Drug interactions
Gentamicin + Spironolactone
Severity: Moderate
Gentamicin and Spironolactone: 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
Gentamicin can cause renal tubular injury with potassium and magnesium wasting, while spironolactone retains potassium. The net effect on potassium is unpredictable, and if gentamicin reduces renal function, hyperkalemia from spironolactone becomes more likely.
What this interaction means in plain words
Gentamicin and Spironolactone 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.
Gentamicin belongs to Anti Bacterial; Spironolactone belongs to Cardiovascular.
Why it happens
Opposing effects on renal potassium handling combined with aminoglycoside nephrotoxicity reducing potassium excretion.
What to do
Monitor serum potassium, magnesium and creatinine during combined therapy and reduce or hold spironolactone if renal function worsens.
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 Gentamicin
- Cidofovir + Gentamicin Contraindicated
- Adefovir + Gentamicin Major
- Amikacin + Gentamicin Major
- Amlodipine-hydrochlorothiazide-valsartan + Gentamicin Major
- Amphotericin b deoxycholate + Gentamicin Major
- Amphotericin b + Gentamicin Major
Other interactions of Spironolactone
- Amiloride + Spironolactone Contraindicated
- Eplerenone + Spironolactone Contraindicated
- Spironolactone + Triamterene Contraindicated
- Abiraterone + Spironolactone Major
- Aceclofenac + Spironolactone Major
- Acemetacin + Spironolactone Major
Frequently asked questions
Can I take Gentamicin with Spironolactone?
MediHelp rates the interaction as moderate. Gentamicin and Spironolactone 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. Gentamicin can cause renal tubular injury with potassium and magnesium wasting, while spironolactone retains potassium. The net effect on potassium is unpredictable, and if gentamicin reduces renal function, hyperkalemia from spironolactone becomes more likely.
How serious is the interaction between Gentamicin and Spironolactone?
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, magnesium and creatinine during combined therapy and reduce or hold spironolactone if renal function worsens.
What other medicines interact with Gentamicin?
MediHelp also lists interactions of Gentamicin with, for example, Cidofovir, Adefovir, Amikacin. The full list is on the Gentamicin page.
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