Drug interactions
Amiodarone + Azithromycin
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Overview
Additive QTc prolongation with increased risk of torsades de pointes and serious ventricular arrhythmias; risk amplified by bradycardia or electrolyte abnormalities.
Mechanism of action
Pharmacodynamic: both agents prolong cardiac repolarization (Ikr/hERG blockade), increasing QTc; no clinically meaningful CYP-mediated PK interaction expected.
Clinical management
Avoid combination if possible; consider a non–QT-prolonging antibiotic. If unavoidable: obtain baseline and follow-up ECGs, maintain K >4 mEq/L and Mg >2 mg/dL, avoid other QT-prolonging drugs, consider telemetry in high-risk patients, and discontinue if QTc >500 ms or increases >60 ms.
Drug reference
References
- Zithromax (azithromycin) Prescribing Information — FDA Label
- Amiodarone hydrochloride (Cordarone/Pacerone) Prescribing Information — FDA Label
- Azithromycin: Drug Interactions — Lexicomp
- Amiodarone: Drug Interactions — Lexicomp
Frequently asked questions
Can I take Amiodarone with Azithromycin?
The interaction is rated: Major. Additive QTc prolongation with increased risk of torsades de pointes and serious ventricular arrhythmias; risk amplified by bradycardia or electrolyte abnormalities.
How serious is the interaction between Amiodarone and Azithromycin?
The interaction is rated: Major. Evidence level: Moderate.
How is the interaction between Amiodarone and Azithromycin managed?
Avoid combination if possible; consider a non–QT-prolonging antibiotic. If unavoidable: obtain baseline and follow-up ECGs, maintain K >4 mEq/L and Mg >2 mg/dL, avoid other QT-prolonging drugs, consider telemetry in high-risk patients, and discontinue if QTc >500 ms or increases >60 ms.
Why do Amiodarone and Azithromycin interact?
Pharmacodynamic: both agents prolong cardiac repolarization (Ikr/hERG blockade), increasing QTc; no clinically meaningful CYP-mediated PK interaction expected.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.