Are Aldactone and Azithromycin okay to be taken together for acne treatment?

I have been suffering from acne since age 14. It was kind of in control over my 20's just by applying gel's/creams, face washes. Now I'm 35 and suddenly over the last few months i've noticed quite alot of break out and quite big pimples. I went to a new dermatologist, who prescribed Aldactone 25g (3 times a day) and also Azithromycin (twice a day). I'm wondering if both drugs are okay to be taken together.

Doctor Answers 1

Are Aldactone and Azithromycin okay to be taken together for acne treatment?

These medications are okay to use together; however, I would have probably started you at a lower dose on both medications. For acne aldactone or spironolactone of works very well at low doses 25 to 50 mg/day and when I use azithromycin, I use it at 250 mg per day.
Aldactone is most effective for individuals who have hormonal acne, which is commonly worse around the periods and often most severely affects the lower face.  There are some drug interactions with aldactone including anti-hypertensive medications (Ase inhibitors, Angiotension Receptor Blockers), other potassium spraring diuretics (Aldactone was FDA approved as a potassium sparing diuretic, and most people to periodically monitor potassium levels as well as doing a base line basic metabolic panel), Lithium and prolonged coarses of Bactrim also interact with aldactone. In addition, individuals with a person history of breast cancer are not given aldactone without approval from their oncologist or PCP, and there is also a concern about feminization of a male fetus if you become pregnant on aldactone. If you are on birth control bills, there are both branded and generic BCPs that contain a progestin component that is equivalent to 25 mg of Aldactone, and this should also be taken into consideration 
Azithromycin like doxycycline has significant anti-inflammatory effects and is good for inflammatory acne, and I think it sometimes is effective for individuals who have a rosacea component.
Since, I can not see your acne and I do not know your skin type, I do not know what topical agents would be best, but topical products in cleansers and leave on products should probably also be a part of any acne treatment plan.

Decatur Dermatologic Surgeon

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