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

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Contraindicated (1)

• pimozide
  azithromycin increases toxicity of pimozide by decreasing metabolism. Contraindicated. Risk of prolonged QTc interval.

Serious (74)

• 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.

Monitor Closely (155)

• 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.
• 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.

Minor (47)

• 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.

• adagrasib
  Serious - Use Alternative (1)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.

• afatinib
  Monitor Closely (1)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.

• albuterol
  Serious - Use Alternative (1)albuterol and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• alfuzosin
  Monitor Closely (1)azithromycin and alfuzosin both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)alfuzosin and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• aluminum hydroxide
  Monitor Closely (1)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
  Monitor Closely (1)azithromycin will increase the level or effect of amiodarone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• amisulpride
  Serious - Use Alternative (1)amisulpride and azithromycin both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.

• amitriptyline
  Monitor Closely (1)amitriptyline and azithromycin both increase QTc interval. Use Caution/Monitor.

• amoxapine
  Monitor Closely (1)amoxapine and azithromycin both increase QTc interval. Use Caution/Monitor.

• amoxicillin
  Minor (1)azithromycin decreases effects of amoxicillin by pharmacodynamic antagonism. Minor/Significance Unknown.

• ampicillin
  Minor (1)azithromycin decreases effects of ampicillin by pharmacodynamic antagonism. Minor/Significance Unknown.

• anagrelide
  Serious - Use Alternative (1)anagrelide and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• antithrombin alfa
  Serious - Use Alternative (1)azithromycin increases effects of antithrombin alfa by decreasing metabolism. Avoid or Use Alternate Drug.

• antithrombin III
  Serious - Use Alternative (1)azithromycin increases effects of antithrombin III by decreasing metabolism. Avoid or Use Alternate Drug.

• apomorphine
  Monitor Closely (1)azithromycin increases toxicity of apomorphine by QTc interval. Use Caution/Monitor.

• arformoterol
  Monitor Closely (1)azithromycin increases toxicity of arformoterol by QTc interval. Use Caution/Monitor.

• argatroban
  Serious - Use Alternative (1)azithromycin increases effects of argatroban by decreasing metabolism. Avoid or Use Alternate Drug.

• aripiprazole
  Serious - Use Alternative (1)aripiprazole and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• arsenic trioxide
  Serious - Use Alternative (1)arsenic trioxide and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• artemether
  Serious - Use Alternative (1)artemether and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• artemether/lumefantrine
  Monitor Closely (1)azithromycin and artemether/lumefantrine both increase QTc interval. Use Caution/Monitor.

• asenapine
  Monitor Closely (1)azithromycin increases toxicity of asenapine by QTc interval. Use Caution/Monitor.

• asenapine transdermal
  Monitor Closely (1)asenapine transdermal and azithromycin both increase QTc interval. Use Caution/Monitor.

• atomoxetine
  Serious - Use Alternative (1)atomoxetine and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• atorvastatin
  Monitor Closely (1)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
  Monitor Closely (1)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
  Monitor Closely (1)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.

• BCG vaccine live
  Serious - Use Alternative (1)azithromycin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.

• bedaquiline
  Monitor Closely (1)azithromycin and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely

• bemiparin
  Serious - Use Alternative (1)azithromycin increases effects of bemiparin by decreasing metabolism. Avoid or Use Alternate Drug.

• berotralstat
  Monitor Closely (1)azithromycin increases levels of berotralstat by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• betrixaban
  Monitor Closely (1)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
  Monitor Closely (1)azithromycin will decrease the level or effect of biotin by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.

• bivalirudin
  Serious - Use Alternative (1)azithromycin increases effects of bivalirudin by decreasing metabolism. Avoid or Use Alternate Drug.

