What You Need to Know About Alprim, When Natural Cures for Bladder Infections Don't Work

Alprim, also known as trimethoprim, is an antibiotic that is based on the principle that bacteria need their vitamins, too. This remarkably versatile bacteria killer interferes with an enzyme that activates the B vitamin folic acid into a form that cells can actually use for making energy. It also has this effect in human cells, but it is several thousand times more deadly to bacterial cells than it is to human cells, so infections usually can be brought under control before there is any damage to human health.

Alprim Is Often Teamed Up with Another Antibiotic

In the UK, until a few years ago, doctors typically prescribed Alprim with another antibiotic known as Bactrim, Septrin, Septra, or generic sulfamethaxole. The second antibiotic deactivated a different enzyme that bacteria, and humans, also need to to use folic acid. However, the combination of antibiotics was found to be so potent that it could cause anemia so it has been discontinued for treating adults, although the combination is still used for treating chronic ear infections in children.

What Is the Most Important Use of Alprim?

The most important use of Alprim is to treat urinary tract infections when a simple natural cure for bladder infections, such as cranberry juice and drinking more water, has not worked. Around the world, bladder infections are not just a frequent source of pain and embarrassment, they are also one of the most common causes of dementia and even death in the elderly.

READ Urinary Tract Infection: Causes, Symptoms, And Treatment

What Might Your Doctor Not Tell You About Alprim?

Especially in the United States, family doctors tend to be rushed, and patients simply don't have time to think about and ask all the questions they like. Alprim is an often-effective and inexpensive antibiotic, but there are some things the doctor may not warn you about that you need to know.

• Elderly people are more likely to experience side effects when they are given Alprim (trimethoprim), especialy when they are also given Bactrim (sulfamethaxole). In a medical chart, the combination is usually noted as TMP-SMX, TMP standing for trimethoprim (Alprim), and SMX standing for sulfamethaxole (Batrim). The most common complication is high potassium levels in the bloodstream, a condition called hyperkalemia. Elderly persons who take high blood pressure medications in a class known as ACE inhibitors (lisinopril, ramipril, and similar medications with -il in their names) or ACE receptor blockers (such as losartan) are especially vulnerable to this complication. High potassium levels are more likely when people are taking multiple medications, but they can have very serious complications.[1]
• Young people taking Alprim for bladder infections sometimes develop anemia. More specifically, they develop a condition known as megaloblastic anemia, in which a shortage of usable folic acid (the B vitamin) causes malformations in red blood cells. Taking supplemental folic acid won't help. In fact, it makes the problem worse.[2]

More Critical Facts About Alprim

There is a great deal more that doctors may simply not have time to tell their patients. 

It is important to take the entire package of Alprim you have been prescribed. Usually Alprim is taken for seven days. It is critical to take the entire course of the medication to make sure all the disease-causing bacteria are killed. Otherwise, the most virulent bacteria may survive, and it will take longer to bring the rebound infection back under control.

Never take a double dose of Alprim, even if you have forgotten a dose. Taking a double dose greatly increases the risk of side effects.

The most important warning sign that Alprim is causing a serious side effect is usually a change in skin color. This can be jaundice, yellowing of the skin, or a red rash. You should call your doctor and ask what to do at the first sign of skin changes. Chances are that your physician will take you off the medication immediately. It is especially important to let the doctor know if you have a purple rash break out. This can be caused by a condition called thrombocytopenic purpura, in which the body breaks down red blood cells and the bloodstream cannot stop bleeding.

Another side effect of Alprim use in the elderly is tendon damage. Aches and pains in the elbows and knees that come about a week after the beginning of treatment are also a sign of mild toxicity.

Women who are or who want to become pregnant should not take Alprim. By interfering with the embryo's use of folic acid, Alprim in the first trimester can cause serious defects in the formation of the nervous system, usually resulting in a miscarriage.

Hikers and mountain climbers should avoid Alprim during and for six weeks after their trips. Many mountain streams that appear to be clear and safe actually contain Shigella, a microorganism that causes giardiasis, a persistent form of diarrhea characterized by "purple burps." Alprim makes the microorganism more toxic to the digestive tract. This problem is most common among hiking enthusiasts who have taken trips either to Oregon, or to Nepal.

If you take Alprim for longer than a month (at your doctor's direction), you will probably need to have regular blood tests to make sure you are not developing anemia, due to the depletion of the active form of folic acid. Again, taking a folic acid supplement is not helpful, because the body has a shortage of enzymes to use it. It may even be helpful to avoid fortified foods, such as the "enriched" baked goods, bread, and snack foods common in Canada and the United States.

READ How Long Does It Take for Antibiotics to Work?

More and more strains of bacteria are becoming resistant to Alprim, and fewer and fewer infectious diseases are being treated with it. Especially for urinary tract infections, Alprim is far less useful than it once was. Your best bet for beating persistent urinary tract infections is to take all your prescribed medications, and also to reduce consumption of sugar, increase your consumption of water and other fluids, and to drink unsweetened cranberry or blueberry juices. It can also help to eat an apple a day to keep the doctor away. The plant chemical quercetin in its peel has a mild antibacterial effect.