Zithromax (azithromycin) dosing, indications, interactions, adverse effects, and more (2024)

  • adagrasib

    adagrasib, azithromycin.Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.

  • albuterol

    albuterol and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • alfuzosin

    alfuzosin and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • amisulpride

    amisulpride and azithromycin both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.

  • anagrelide

    anagrelide and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • antithrombin alfa

    azithromycin increases effects of antithrombin alfa by decreasing metabolism. Avoid or Use Alternate Drug.

  • antithrombin III

    azithromycin increases effects of antithrombin III by decreasing metabolism. Avoid or Use Alternate Drug.

  • argatroban

    azithromycin increases effects of argatroban by decreasing metabolism. Avoid or Use Alternate Drug.

  • aripiprazole

    aripiprazole and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • arsenic trioxide

    arsenic trioxide and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • artemether

    artemether and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • atomoxetine

    atomoxetine and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • BCG vaccine live

    azithromycin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.

  • bemiparin

    azithromycin increases effects of bemiparin by decreasing metabolism. Avoid or Use Alternate Drug.

  • bivalirudin

    azithromycin increases effects of bivalirudin by decreasing metabolism. Avoid or Use Alternate Drug.

  • buprenorphine

    buprenorphine and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • buprenorphine buccal

    buprenorphine buccal and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • buprenorphine subdermal implant

    buprenorphine subdermal implant and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • buprenorphine transdermal

    buprenorphine transdermal and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • buprenorphine, long-acting injection

    buprenorphine, long-acting injection and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • ceritinib

    ceritinib and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • cholera vaccine

    azithromycin, cholera vaccine. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid coadministration of cholera vaccine with systemic antibiotics since these agents may be active against the vaccine strain. Do not administer cholera vaccine to patients who have received oral or parenteral antibiotics within 14 days prior to vaccination.

  • cisapride

    azithromycin increases toxicity of cisapride by QTc interval. Avoid or Use Alternate Drug.

  • clozapine

    clozapine and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • cobicistat

    cobicistat, azithromycin.Either increases levels of the other by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Consider alternative antibiotics with concomitant use of cobicistat coadministered with atazanavir or darunavir. .

  • colchicine

    azithromycin will increase the level or effect of colchicine by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Avoid use of colchicine with P-gp inhibitors. If coadministration is necessary, decrease colchicine dose or frequency as recommended in prescribing information. Use of any colchicine product in conjunction with P-gp inhibitors is contraindicated in patients with renal or hepatic impairment.

  • dalteparin

    azithromycin increases effects of dalteparin by decreasing metabolism. Avoid or Use Alternate Drug.

  • desflurane

    desflurane and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • digoxin

    azithromycin will increase the level or effect of digoxin by altering intestinal flora. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

  • dofetilide

    dofetilide increases toxicity of azithromycin by QTc interval. Avoid or Use Alternate Drug.

  • donepezil

    donepezil and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • dronedarone

    azithromycin and dronedarone both increase QTc interval. Contraindicated. Concomitant use of azithromycin and dronedarone may increase the risk of QT prolongation, cardiac arrhythmias.

  • efavirenz

    efavirenz and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • eliglustat

    eliglustat and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • enoxaparin

    azithromycin increases effects of enoxaparin by decreasing metabolism. Avoid or Use Alternate Drug.

  • escitalopram

    escitalopram increases toxicity of azithromycin by QTc interval. Avoid or Use Alternate Drug.

  • fexinidazole

    fexinidazole and azithromycin both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.

  • fingolimod

    fingolimod and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • fondaparinux

    azithromycin increases effects of fondaparinux by decreasing metabolism. Avoid or Use Alternate Drug.

  • gilteritinib

    gilteritinib and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • givinostat

    azithromycin and givinostat both increase QTc interval. Avoid or Use Alternate Drug. If unable to avoid coadministration, obtain ECGs when initiating, during concomitant use, and as clinically indicated. Withhold if QTc interval >500 ms or a change from baseline >60 ms.