• buprenorphine
  Serious - Use Alternative (1)buprenorphine and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine buccal
  Serious - Use Alternative (1)buprenorphine buccal and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine subdermal implant
  Serious - Use Alternative (1)buprenorphine subdermal implant and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine transdermal
  Serious - Use Alternative (1)buprenorphine transdermal and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine, long-acting injection
  Serious - Use Alternative (1)buprenorphine, long-acting injection and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• calcium carbonate
  Monitor Closely (1)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
  Monitor Closely (1)azithromycin decreases effects of cefdinir by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

• cefditoren
  Monitor Closely (1)azithromycin decreases effects of cefditoren by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

• cefoxitin
  Monitor Closely (1)azithromycin decreases effects of cefoxitin by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

• cefpodoxime
  Monitor Closely (1)azithromycin decreases effects of cefpodoxime by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

• cefuroxime
  Monitor Closely (1)azithromycin decreases effects of cefuroxime by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

• ceritinib
  Monitor Closely (1)azithromycin increases levels of ceritinib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Serious - Use Alternative (1)ceritinib and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• cetirizine
  Monitor Closely (1)azithromycin will increase the level or effect of cetirizine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• chloroquine
  Monitor Closely (2)chloroquine increases toxicity of azithromycin by QTc interval. Use Caution/Monitor.
  azithromycin increases toxicity of chloroquine by QTc interval. Modify Therapy/Monitor Closely.

• chlorpromazine
  Monitor Closely (1)chlorpromazine and azithromycin both increase QTc interval. Use Caution/Monitor.

• cholera vaccine
  Serious - Use Alternative (1)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.

• ciprofloxacin
  Monitor Closely (1)azithromycin increases toxicity of ciprofloxacin by QTc interval. Use Caution/Monitor.

• cisapride
  Serious - Use Alternative (1)azithromycin increases toxicity of cisapride by QTc interval. Avoid or Use Alternate Drug.

• citalopram
  Monitor Closely (1)azithromycin and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.

• clarithromycin
  Monitor Closely (1)azithromycin and clarithromycin both increase QTc interval. Use Caution/Monitor.

• clofazimine
  Monitor Closely (1)azithromycin increases toxicity of clofazimine by QTc interval. Modify Therapy/Monitor Closely.

• clomipramine
  Monitor Closely (1)clomipramine and azithromycin both increase QTc interval. Use Caution/Monitor.

• clozapine
  Serious - Use Alternative (1)clozapine and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)azithromycin increases toxicity of clozapine by unspecified interaction mechanism. Minor/Significance Unknown. Enhanced CNS toxicity.

• cobicistat
  Serious - Use Alternative (1)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
  Serious - Use Alternative (1)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.

• conjugated estrogens
  Monitor Closely (1)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
  Monitor Closely (2)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
  Monitor Closely (1)azithromycin will increase the level or effect of cyclosporine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• dabigatran
  Monitor Closely (1)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

• dalteparin
  Serious - Use Alternative (1)azithromycin increases effects of dalteparin by decreasing metabolism. Avoid or Use Alternate Drug.

• dasatinib
  Minor (1)azithromycin and dasatinib both increase QTc interval. Minor/Significance Unknown.

• degarelix
  Minor (1)azithromycin increases toxicity of degarelix by QTc interval. Minor/Significance Unknown.

• desflurane
  Serious - Use Alternative (1)desflurane and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• desipramine
  Monitor Closely (1)desipramine and azithromycin both increase QTc interval. Use Caution/Monitor.

• deutetrabenazine
  Monitor Closely (1)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
  Monitor Closely (1)dichlorphenamide and azithromycin both decrease serum potassium. Use Caution/Monitor.

• dicloxacillin
  Minor (1)azithromycin decreases effects of dicloxacillin by pharmacodynamic antagonism. Minor/Significance Unknown.

• dienogest/estradiol valerate
  Monitor Closely (1)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.

• digoxin
  Serious - Use Alternative (1)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.

• disopyramide
  Monitor Closely (1)azithromycin and disopyramide both increase QTc interval. Modify Therapy/Monitor Closely.

• dofetilide
  Monitor Closely (1)azithromycin and dofetilide both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)dofetilide increases toxicity of azithromycin by QTc interval. Avoid or Use Alternate Drug.

• dolasetron
  Minor (1)azithromycin and dolasetron both increase QTc interval. Minor/Significance Unknown.

