and NTD, however, folate is needed for other processes as well so there could be a need to monitor folate levels at any time. Ask your doctor about increasing your folate intake for the remainder of the 1st trimester as if there was a folate deficiency, so from 1-5mg instead of .800-1mg normal dosage. Septra is cat C with few findings of congenital anomalies, however, SEPTRA may interfere with folic acid metabolism, it should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus and is contraindicated in patients with a known hypersensitivity to sulfonamides and in patients with documented megaloblastic anemia due to folate deficiency, it is also contraindicated in pregnant patients at term and in nursing mothers, because sulfonamides pass the placenta and are excreted in the milk and may cause kernicterus. Sulfamethoxazole; is contraindicated in pediatric patients less than 2 months of age. Of the three trimesters, there is less risk during the second, so it depends on what your individual history is with this kind of medication and your doctors guidance. Marie

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