  • glasdegib

    azithromycin and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.

  • granisetron

    granisetron and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • heparin

    azithromycin increases effects of heparin by decreasing metabolism. Avoid or Use Alternate Drug.

  • hydroxychloroquine sulfate

    hydroxychloroquine sulfate and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • inotuzumab

    inotuzumab and azithromycin both increase QTc interval. Avoid or Use Alternate Drug. If unable to avoid concomitant use, obtain ECGs and electrolytes before and after initiation of any drug known to prolong QTc, and periodically monitor as clinically indicated during treatment.

  • isoflurane

    isoflurane and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • lefamulin

    lefamulin and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • lithium

    lithium and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • macimorelin

    macimorelin and azithromycin both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.

  • microbiota oral

    azithromycin decreases effects of microbiota oral by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Microbiota oral contains bacterial spores. Antibacterial agents may decrease efficacy if coadministered. Complete antibiotic regimens 2-4 days before initiating microbiota oral. .

  • mirtazapine

    mirtazapine and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • ondansetron

    azithromycin and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.

  • oxaliplatin

    oxaliplatin and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • panobinostat

    azithromycin and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.

  • phenindione

    azithromycin increases effects of phenindione by decreasing metabolism. Avoid or Use Alternate Drug.

  • pomalidomide

    azithromycin increases levels of pomalidomide by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.

  • primaquine

    primaquine and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • protamine

    azithromycin increases effects of protamine by decreasing metabolism. Avoid or Use Alternate Drug.

  • repotrectinib

    azithromycin will increase the level or effect of repotrectinib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.

  • ribociclib

    ribociclib increases toxicity of azithromycin by QTc interval. Avoid or Use Alternate Drug.

  • rimegepant

    azithromycin will increase the level or effect of rimegepant by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.

  • riociguat

    azithromycin will increase the level or effect of riociguat by decreasing metabolism. Avoid or Use Alternate Drug. Coadministration of riociguat (substrate of CYP isoenzymes 1A1, 2C8, 3A, 2J2) with strong CYP inhibitors may require a decreased initial dose of 0.5 mg PO TID; monitor for signs of hypotension and reduce dose if needed

  • sevoflurane

    sevoflurane and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • siponimod

    siponimod and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • tacrolimus

    tacrolimus and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

  • topotecan

    azithromycin will increase the level or effect of topotecan by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Product labeling for PO topotecan recommends avoiding concomitant use of P-gp inhibitors; the interaction with IV topotecan may be less severe but is still likely of clinical significance

  • toremifene

    azithromycin increases levels of toremifene by decreasing metabolism. Avoid or Use Alternate Drug. Concurrent use of toremifene with agents causing QT prolongation should be avoided. If concomitant use is required it's recommended that toremifene be interrupted. If interruption not possible, patients requiring therapy with a drug that prolongs QT should be closely monitored. ECGs should be obtained for high risk patients.

  • typhoid vaccine live

    azithromycin decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.

  • umeclidinium bromide/vilanterol inhaled

    azithromycin increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.

  • vandetanib

    azithromycin, vandetanib.Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a drug known to prolong QT interval must be used, more frequent ECG monitoring is recommended.

  • vemurafenib

    vemurafenib and azithromycin both increase QTc interval. Avoid or Use Alternate Drug. Concomitant use of vemurafenib with drugs that prolong QT interval is not recommended.

  • venetoclax

    azithromycin will increase the level or effect of venetoclax by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If a P-gp inhibitor must be used, reduce the venetoclax dose by at least 50%. Monitor more closely for signs of venetoclax toxicities.

  • vilanterol/fluticasone furoate inhaled

    azithromycin increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.

  • afatinib

    azithromycin increases levels of afatinib by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Reduce afatinib daily dose by 10 mg if not tolerated when coadministered with P-gp inhibitors.