• donepezil
  Serious - Use Alternative (1)donepezil and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• doxepin
  Monitor Closely (1)doxepin and azithromycin both increase QTc interval. Use Caution/Monitor.

• dronedarone
  Serious - Use Alternative (1)azithromycin and dronedarone both increase QTc interval. Contraindicated. Concomitant use of azithromycin and dronedarone may increase the risk of QT prolongation, cardiac arrhythmias.

• droperidol
  Monitor Closely (1)azithromycin and droperidol both increase QTc interval. Use Caution/Monitor.

• duvelisib
  Monitor Closely (1)azithromycin will increase the level or effect of duvelisib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• edoxaban
  Monitor Closely (1)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

• efavirenz
  Serious - Use Alternative (1)efavirenz and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• eliglustat
  Serious - Use Alternative (1)eliglustat and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• encorafenib
  Monitor Closely (1)azithromycin increases toxicity of encorafenib by QTc interval. Use Caution/Monitor.

• enoxaparin
  Serious - Use Alternative (1)azithromycin increases effects of enoxaparin by decreasing metabolism. Avoid or Use Alternate Drug.

• entrectinib
  Monitor Closely (1)azithromycin increases toxicity of entrectinib by QTc interval. Use Caution/Monitor.

• epinephrine
  Monitor Closely (1)epinephrine and azithromycin both increase QTc interval. Use Caution/Monitor.

• epinephrine racemic
  Monitor Closely (1)epinephrine racemic and azithromycin both increase QTc interval. Use Caution/Monitor.

• ergotamine
  Minor (1)azithromycin increases levels of ergotamine by unknown mechanism. Minor/Significance Unknown.

• eribulin
  Minor (1)azithromycin increases toxicity of eribulin by QTc interval. Minor/Significance Unknown.

• erythromycin base
  Monitor Closely (2)azithromycin will increase the level or effect of erythromycin base by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
  azithromycin and erythromycin base both increase QTc interval. Use Caution/Monitor.

• erythromycin ethylsuccinate
  Monitor Closely (2)azithromycin will increase the level or effect of erythromycin ethylsuccinate by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
  azithromycin and erythromycin ethylsuccinate both increase QTc interval. Use Caution/Monitor.

• erythromycin lactobionate
  Monitor Closely (2)azithromycin will increase the level or effect of erythromycin lactobionate by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
  azithromycin and erythromycin lactobionate both increase QTc interval. Use Caution/Monitor.

• erythromycin stearate
  Monitor Closely (2)azithromycin will increase the level or effect of erythromycin stearate by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
  azithromycin and erythromycin stearate both increase QTc interval. Use Caution/Monitor.

• escitalopram
  Monitor Closely (1)azithromycin increases toxicity of escitalopram by QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)escitalopram increases toxicity of azithromycin by QTc interval. Avoid or Use Alternate Drug.

• estradiol
  Monitor Closely (1)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
  Monitor Closely (1)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
  Monitor Closely (1)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
  Monitor Closely (1)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.

• fexinidazole
  Serious - Use Alternative (1)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
  Serious - Use Alternative (1)fingolimod and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• flecainide
  Minor (1)azithromycin and flecainide both increase QTc interval. Minor/Significance Unknown.

• fluconazole
  Monitor Closely (1)azithromycin and fluconazole both increase QTc interval. Use Caution/Monitor.

• fluoxetine
  Minor (1)azithromycin and fluoxetine both increase QTc interval. Minor/Significance Unknown.

• fluphenazine
  Monitor Closely (1)fluphenazine and azithromycin both increase QTc interval. Use Caution/Monitor.

• fondaparinux
  Serious - Use Alternative (1)azithromycin increases effects of fondaparinux by decreasing metabolism. Avoid or Use Alternate Drug.

• formoterol
  Monitor Closely (1)azithromycin and formoterol both increase QTc interval. Use Caution/Monitor.

• foscarnet
  Minor (1)azithromycin and foscarnet both increase QTc interval. Minor/Significance Unknown.

• fostemsavir
  Monitor Closely (1)azithromycin and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.

