Side Effects of Aldactone with Septra, Bactrim May Increase Risk of Death for Elderly: Study

Canadian researchers warn that elderly patients may face a higher fatality risk if they combine the medication Aldactone with certain antibiotics, such as Septra or Bactrim. 

In a study published in the Canadian Medical Association Journal on February 2, researchers looked at the risk of combining the antibiotic trimethoprim-sulfamethoxazole, sold under the brand names Septra and Bactrim, with the diuretic Aldactone (spironolactone).

The study was conducted because it is already known that Aldactone, Septra, and Bactrim separately increase the risk of high potassium levels, known as hyperkalemia, which can cause heart rhythm problems. Researchers wanted to determine if this risk translated into an actual increased risk of death for some patients.

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Researchers looked at data on nearly 12,000 patients who died suddenly while taking Aldactone. They found 328 cases which occurred within 14 days of the patients taking an antibiotic, most of whom were over the age of 65.

According to the findings, the rate of death among patients on Aldactone who were given Septra or Bactrim after just two weeks was twice that of patients given other antibiotics. While they also found a possible association between the use of Cipro and nitrofurantoin, the link between those antibiotics and sudden death in Aldactone patients was less certain.

The consumer watchdog group Public Citizen warned of hyperkalemia risks linked to the combination of Aldactone and Septra in late 2011, indicating that patients should let their physician know they are on Aldactone if they are being treated for a urinary tract infection and to make sure their health care provider is aware of the potential risks of combining the two drugs. They also warned patients in their “Worst Pills, Best Pills” Newsletter to be aware of the potential symptoms if they are on the two drugs or any drugs that increase potassium blood levels, and to seek immediate medical attention if the symptoms occur.

Aldactone (spironolactone) was approved by the FDA in 1985 as a diuretic. Originally manufactured by Pfizer, it is available as a generic.

Septra (sulfamethoxazole and trimethoprim; also known as cotrimoxazole) was approved as an antibiotic by the FDA in 1973 and is widely available as a generic. The brand name versions, Septra and Septra DS, are distrubited by Monarch Pharmaceuticals, a division of King Pharmaceuticals. Bactrim is available as a generic.

2 Comments

  • PhilJanuary 8, 2022 at 12:16 pm

    34 yr old gf had a cyst on her buttocks. A culture was taken but before the results came back was prescribed bactrim for gram positive MRSA. She immediately started getting sick. Dizzy, weak... Results came back after she had already finished the prescription for rare gram-negative. Her white blood cells are now messed up and her blood is super super thin. She's gotten an irregular hheartbeat [Show More]34 yr old gf had a cyst on her buttocks. A culture was taken but before the results came back was prescribed bactrim for gram positive MRSA. She immediately started getting sick. Dizzy, weak... Results came back after she had already finished the prescription for rare gram-negative. Her white blood cells are now messed up and her blood is super super thin. She's gotten an irregular hheartbeat and has trouble lying down at night. Now we're waiting to see specialists. The doctor has no idea what it is and they are not sure if she has lupus or r.a. but they know she has some kind of autoimmune disorder now. Suffering from anemia now... Was told she should normally go to the hospital but now is advising against it because of covid in her weakened state. All these problems started almost immediatelyafter she was wrongly prescribed bactrim. And now months later is so much worse. I don't know what to do

  • GordonAugust 6, 2017 at 3:13 am

    Bactrim A doctor prescribed Bactrim for my diabetic foot infection, and my big toe turned black overnight, and so did all my blood. I went through three years of pain, and agony with reoccurring bone, and foot infections. I was hospitalized three times to have a toes amputated one at a time. The third time the Doctor removed my right leg below the knee. 10/16/17 That was the leg I use to d[Show More]Bactrim A doctor prescribed Bactrim for my diabetic foot infection, and my big toe turned black overnight, and so did all my blood. I went through three years of pain, and agony with reoccurring bone, and foot infections. I was hospitalized three times to have a toes amputated one at a time. The third time the Doctor removed my right leg below the knee. 10/16/17 That was the leg I use to drive my car. I am unable to pay my hospital bills, or find employment.

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