  • alfuzosin

    azithromycin and alfuzosin both increase QTc interval. Use Caution/Monitor.

  • aluminum hydroxide

    aluminum hydroxide decreases levels of azithromycin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

  • amiodarone

    azithromycin will increase the level or effect of amiodarone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

  • amitriptyline

    amitriptyline and azithromycin both increase QTc interval. Use Caution/Monitor.

  • amoxapine

    amoxapine and azithromycin both increase QTc interval. Use Caution/Monitor.

  • apomorphine

    azithromycin increases toxicity of apomorphine by QTc interval. Use Caution/Monitor.

  • arformoterol

    azithromycin increases toxicity of arformoterol by QTc interval. Use Caution/Monitor.

  • artemether/lumefantrine

    azithromycin and artemether/lumefantrine both increase QTc interval. Use Caution/Monitor.

  • asenapine

    azithromycin increases toxicity of asenapine by QTc interval. Use Caution/Monitor.

  • asenapine transdermal

    asenapine transdermal and azithromycin both increase QTc interval. Use Caution/Monitor.

  • atorvastatin

    azithromycin will increase the level or effect of atorvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. If this combination is used, closely monitor for evidence of atorvastatin toxicity (eg, muscle aches or pains, renal dysfunction).

  • balsalazide

    azithromycin will decrease the level or effect of balsalazide by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.

  • bazedoxifene/conjugated estrogens

    azithromycin will decrease the level or effect of bazedoxifene/conjugated estrogens by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Modify Therapy/Monitor Closely.

  • bedaquiline

    azithromycin and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely

  • berotralstat

    azithromycin increases levels of berotralstat by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

  • betrixaban

    azithromycin increases levels of betrixaban by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Decrease betrixaban dose to 80 mg PO once, then 40 mg PO qDay if coadministered with a P-gp inhibitor.

  • biotin

    azithromycin will decrease the level or effect of biotin by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.

  • calcium carbonate

    calcium carbonate decreases levels of azithromycin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

  • cefdinir

    azithromycin decreases effects of cefdinir by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

  • cefditoren

    azithromycin decreases effects of cefditoren by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

  • cefoxitin

    azithromycin decreases effects of cefoxitin by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

  • cefpodoxime

    azithromycin decreases effects of cefpodoxime by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

  • cefuroxime

    azithromycin decreases effects of cefuroxime by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

  • ceritinib

    azithromycin increases levels of ceritinib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

  • cetirizine

    azithromycin will increase the level or effect of cetirizine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

  • chloroquine

    azithromycin increases toxicity of chloroquine by QTc interval. Modify Therapy/Monitor Closely.chloroquine increases toxicity of azithromycin by QTc interval. Use Caution/Monitor.

  • chlorpromazine

    chlorpromazine and azithromycin both increase QTc interval. Use Caution/Monitor.

  • ciprofloxacin

    azithromycin increases toxicity of ciprofloxacin by QTc interval. Use Caution/Monitor.

  • citalopram

    azithromycin and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.

  • clarithromycin

    azithromycin and clarithromycin both increase QTc interval. Use Caution/Monitor.

  • clofazimine

    azithromycin increases toxicity of clofazimine by QTc interval. Modify Therapy/Monitor Closely.

  • clomipramine

    clomipramine and azithromycin both increase QTc interval. Use Caution/Monitor.

  • conjugated estrogens

    azithromycin will decrease the level or effect of conjugated estrogens by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Modify Therapy/Monitor Closely.

  • crizotinib

    crizotinib and azithromycin both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.azithromycin increases toxicity of crizotinib by QTc interval. Use Caution/Monitor.

  • cyclosporine

    azithromycin will increase the level or effect of cyclosporine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

  • dabigatran

    azithromycin will increase the level or effect of dabigatran by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Atrial fibrillation: Avoid coadministering dabigatran with P-gp inhibitors if CrCl <30 mL/min. DVT/PE treatment: Avoid coadministering dabigatran with P-gp inhibitors if CrCl <50 mL/min

  • desipramine

    desipramine and azithromycin both increase QTc interval. Use Caution/Monitor.