• gadobenate
  Monitor Closely (1)gadobenate and azithromycin both increase QTc interval. Use Caution/Monitor.

• gemifloxacin
  Monitor Closely (1)azithromycin increases toxicity of gemifloxacin by QTc interval. Use Caution/Monitor.

• gemtuzumab
  Monitor Closely (1)azithromycin and gemtuzumab both increase QTc interval. Use Caution/Monitor.

• gepirone
  Monitor Closely (1)gepirone and azithromycin both increase QTc interval. Modify Therapy/Monitor Closely.

• gilteritinib
  Serious - Use Alternative (1)gilteritinib and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• givinostat
  Serious - Use Alternative (1)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
  Serious - Use Alternative (1)azithromycin and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.

• glecaprevir/pibrentasvir
  Monitor Closely (1)azithromycin will increase the level or effect of glecaprevir/pibrentasvir by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• goserelin
  Monitor Closely (1)goserelin increases toxicity of azithromycin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• granisetron
  Serious - Use Alternative (1)granisetron and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• haloperidol
  Monitor Closely (1)azithromycin and haloperidol both increase QTc interval. Use Caution/Monitor.

• heparin
  Serious - Use Alternative (1)azithromycin increases effects of heparin by decreasing metabolism. Avoid or Use Alternate Drug.

• histrelin
  Monitor Closely (1)histrelin increases toxicity of azithromycin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• hydroxychloroquine sulfate
  Serious - Use Alternative (1)hydroxychloroquine sulfate and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• hydroxyzine
  Monitor Closely (1)hydroxyzine increases toxicity of azithromycin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• ibutilide
  Monitor Closely (1)azithromycin and ibutilide both increase QTc interval. Modify Therapy/Monitor Closely.

• iloperidone
  Minor (1)azithromycin and iloperidone both increase QTc interval. Minor/Significance Unknown.

• imipramine
  Monitor Closely (1)imipramine and azithromycin both increase QTc interval. Use Caution/Monitor.

• indacaterol, inhaled
  Monitor Closely (1)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
  Monitor Closely (1)azithromycin and indapamide both increase QTc interval. Modify Therapy/Monitor Closely.

• inotuzumab
  Serious - Use Alternative (1)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
  Serious - Use Alternative (1)isoflurane and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• isradipine
  Monitor Closely (1)azithromycin increases toxicity of isradipine by QTc interval. Use Caution/Monitor.

• itraconazole
  Monitor Closely (1)azithromycin and itraconazole both increase QTc interval. Use Caution/Monitor.

• ketoconazole
  Monitor Closely (1)azithromycin and ketoconazole both increase QTc interval. Use Caution/Monitor.

• lapatinib
  Minor (1)azithromycin and lapatinib both increase QTc interval. Minor/Significance Unknown.

• lefamulin
  Serious - Use Alternative (1)lefamulin and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• lenvatinib
  Monitor Closely (1)azithromycin and lenvatinib both increase QTc interval. Use Caution/Monitor. Lenvatinib prescribing information recommends monitoring ECG closely when coadministered with QT prolonging drugs.

• leuprolide
  Monitor Closely (1)leuprolide increases toxicity of azithromycin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• levofloxacin
  Minor (1)azithromycin and levofloxacin both increase QTc interval. Minor/Significance Unknown.

• levoketoconazole
  Monitor Closely (2)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.

• lithium
  Serious - Use Alternative (1)lithium and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• lofepramine
  Monitor Closely (1)lofepramine and azithromycin both increase QTc interval. Use Caution/Monitor.

• lofexidine
  Monitor Closely (1)azithromycin increases toxicity of lofexidine by QTc interval. Use Caution/Monitor.

• lopinavir
  Monitor Closely (1)azithromycin increases toxicity of lopinavir by QTc interval. Use Caution/Monitor.

• loratadine
  Monitor Closely (1)azithromycin will increase the level or effect of loratadine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• lovastatin
  Monitor Closely (1)azithromycin will increase the level or effect of lovastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• lumefantrine
  Monitor Closely (1)azithromycin and lumefantrine both increase QTc interval. Use Caution/Monitor.

