Do not use SPIRAMYCIN if you are allergic to SPIRAMYCIN or its components. Tell your doctor if you have liver problems, muscle problems (myasthenia gravis), heart rhythm disorder (arrhythmia), porphyria (rare inherited blood disorders), or electrolyte imbalance (low potassium or magnesium level). Regular monitoring of liver function tests may be required while using SPIRAMYCIN. In rare cases, the use of SPIRAMYCIN can cause diarrhoea, so in case you have watery or bloody diarrhoea, stop taking SPIRAMYCIN and call your doctor. However, do not take any anti-diarrheal medicine until your doctor tells you.  SPIRAMYCIN is safe to use during pregnancy. However, please consult your doctor if you are pregnant, planning for pregnancy, or breastfeeding before using SPIRAMYCIN. It should be taken by the children only if the doctor has prescribed it. In some cases, SPIRAMYCIN may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause fast/irregular heartbeat and other symptoms (such as severe dizziness and fainting) that need medical attention immediately. Elderly adults may be more sensitive to the side effects of SPIRAMYCIN, especially QT prolongation. SPIRAMYCIN may cause live bacterial vaccines (such as typhoid vaccine) to not work as well. Do not have any immunizations/vaccinations while using this medication unless your doctor tells you to. Do not skip the doses and finish the full course of treatment even if you feel better. Stopping the SPIRAMYCIN too early may lead to the infection returning or worsening.

Drug-Drug Interaction: SPIRAMYCIN have interactions with ergot alkaloids (ergotamine, dihydroergotamine), drugs used to treat abnormal heart rhythm (amiodarone, dofetilide, pimozide, procainamide, quinidine), macrolide antibiotics (erythromycin).

Drug-Food Interaction: No relevant drug-food interaction was found with SPIRAMYCIN. As a precautionary measure, the consumption of alcoholic beverages should be avoided as it may lead to drowsiness and dizziness.

Drug-Disease Interaction: SPIRAMYCIN should not be given to people with liver problems, muscle problems (myasthenia gravis), heart rhythm disorder (arrhythmia), electrolyte imbalance (low potassium or magnesium level), colitis (inflammation of the intestine), and porphyria (rare genetic blood disorder).

• Probiotics should be taken after taking a full course of SPIRAMYCIN in order to restore some of the healthy bacteria in the intestines that may have been killed. Taking probiotics after antibiotic treatment can reduce the risk of antibiotic-associated diarrhoea. Certain fermented foods like yoghurt, cheese, sauerkraut, kombucha, and kimchi can help to restore the good bacteria of the intestine. 

• Include more fibre-enriched food in your diet, as it can be easily digested by gut bacteria, which helps stimulate their growth. Thus, fibre foods may help restore healthy gut bacteria after antibiotics. Whole grains like whole-grain bread and brown rice should be included in your diet. 

• Avoid taking too much calcium, iron-enriched foods, and drinks as it might affect the working of SPIRAMYCIN. 

• Avoid intake of alcoholic beverages with SPIRAMYCIN as it can make you dehydrated and affect your sleep. This can make it harder for your body to aid the SPIRAMYCIN in fighting off infections.

• Liver function monitoring (liver function tests) is recommended in patients with severe liver disease.

• SPIRAMYCIN may cause Clostridium difficile-associated diarrhea (CDAD); hence it is advised to undergo regular gastrointestinal screening.