  • deutetrabenazine

    azithromycin increases toxicity of deutetrabenazine by QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).

  • dichlorphenamide

    dichlorphenamide and azithromycin both decrease serum potassium. Use Caution/Monitor.

  • dienogest/estradiol valerate

    azithromycin will decrease the level or effect of dienogest/estradiol valerate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. An alternate or additional form of birth control may be advisable during concomitant use.

  • disopyramide

    azithromycin and disopyramide both increase QTc interval. Modify Therapy/Monitor Closely.

  • dofetilide

    azithromycin and dofetilide both increase QTc interval. Use Caution/Monitor.

  • doxepin

    doxepin and azithromycin both increase QTc interval. Use Caution/Monitor.

  • droperidol

    azithromycin and droperidol both increase QTc interval. Use Caution/Monitor.

  • duvelisib

    azithromycin will increase the level or effect of duvelisib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

  • edoxaban

    azithromycin will increase the level or effect of edoxaban by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Dose adjustment may be required with strong P-gp inhibitors. DVT/PE treatment: Decrease dose to 30 mg PO once daily. NVAF: No dose reduction recommended

  • encorafenib

    azithromycin increases toxicity of encorafenib by QTc interval. Use Caution/Monitor.

  • entrectinib

    azithromycin increases toxicity of entrectinib by QTc interval. Use Caution/Monitor.

  • epinephrine

    epinephrine and azithromycin both increase QTc interval. Use Caution/Monitor.

  • epinephrine racemic

    epinephrine racemic and azithromycin both increase QTc interval. Use Caution/Monitor.

  • erythromycin base

    azithromycin and erythromycin base both increase QTc interval. Use Caution/Monitor.azithromycin will increase the level or effect of erythromycin base by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

  • erythromycin ethylsuccinate

    azithromycin and erythromycin ethylsuccinate both increase QTc interval. Use Caution/Monitor.azithromycin will increase the level or effect of erythromycin ethylsuccinate by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

  • erythromycin lactobionate

    azithromycin and erythromycin lactobionate both increase QTc interval. Use Caution/Monitor.azithromycin will increase the level or effect of erythromycin lactobionate by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

  • erythromycin stearate

    azithromycin and erythromycin stearate both increase QTc interval. Use Caution/Monitor.azithromycin will increase the level or effect of erythromycin stearate by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

  • escitalopram

    azithromycin increases toxicity of escitalopram by QTc interval. Use Caution/Monitor.

  • estradiol

    azithromycin will decrease the level or effect of estradiol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Modify Therapy/Monitor Closely.

  • estrogens conjugated synthetic

    azithromycin will decrease the level or effect of estrogens conjugated synthetic by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Modify Therapy/Monitor Closely.

  • estropipate

    azithromycin will decrease the level or effect of estropipate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Modify Therapy/Monitor Closely.

  • ezogabine

    ezogabine, azithromycin.Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Slight and transient QT-prolongation observed with ezogabine, particularly when dose titrated to 1200 mg/day. QT interval should be monitored when ezogabine is prescribed with agents known to increase QT interval.

  • fluconazole

    azithromycin and fluconazole both increase QTc interval. Use Caution/Monitor.

  • fluphenazine

    fluphenazine and azithromycin both increase QTc interval. Use Caution/Monitor.

  • formoterol

    azithromycin and formoterol both increase QTc interval. Use Caution/Monitor.

  • fostemsavir

    azithromycin and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.

  • gadobenate

    gadobenate and azithromycin both increase QTc interval. Use Caution/Monitor.

  • gemifloxacin

    azithromycin increases toxicity of gemifloxacin by QTc interval. Use Caution/Monitor.

  • gemtuzumab

    azithromycin and gemtuzumab both increase QTc interval. Use Caution/Monitor.