• macimorelin
  Serious - Use Alternative (1)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.

• maprotiline
  Monitor Closely (1)maprotiline and azithromycin both increase QTc interval. Use Caution/Monitor.

• mavorixafor
  Monitor Closely (1)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.

• mefloquine
  Minor (1)azithromycin increases toxicity of mefloquine by QTc interval. Minor/Significance Unknown.

• mestranol
  Monitor Closely (1)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.

• methadone
  Minor (1)azithromycin and methadone both increase QTc interval. Minor/Significance Unknown.

• microbiota oral
  Serious - Use Alternative (1)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. .

• mifepristone
  Monitor Closely (1)mifepristone, azithromycin. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.

• mirtazapine
  Serious - Use Alternative (1)mirtazapine and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• moxifloxacin
  Monitor Closely (1)azithromycin and moxifloxacin both increase QTc interval. Use Caution/Monitor.

• nafcillin
  Minor (1)azithromycin decreases effects of nafcillin by pharmacodynamic antagonism. Minor/Significance Unknown. bacteriostatic antibiotics may interfere with the bactericidal actions of penicillins.

• naldemedine
  Monitor Closely (1)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
  Monitor Closely (1)azithromycin and nilotinib both increase QTc interval. Use Caution/Monitor.

• nintedanib
  Monitor Closely (1)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
  Monitor Closely (1)nortriptyline and azithromycin both increase QTc interval. Use Caution/Monitor.

• octreotide
  Monitor Closely (1)azithromycin and octreotide both increase QTc interval. Use Caution/Monitor.

• octreotide (Antidote)
  Monitor Closely (1)azithromycin and octreotide (Antidote) both increase QTc interval. Use Caution/Monitor.

• ofloxacin
  Minor (1)azithromycin and ofloxacin both increase QTc interval. Minor/Significance Unknown.

• olanzapine
  Monitor Closely (1)azithromycin increases toxicity of olanzapine by QTc interval. Use Caution/Monitor.

• olodaterol inhaled
  Monitor Closely (1)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

• ondansetron
  Serious - Use Alternative (1)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.

• osilodrostat
  Monitor Closely (1)osilodrostat and azithromycin both increase QTc interval. Use Caution/Monitor.

• osimertinib
  Monitor Closely (1)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.

• oxacillin
  Minor (1)azithromycin decreases effects of oxacillin by pharmacodynamic antagonism. Minor/Significance Unknown. bacteriostatic antibiotics may interfere with the bactericidal actions of penicillins.

• oxaliplatin
  Monitor Closely (1)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.Serious - Use Alternative (1)oxaliplatin and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• ozanimod
  Monitor Closely (1)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.

• paliperidone
  Minor (1)azithromycin and paliperidone both increase QTc interval. Minor/Significance Unknown.

• panobinostat
  Serious - Use Alternative (1)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.

• pantothenic acid
  Monitor Closely (1)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.

• paroxetine
  Minor (1)azithromycin and paroxetine both increase QTc interval. Minor/Significance Unknown.

• pasireotide
  Monitor Closely (1)azithromycin and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.

• pazopanib
  Minor (1)azithromycin and pazopanib both increase QTc interval. Minor/Significance Unknown.

• penicillin G aqueous
  Minor (1)azithromycin decreases effects of penicillin G aqueous by pharmacodynamic antagonism. Minor/Significance Unknown.

• penicillin VK
  Minor (1)azithromycin decreases effects of penicillin VK by pharmacodynamic antagonism. Minor/Significance Unknown.

• pentamidine
  Monitor Closely (1)azithromycin and pentamidine both increase QTc interval. Modify Therapy/Monitor Closely.

• perphenazine
  Monitor Closely (1)perphenazine and azithromycin both increase QTc interval. Use Caution/Monitor.

• phenindione
  Serious - Use Alternative (1)azithromycin increases effects of phenindione by decreasing metabolism. Avoid or Use Alternate Drug.

• pimavanserin
  Minor (1)azithromycin increases toxicity of pimavanserin by QTc interval. Minor/Significance Unknown.

