Drug interactions
Amitriptyline + Azithromycin
Severity: Moderate
Amitriptyline and Azithromycin: moderate interaction.
Last updated
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.
Summary
Both drugs can prolong the QT interval, so combined use may raise the risk of torsades de pointes. The risk is greater with higher amitriptyline doses, electrolyte disturbances or underlying heart disease.
What this interaction means in plain words
Amitriptyline and Azithromycin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Amitriptyline belongs to Central Nervous System; Azithromycin belongs to Anti Bacterial.
Why it happens
Additive QT prolongation through effects on cardiac repolarization.
What to do
Check baseline ECG and correct hypokalemia and hypomagnesemia. Consider a non-QT-prolonging antibiotic in patients with additional risk factors.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Azithromycin
- Azithromycin + Cisapride Contraindicated
- Azithromycin + Domperidone Contraindicated
- Azithromycin + Dronedarone Contraindicated
- Azithromycin + Pimozide Contraindicated
- Azithromycin + Piperaquine Contraindicated
- Azithromycin + Thioridazine Contraindicated
Other interactions of Amitriptyline
- Amitriptyline + Isocarboxazid Contraindicated
- Amitriptyline + Methylene blue Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amitriptyline + Pimozide Contraindicated
- Amitriptyline + Procarbazine Contraindicated
- Amitriptyline + Safinamide Contraindicated
Frequently asked questions
Can I take Amitriptyline with Azithromycin?
MediHelp rates the interaction as moderate. Amitriptyline and Azithromycin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Both drugs can prolong the QT interval, so combined use may raise the risk of torsades de pointes. The risk is greater with higher amitriptyline doses, electrolyte disturbances or underlying heart disease.
How serious is the interaction between Amitriptyline and Azithromycin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check baseline ECG and correct hypokalemia and hypomagnesemia. Consider a non-QT-prolonging antibiotic in patients with additional risk factors.
What other medicines interact with Azithromycin?
MediHelp also lists interactions of Azithromycin with, for example, Cisapride, Domperidone, Dronedarone. The full list is on the Azithromycin page.
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