  • gepirone

    gepirone and azithromycin both increase QTc interval. Modify Therapy/Monitor Closely.

  • glecaprevir/pibrentasvir

    azithromycin will increase the level or effect of glecaprevir/pibrentasvir by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

  • goserelin

    goserelin increases toxicity of azithromycin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

  • haloperidol

    azithromycin and haloperidol both increase QTc interval. Use Caution/Monitor.

  • histrelin

    histrelin increases toxicity of azithromycin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

  • hydroxyzine

    hydroxyzine increases toxicity of azithromycin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

  • ibutilide

    azithromycin and ibutilide both increase QTc interval. Modify Therapy/Monitor Closely.

  • imipramine

    imipramine and azithromycin both increase QTc interval. Use Caution/Monitor.

  • indacaterol, inhaled

    indacaterol, inhaled, azithromycin. QTc interval. Use Caution/Monitor. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.

  • indapamide

    azithromycin and indapamide both increase QTc interval. Modify Therapy/Monitor Closely.

  • indinavir

    azithromycin will increase the level or effect of indinavir by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

  • isradipine

    azithromycin increases toxicity of isradipine by QTc interval. Use Caution/Monitor.

  • itraconazole

    azithromycin and itraconazole both increase QTc interval. Use Caution/Monitor.

  • ketoconazole

    azithromycin and ketoconazole both increase QTc interval. Use Caution/Monitor.

  • lenvatinib

    azithromycin and lenvatinib both increase QTc interval. Use Caution/Monitor. Lenvatinib prescribing information recommends monitoring ECG closely when coadministered with QT prolonging drugs.

  • leuprolide

    leuprolide increases toxicity of azithromycin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

  • levoketoconazole

    levoketoconazole will increase the level or effect of azithromycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.azithromycin and levoketoconazole both increase QTc interval. Use Caution/Monitor.

  • lofepramine

    lofepramine and azithromycin both increase QTc interval. Use Caution/Monitor.

  • lofexidine

    azithromycin increases toxicity of lofexidine by QTc interval. Use Caution/Monitor.

  • lopinavir

    azithromycin increases toxicity of lopinavir by QTc interval. Use Caution/Monitor.

  • loratadine

    azithromycin will increase the level or effect of loratadine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

  • lovastatin

    azithromycin will increase the level or effect of lovastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • lumefantrine

    azithromycin and lumefantrine both increase QTc interval. Use Caution/Monitor.

  • maprotiline

    maprotiline and azithromycin both increase QTc interval. Use Caution/Monitor.

  • mavorixafor

    mavorixafor and azithromycin both increase QTc interval. Modify Therapy/Monitor Closely. Mavorixafor causes concentration-dependent QTc prolongation. Monitor QTc during treatment in patients with risk factors for QTc prolongation (eg, coadministered medications that increase mavorixafor exposure or other drugs with a high risk to prolong the QTc interval). Mavorixafor dose reduction or discontinuation may be required.

  • mestranol

    azithromycin will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Modify Therapy/Monitor Closely.

  • mifepristone

    mifepristone, azithromycin. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.

  • moxifloxacin

    azithromycin and moxifloxacin both increase QTc interval. Use Caution/Monitor.

  • naldemedine

    azithromycin increases levels of naldemedine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor naldemedine for potential adverse effects if coadministered with P-gp inhibitors.

  • nilotinib

    azithromycin and nilotinib both increase QTc interval. Use Caution/Monitor.

  • nintedanib

    azithromycin increases levels of nintedanib by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. If nintedanib adverse effects occur, management may require interruption, dose reduction, or discontinuation of therapy .

  • nortriptyline

    nortriptyline and azithromycin both increase QTc interval. Use Caution/Monitor.

  • octreotide

    azithromycin and octreotide both increase QTc interval. Use Caution/Monitor.

  • octreotide (Antidote)

    azithromycin and octreotide (Antidote) both increase QTc interval. Use Caution/Monitor.

