Drug interactions
Eplerenone + Isoniazid
Severity: Moderate
Eplerenone and Isoniazid: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Eplerenone is cleared mainly by CYP3A4, so inhibition by isoniazid may raise its levels. This increases the risk of hyperkalemia, particularly in patients with renal impairment or on other potassium-raising drugs.
What this interaction means in plain words
Eplerenone and Isoniazid can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Eplerenone belongs to Cardiovascular; Isoniazid belongs to Anti Bacterial.
Why it happens
Isoniazid inhibits CYP3A4, reducing eplerenone metabolism.
What to do
Monitor serum potassium and renal function after starting isoniazid. Reduce the eplerenone dose if potassium rises.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Isoniazid
Other interactions of Eplerenone
- Amiloride + Eplerenone Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Clarithromycin + Eplerenone Contraindicated
- Cobicistat + Eplerenone Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Eplerenone Contraindicated
- Ensitrelvir + Eplerenone Contraindicated
Frequently asked questions
Can I take Eplerenone with Isoniazid?
MediHelp rates the interaction as moderate. Eplerenone and Isoniazid can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Eplerenone is cleared mainly by CYP3A4, so inhibition by isoniazid may raise its levels. This increases the risk of hyperkalemia, particularly in patients with renal impairment or on other potassium-raising drugs.
How serious is the interaction between Eplerenone and Isoniazid?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum potassium and renal function after starting isoniazid. Reduce the eplerenone dose if potassium rises.
What other medicines interact with Isoniazid?
MediHelp also lists interactions of Isoniazid with, for example, Bacillus calmette-guerin substrain tice, Benzhydrocodone / acetaminophen, Carbamazepine. The full list is on the Isoniazid page.
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