• pimozide
  Contraindicated (1)azithromycin increases toxicity of pimozide by decreasing metabolism. Contraindicated. Risk of prolonged QTc interval.Monitor Closely (1)azithromycin and pimozide both increase QTc interval. Modify Therapy/Monitor Closely.

• piperacillin
  Monitor Closely (1)azithromycin decreases effects of piperacillin by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.

• pitolisant
  Minor (1)azithromycin increases toxicity of pitolisant by QTc interval. Minor/Significance Unknown.

• pomalidomide
  Serious - Use Alternative (1)azithromycin increases levels of pomalidomide by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.

• posaconazole
  Minor (1)azithromycin and posaconazole both increase QTc interval. Minor/Significance Unknown.

• primaquine
  Serious - Use Alternative (1)primaquine and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• procainamide
  Monitor Closely (1)azithromycin and procainamide both increase QTc interval. Modify Therapy/Monitor Closely.

• prochlorperazine
  Monitor Closely (1)prochlorperazine and azithromycin both increase QTc interval. Use Caution/Monitor.

• promazine
  Monitor Closely (1)promazine and azithromycin both increase QTc interval. Use Caution/Monitor.

• promethazine
  Monitor Closely (1)promethazine and azithromycin both increase QTc interval. Use Caution/Monitor.

• propafenone
  Monitor Closely (1)azithromycin increases toxicity of propafenone by QTc interval. Use Caution/Monitor.

• protamine
  Serious - Use Alternative (1)azithromycin increases effects of protamine by decreasing metabolism. Avoid or Use Alternate Drug.

• protriptyline
  Monitor Closely (1)protriptyline and azithromycin both increase QTc interval. Use Caution/Monitor.

• pyridoxine
  Monitor Closely (1)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)
  Monitor Closely (1)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
  Monitor Closely (1)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
  Monitor Closely (1)quinidine and azithromycin both increase QTc interval. Modify Therapy/Monitor Closely.

• quinine
  Monitor Closely (1)azithromycin and quinine both increase QTc interval. Use Caution/Monitor.

• quizartinib
  Monitor Closely (1)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
  Monitor Closely (1)azithromycin will increase the level or effect of ranolazine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Minor (1)azithromycin and ranolazine both increase QTc interval. Minor/Significance Unknown.

• repotrectinib
  Serious - Use Alternative (1)azithromycin will increase the level or effect of repotrectinib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.

• ribociclib
  Monitor Closely (1)azithromycin increases toxicity of ribociclib by QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)ribociclib increases toxicity of azithromycin by QTc interval. Avoid or Use Alternate Drug.

• rifabutin
  Monitor Closely (1)azithromycin increases toxicity of rifabutin by decreasing metabolism. Use Caution/Monitor.

• rifampin
  Monitor Closely (1)azithromycin will increase the level or effect of rifampin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• rifaximin
  Monitor Closely (1)azithromycin increases levels of rifaximin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• rilpivirine
  Monitor Closely (1)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.

• rimegepant
  Serious - Use Alternative (1)azithromycin will increase the level or effect of rimegepant by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.

• riociguat
  Serious - Use Alternative (1)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

• risperidone
  Minor (1)azithromycin and risperidone both increase QTc interval. Minor/Significance Unknown.

• ritonavir
  Monitor Closely (1)azithromycin will increase the level or effect of ritonavir by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• rivaroxaban
  Monitor Closely (1)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
  Monitor Closely (2)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.

• ruxolitinib
  Minor (1)azithromycin will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• ruxolitinib topical
  Minor (1)azithromycin will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• selpercatinib
  Monitor Closely (1)selpercatinib increases toxicity of azithromycin by QTc interval. Use Caution/Monitor.

• sertraline
  Minor (1)azithromycin increases toxicity of sertraline by QTc interval. Minor/Significance Unknown.

• sevoflurane
  Serious - Use Alternative (1)sevoflurane and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• simvastatin
  Monitor Closely (1)azithromycin will increase the level or effect of simvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• siponimod
  Serious - Use Alternative (1)siponimod and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• sodium bicarbonate
  Monitor Closely (1)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
  Monitor Closely (1)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
  Monitor Closely (1)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.

