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Does spironolactone have fewer side effects when taken as blood pressure medication?

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Posted on Thu, 8 Apr 2021
Question: I've been prescribed clarithromycin 500 mg 1 tablet by mouth twice a day. I am also taking amlodipine for high blood pressure, which I understand is a calcium channel blocker. I just read that there could be serious side effects between the two and am considering stopping the amlodipine for the duration. I am taking 5 mg of the amlodipine. I am also taking spironolactone 500 mg which is my main blood pressure medication. I am also concerned about all the side effects of clarithromycin and have used erythromycin safely in the past. Does that have fewer side effects? So, is it okay to stop the amlodipine for the duration? It is a very small dose as you can see.
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Answered by Dr. Bhanu Partap (49 minutes later)
Brief Answer:
Kindly refer to the detailed answer below

Detailed Answer:
Hello Ma'am

After going through your medical details I understand your concern for your health and I would like to tell you that clarithromycin increases the efficacy of Amlodipine which may cause hypotension.

It's recommend for you to decrease the dosage of Amlodipine from 5mg to 2.5mg rather than stopping it and monitor your blood pressure during the course.

You can take clarithromycin as it is more effective than erythromycin.

Hopefully this information will answer your query.

Kind Regards
Dr. Bhanu Partap
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Bhanu Partap (1 hour later)
What about using doxycycline instead of clarithromycin? I am leery of the side effects using clarithromycin; doxycycline seems better tolerated if taken with food. I have a very sensitive stomach and really would prefer to switch.

What other antibiotic is good for a sinus infection? amoxicillin? Don't want to take the zpack and can't take Augmentin. That really upsets my stomach.

And how do I know if this is a bacterial or virus infection? Fever rises during the day, was 98.4 when I woke up, is 99.3 right now, and at night it is over 100, at 100.4. Tylenol makes the fever go away, but shouldn't the antibiotics do that?
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Answered by Dr. Bhanu Partap (9 hours later)
Brief Answer:
Hello Again

Detailed Answer:
Doxycycline won’t be as effective for sinus infection as compared to clarithromycin so it’s advisable to stick with the medication which your treating physician has advised.

To confirm weather it’s a viral or bacterial infection the cultures are to be fine but in majority of the cases sinusitis occurs as result of bacterial infection only.

Fever is a physiological response to any infection inside the body against the pathogens. The role of antibiotics is to kill those pathogens there by bringing down the fever but this process takes few days. That’s why Tylenol is used to bring down fever quickly and gives symptomatic relief to the patient.

Hope to have been helpful.

Kind Regards
Dr. Bhanu Partap
Above answer was peer-reviewed by : Dr. Remy Koshy
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Follow up: Dr. Bhanu Partap (7 hours later)
I've only taken tylenol up to now and it has brought down my fever substantially to normal this morning and will be switching to an antibiotic today. However, I have another concern. My sinuses have been draining, and the mucous I coughed up this morning was quite bloody. All the mucous has been tinged with blood, but this one was very bloody. Is this cause for concern?

Also, would amoxicillin 500 twice a day be a good alternative?. Don't really like the side effects from the clarinthomycin. But am more concerned with the bloody sputum than anything.

Thanks for your help.
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Answered by Dr. Bhanu Partap (6 hours later)
Brief Answer:
Hello Again

Detailed Answer:
Yes, you can take Amoxicillin for the sinusitis .

Need not to worry about blood tinged drainage as it can be due to minor bleeding from the irritated lining of the sinuses and nose, and usually appears as red to dark brown streaks in the nasal mucus.
XXXXXXX bleeding can be due to something else which may require immediate medical attention.

Hopefully this information will answer your query.

Kind Regards
Dr Bhanu Partap
Above answer was peer-reviewed by : Dr. Raju A.T
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Dr. Bhanu Partap

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Practicing since :2010

Answered : 4505 Questions

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Does spironolactone have fewer side effects when taken as blood pressure medication?

Brief Answer: Kindly refer to the detailed answer below Detailed Answer: Hello Ma'am After going through your medical details I understand your concern for your health and I would like to tell you that clarithromycin increases the efficacy of Amlodipine which may cause hypotension. It's recommend for you to decrease the dosage of Amlodipine from 5mg to 2.5mg rather than stopping it and monitor your blood pressure during the course. You can take clarithromycin as it is more effective than erythromycin. Hopefully this information will answer your query. Kind Regards Dr. Bhanu Partap