  • olanzapine

    azithromycin increases toxicity of olanzapine by QTc interval. Use Caution/Monitor.

  • olodaterol inhaled

    azithromycin and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias

  • osilodrostat

    osilodrostat and azithromycin both increase QTc interval. Use Caution/Monitor.

  • osimertinib

    osimertinib and azithromycin both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.

  • oxaliplatin

    oxaliplatin will increase the level or effect of azithromycin by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.

  • ozanimod

    ozanimod and azithromycin both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.

  • pantothenic acid

    azithromycin will decrease the level or effect of pantothenic acid by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.

  • pasireotide

    azithromycin and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.

  • pentamidine

    azithromycin and pentamidine both increase QTc interval. Modify Therapy/Monitor Closely.

  • perphenazine

    perphenazine and azithromycin both increase QTc interval. Use Caution/Monitor.

  • pimozide

    azithromycin and pimozide both increase QTc interval. Modify Therapy/Monitor Closely.

  • piperacillin

    azithromycin decreases effects of piperacillin by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

  • procainamide

    azithromycin and procainamide both increase QTc interval. Modify Therapy/Monitor Closely.

  • prochlorperazine

    prochlorperazine and azithromycin both increase QTc interval. Use Caution/Monitor.

  • promazine

    promazine and azithromycin both increase QTc interval. Use Caution/Monitor.

  • promethazine

    promethazine and azithromycin both increase QTc interval. Use Caution/Monitor.

  • propafenone

    azithromycin increases toxicity of propafenone by QTc interval. Use Caution/Monitor.

  • protriptyline

    protriptyline and azithromycin both increase QTc interval. Use Caution/Monitor.

  • pyridoxine

    azithromycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.

  • pyridoxine (Antidote)

    azithromycin will decrease the level or effect of pyridoxine (Antidote) by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.

  • quetiapine

    quetiapine, azithromycin.Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT.

  • quinidine

    quinidine and azithromycin both increase QTc interval. Modify Therapy/Monitor Closely.

  • quinine

    azithromycin and quinine both increase QTc interval. Use Caution/Monitor.

  • quizartinib

    quizartinib, azithromycin.Either increases effects of the other by QTc interval. Modify Therapy/Monitor Closely. Monitor patients more frequently with ECG if coadministered with QT prolonging drugs.

  • ranolazine

    azithromycin will increase the level or effect of ranolazine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

  • ribociclib

    azithromycin increases toxicity of ribociclib by QTc interval. Use Caution/Monitor.

  • rifabutin

    azithromycin increases toxicity of rifabutin by decreasing metabolism. Use Caution/Monitor.

  • rifampin

    azithromycin will increase the level or effect of rifampin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

  • rifaximin

    azithromycin increases levels of rifaximin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

  • rilpivirine

    rilpivirine increases toxicity of azithromycin by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsades de Pointes.

  • ritonavir

    azithromycin will increase the level or effect of ritonavir by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

  • rivaroxaban

    azithromycin increases levels of rivaroxaban by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Patients with renal impairment receiving rivaroxaban with drugs that are combined P-gp and weak or moderate CYP3A4 inhibitors may have significant increases in exposure compared with patients with normal renal function and no inhibitor use, since both pathways of rivaroxaban elimination are affected. Since these increases may increase bleeding risk, use rivaroxaban in this situation only if the potential benefit justifies the potential risk.

  • romidepsin

    azithromycin and romidepsin both increase QTc interval. Use Caution/Monitor.azithromycin will increase the level or effect of romidepsin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

  • selpercatinib

    selpercatinib increases toxicity of azithromycin by QTc interval. Use Caution/Monitor.

