Anti-Depressants with antibiotics: interactions and safety
Antibiotic courses are common, short-term and often combined with chronic medications such as Anti-Depressants (Anti-Depressants). Most antibiotics do not interfere meaningfully with Amitriptyline, Bupropion, Citalopram, Duloxetine, Escitalopram, Fluoxetine, Mirtazapine, Paroxetine, Sertraline, Trazodone, Venlafaxine at 10mg, 20mg, 40mg, 30mg, 60mg, but a few classes do, and a small number of combinations are best avoided.
Common antibiotic interactions
Macrolides (clarithromycin, erythromycin) and certain antifungals can inhibit hepatic metabolism (CYP3A4) and raise plasma levels of many medications including some Anti-Depressants agents. Rifampicin has the opposite effect, accelerating metabolism. Most penicillins, cephalosporins, fluoroquinolones and tetracyclines have no clinically meaningful interaction with Amitriptyline, Bupropion, Citalopram, Duloxetine, Escitalopram, Fluoxetine, Mirtazapine, Paroxetine, Sertraline, Trazodone, Venlafaxine at 10mg, 20mg, 40mg, 30mg, 60mg.
Practical guidance
According to the prescribing information for Amitriptyline, Bupropion, Citalopram, Duloxetine, Escitalopram, Fluoxetine, Mirtazapine, Paroxetine, Sertraline, Trazodone, Venlafaxine, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Anti-Depressants is co-administered. Adjusted 10mg, 20mg, 40mg, 30mg, 60mg dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.
Frequently asked questions
Can I take Anti-Depressants during an antibiotic course? ▾
For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Amitriptyline, Bupropion, Citalopram, Duloxetine, Escitalopram, Fluoxetine, Mirtazapine, Paroxetine, Sertraline, Trazodone, Venlafaxine is metabolised and may need a temporary 10mg, 20mg, 40mg, 30mg, 60mg adjustment. The prescribing pharmacist should review any new antibiotic against the existing Anti-Depressants regimen.
Will antibiotics make Anti-Depressants stop working? ▾
Most antibiotics do not affect Anti-Depressants efficacy. Rifampicin and a few others can lower Amitriptyline, Bupropion, Citalopram, Duloxetine, Escitalopram, Fluoxetine, Mirtazapine, Paroxetine, Sertraline, Trazodone, Venlafaxine levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.
Medications in Anti-Depressants
More on Anti-Depressants
- With alcoholAnti-Depressants and alcohol — is it safe to drink?
- With foodShould Anti-Depressants be taken with food?
- Side effectsAnti-Depressants side effects: common, rare and warning signs
- For older adultsAnti-Depressants after 60: doses and safety in older adults
- For womenAnti-Depressants for women: indications and considerations
- For menAnti-Depressants for men: indications and considerations
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