• solifenacin
  Minor (1)azithromycin increases toxicity of solifenacin by QTc interval. Minor/Significance Unknown.

• sorafenib
  Monitor Closely (1)sorafenib and azithromycin both increase QTc interval. Use Caution/Monitor.

• sotalol
  Monitor Closely (1)azithromycin and sotalol both increase QTc interval. Modify Therapy/Monitor Closely.

• sulfamethoxazole
  Minor (1)azithromycin and sulfamethoxazole both increase QTc interval. Minor/Significance Unknown.

• sunitinib
  Minor (1)azithromycin increases toxicity of sunitinib by QTc interval. Minor/Significance Unknown.

• tacrolimus
  Monitor Closely (1)azithromycin will increase the level or effect of tacrolimus by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Serious - Use Alternative (1)tacrolimus and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• talazoparib
  Monitor Closely (1)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.

• telavancin
  Minor (1)azithromycin and telavancin both increase QTc interval. Minor/Significance Unknown.

• temocillin
  Minor (1)azithromycin decreases effects of temocillin by pharmacodynamic antagonism. Minor/Significance Unknown.

• tetrabenazine
  Minor (1)azithromycin increases toxicity of tetrabenazine by QTc interval. Minor/Significance Unknown.

• thiamine
  Monitor Closely (1)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
  Monitor Closely (1)thioridazine and azithromycin both increase QTc interval. Use Caution/Monitor.

• thiothixene
  Minor (1)azithromycin increases toxicity of thiothixene by QTc interval. Minor/Significance Unknown.

• tobramycin inhaled
  Monitor Closely (1)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
  Monitor Closely (1)azithromycin will increase the level or effect of tolvaptan by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• topotecan
  Serious - Use Alternative (1)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
  Serious - Use Alternative (1)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.

• trazodone
  Monitor Closely (1)trazodone and azithromycin both increase QTc interval. Use Caution/Monitor.

• trifluoperazine
  Monitor Closely (1)trifluoperazine and azithromycin both increase QTc interval. Use Caution/Monitor.

• trimethoprim
  Minor (1)azithromycin and trimethoprim both increase QTc interval. Minor/Significance Unknown.

• trimipramine
  Monitor Closely (1)trimipramine and azithromycin both increase QTc interval. Use Caution/Monitor.Minor (1)azithromycin increases toxicity of trimipramine by QTc interval. Minor/Significance Unknown.

• triptorelin
  Monitor Closely (1)triptorelin increases toxicity of azithromycin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• tropisetron
  Minor (1)azithromycin and tropisetron both increase QTc interval. Minor/Significance Unknown.

• typhoid vaccine live
  Serious - Use Alternative (1)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
  Serious - Use Alternative (1)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.

• valbenazine
  Monitor Closely (1)valbenazine and azithromycin both increase QTc interval. Use Caution/Monitor.

• vandetanib
  Serious - Use Alternative (1)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.

• vardenafil
  Minor (1)azithromycin increases toxicity of vardenafil by QTc interval. Minor/Significance Unknown.

• vemurafenib
  Serious - Use Alternative (1)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
  Serious - Use Alternative (1)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.

• venlafaxine
  Minor (1)azithromycin and venlafaxine both increase QTc interval. Minor/Significance Unknown.

• verapamil
  Monitor Closely (1)azithromycin will increase the level or effect of verapamil by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• vilanterol/fluticasone furoate inhaled
  Serious - Use Alternative (1)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.

• voclosporin
  Monitor Closely (1)voclosporin, azithromycin. Either increases effects of the other by QTc interval. Use Caution/Monitor.

• voriconazole
  Minor (1)azithromycin and voriconazole both increase QTc interval. Minor/Significance Unknown.

• vorinostat
  Minor (1)azithromycin increases toxicity of vorinostat by QTc interval. Minor/Significance Unknown.

• warfarin
  Monitor Closely (1)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
  Monitor Closely (1)azithromycin and ziprasidone both increase QTc interval. Use Caution/Monitor.