  • simvastatin

    azithromycin will increase the level or effect of simvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • sodium bicarbonate

    sodium bicarbonate decreases levels of azithromycin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

  • sodium citrate/citric acid

    sodium citrate/citric acid decreases levels of azithromycin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

  • sodium picosulfate/magnesium oxide/anhydrous citric acid

    azithromycin decreases effects of sodium picosulfate/magnesium oxide/anhydrous citric acid by altering metabolism. Use Caution/Monitor. Coadministration with antibiotics decreases efficacy by altering colonic bacterial flora needed to convert sodium picosulfate to active drug.

  • sorafenib

    sorafenib and azithromycin both increase QTc interval. Use Caution/Monitor.

  • sotalol

    azithromycin and sotalol both increase QTc interval. Modify Therapy/Monitor Closely.

  • tacrolimus

    azithromycin will increase the level or effect of tacrolimus by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

  • talazoparib

    azithromycin will increase the level or effect of talazoparib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Talazoparib is a P-glycoprotein (P-gp) substrate; coadministration with P-gp inhibitors may increase talazoparib systemic exposure.

  • thiamine

    azithromycin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.

  • thioridazine

    thioridazine and azithromycin both increase QTc interval. Use Caution/Monitor.

  • tobramycin inhaled

    tobramycin inhaled and azithromycin both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Avoid concurrent or sequential use to decrease risk for ototoxicity

  • tolvaptan

    azithromycin will increase the level or effect of tolvaptan by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

  • trazodone

    trazodone and azithromycin both increase QTc interval. Use Caution/Monitor.

  • trifluoperazine

    trifluoperazine and azithromycin both increase QTc interval. Use Caution/Monitor.

  • trimipramine

    trimipramine and azithromycin both increase QTc interval. Use Caution/Monitor.

  • triptorelin

    triptorelin increases toxicity of azithromycin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

  • valbenazine

    valbenazine and azithromycin both increase QTc interval. Use Caution/Monitor.

  • verapamil

    azithromycin will increase the level or effect of verapamil by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

  • voclosporin

    voclosporin, azithromycin.Either increases effects of the other by QTc interval. Use Caution/Monitor.

  • warfarin

    azithromycin increases toxicity of warfarin by anticoagulation. Use Caution/Monitor. Postmarketing reports have suggested that concomitant administration of azithromycin may potentiate effects of oral warfarin but the interaction does not appear to alter prothrombin time.

  • ziprasidone

    azithromycin and ziprasidone both increase QTc interval. Use Caution/Monitor.

  • amoxicillin

    azithromycin decreases effects of amoxicillin by pharmacodynamic antagonism. Minor/Significance Unknown.

  • ampicillin

    azithromycin decreases effects of ampicillin by pharmacodynamic antagonism. Minor/Significance Unknown.

  • clozapine

    azithromycin increases toxicity of clozapine by unspecified interaction mechanism. Minor/Significance Unknown. Enhanced CNS toxicity.

  • dasatinib

    azithromycin and dasatinib both increase QTc interval. Minor/Significance Unknown.

  • degarelix

    azithromycin increases toxicity of degarelix by QTc interval. Minor/Significance Unknown.

  • dicloxacillin

    azithromycin decreases effects of dicloxacillin by pharmacodynamic antagonism. Minor/Significance Unknown.

  • dolasetron

    azithromycin and dolasetron both increase QTc interval. Minor/Significance Unknown.

  • ergotamine

    azithromycin increases levels of ergotamine by unknown mechanism. Minor/Significance Unknown.

  • eribulin

    azithromycin increases toxicity of eribulin by QTc interval. Minor/Significance Unknown.

  • flecainide

    azithromycin and flecainide both increase QTc interval. Minor/Significance Unknown.

  • fluoxetine

    azithromycin and fluoxetine both increase QTc interval. Minor/Significance Unknown.

  • foscarnet

    azithromycin and foscarnet both increase QTc interval. Minor/Significance Unknown.

  • iloperidone

    azithromycin and iloperidone both increase QTc interval. Minor/Significance Unknown.

  • lapatinib

    azithromycin and lapatinib both increase QTc interval. Minor/Significance Unknown.

