Spironolactone with antibiotics: interactions and safety
Antibiotic courses are common, short-term and often combined with chronic medications such as Spironolactone (Spironolactone). Most antibiotics do not interfere meaningfully with Spironolactone at 25mg, 50mg, 100mg, 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 Diuretics agents. Rifampicin has the opposite effect, accelerating metabolism. Most penicillins, cephalosporins, fluoroquinolones and tetracyclines have no clinically meaningful interaction with Spironolactone at 25mg, 50mg, 100mg.
Practical guidance
According to the prescribing information for Spironolactone, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Spironolactone is co-administered. Adjusted 25mg, 50mg, 100mg dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.
Frequently asked questions
Can I take Spironolactone during an antibiotic course? ▾
For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Spironolactone is metabolised and may need a temporary 25mg, 50mg, 100mg adjustment. The prescribing pharmacist should review any new antibiotic against the existing Spironolactone regimen.
Will antibiotics make Spironolactone stop working? ▾
Most antibiotics do not affect Spironolactone efficacy. Rifampicin and a few others can lower Spironolactone levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.
More on Spironolactone
- With alcoholSpironolactone and alcohol — is it safe to drink?
- With foodShould Spironolactone be taken with food?
- Side effectsSpironolactone side effects: common, rare and warning signs
- Dosage guideSpironolactone dosage guide: how much to take and when
- OnsetHow fast does Spironolactone start working?
- DurationHow long does Spironolactone last?
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.