Lexapro with antibiotics: interactions and safety
Antibiotic courses are common, short-term and often combined with chronic medications such as Lexapro (Escitalopram). Most antibiotics do not interfere meaningfully with Escitalopram at 5mg, 10mg, 20mg, 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 Escitalopram at 5mg, 10mg, 20mg.
Practical guidance
According to the prescribing information for Escitalopram, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Lexapro is co-administered. Adjusted 5mg, 10mg, 20mg dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.
Frequently asked questions
Can I take Lexapro during an antibiotic course? ▾
For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Escitalopram is metabolised and may need a temporary 5mg, 10mg, 20mg adjustment. The prescribing pharmacist should review any new antibiotic against the existing Lexapro regimen.
Will antibiotics make Lexapro stop working? ▾
Most antibiotics do not affect Lexapro efficacy. Rifampicin and a few others can lower Escitalopram levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.
More on Lexapro
- With alcoholLexapro and alcohol — is it safe to drink?
- With foodShould Lexapro be taken with food?
- Side effectsLexapro side effects: common, rare and warning signs
- Dosage guideLexapro dosage guide: how much to take and when
- OnsetHow fast does Lexapro start working?
- DurationHow long does Lexapro last?
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.