Thiazide diuretic
Hydrochlorothiazide with antibiotics: interactions and safety
Antibiotic courses are common, short-term and often combined with chronic medications such as Hydrochlorothiazide (Hydrochlorothiazide). Most antibiotics do not interfere meaningfully with Hydrochlorothiazide at 12.5mg, 25mg, 50mg, 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 Thiazide diuretic agents. Rifampicin has the opposite effect, accelerating metabolism. Most penicillins, cephalosporins, fluoroquinolones and tetracyclines have no clinically meaningful interaction with Hydrochlorothiazide at 12.5mg, 25mg, 50mg.
Practical guidance
According to the prescribing information for Hydrochlorothiazide, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Hydrochlorothiazide is co-administered. Adjusted 12.5mg, 25mg, 50mg dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.
Frequently asked questions
Can I take Hydrochlorothiazide during an antibiotic course? ▾
For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Hydrochlorothiazide is metabolised and may need a temporary 12.5mg, 25mg, 50mg adjustment. The prescribing pharmacist should review any new antibiotic against the existing Hydrochlorothiazide regimen.
Will antibiotics make Hydrochlorothiazide stop working? ▾
Most antibiotics do not affect Hydrochlorothiazide efficacy. Rifampicin and a few others can lower Hydrochlorothiazide levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.
Products containing Hydrochlorothiazide
More on Hydrochlorothiazide
- With alcoholHydrochlorothiazide and alcohol — is it safe to drink?
- With foodShould Hydrochlorothiazide be taken with food?
- Side effectsHydrochlorothiazide side effects: common, rare and warning signs
- Dosage guideHydrochlorothiazide dosage guide: how much to take and when
- OnsetHow fast does Hydrochlorothiazide start working?
- DurationHow long does Hydrochlorothiazide last?
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