  • levofloxacin

    azithromycin and levofloxacin both increase QTc interval. Minor/Significance Unknown.

  • mefloquine

    azithromycin increases toxicity of mefloquine by QTc interval. Minor/Significance Unknown.

  • methadone

    azithromycin and methadone both increase QTc interval. Minor/Significance Unknown.

  • nafcillin

    azithromycin decreases effects of nafcillin by pharmacodynamic antagonism. Minor/Significance Unknown. bacteriostatic antibiotics may interfere with the bactericidal actions of penicillins.

  • ofloxacin

    azithromycin and ofloxacin both increase QTc interval. Minor/Significance Unknown.

  • oxacillin

    azithromycin decreases effects of oxacillin by pharmacodynamic antagonism. Minor/Significance Unknown. bacteriostatic antibiotics may interfere with the bactericidal actions of penicillins.

  • paliperidone

    azithromycin and paliperidone both increase QTc interval. Minor/Significance Unknown.

  • paroxetine

    azithromycin and paroxetine both increase QTc interval. Minor/Significance Unknown.

  • pazopanib

    azithromycin and pazopanib both increase QTc interval. Minor/Significance Unknown.

  • penicillin G aqueous

    azithromycin decreases effects of penicillin G aqueous by pharmacodynamic antagonism. Minor/Significance Unknown.

  • penicillin VK

    azithromycin decreases effects of penicillin VK by pharmacodynamic antagonism. Minor/Significance Unknown.

  • pimavanserin

    azithromycin increases toxicity of pimavanserin by QTc interval. Minor/Significance Unknown.

  • pitolisant

    azithromycin increases toxicity of pitolisant by QTc interval. Minor/Significance Unknown.

  • posaconazole

    azithromycin and posaconazole both increase QTc interval. Minor/Significance Unknown.

  • ranolazine

    azithromycin and ranolazine both increase QTc interval. Minor/Significance Unknown.

  • risperidone

    azithromycin and risperidone both increase QTc interval. Minor/Significance Unknown.

  • ruxolitinib

    azithromycin will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

  • ruxolitinib topical

    azithromycin will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

  • sertraline

    azithromycin increases toxicity of sertraline by QTc interval. Minor/Significance Unknown.

  • solifenacin

    azithromycin increases toxicity of solifenacin by QTc interval. Minor/Significance Unknown.

  • sulfamethoxazole

    azithromycin and sulfamethoxazole both increase QTc interval. Minor/Significance Unknown.

  • sunitinib

    azithromycin increases toxicity of sunitinib by QTc interval. Minor/Significance Unknown.

  • telavancin

    azithromycin and telavancin both increase QTc interval. Minor/Significance Unknown.

  • temocillin

    azithromycin decreases effects of temocillin by pharmacodynamic antagonism. Minor/Significance Unknown.

  • tetrabenazine

    azithromycin increases toxicity of tetrabenazine by QTc interval. Minor/Significance Unknown.

  • thiothixene

    azithromycin increases toxicity of thiothixene by QTc interval. Minor/Significance Unknown.

  • trimethoprim

    azithromycin and trimethoprim both increase QTc interval. Minor/Significance Unknown.

  • trimipramine

    azithromycin increases toxicity of trimipramine by QTc interval. Minor/Significance Unknown.

  • tropisetron

    azithromycin and tropisetron both increase QTc interval. Minor/Significance Unknown.

  • vardenafil

    azithromycin increases toxicity of vardenafil by QTc interval. Minor/Significance Unknown.

  • venlafaxine

    azithromycin and venlafaxine both increase QTc interval. Minor/Significance Unknown.

  • voriconazole

    azithromycin and voriconazole both increase QTc interval. Minor/Significance Unknown.

  • vorinostat

    azithromycin increases toxicity of vorinostat by QTc interval. Minor/Significance Unknown.

  • Zithromax (azithromycin) dosing, indications, interactions, adverse effects, and more (2024)

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