Drug interactions
Azithromycin + Cholera vaccine
Severity: Major
Azithromycin and Cholera vaccine: major 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
The oral live attenuated cholera vaccine relies on viable bacteria colonizing the gut. Systemic antibiotics active against Vibrio cholerae may kill the vaccine strain and reduce the immune response.
What this interaction means in plain words
Azithromycin and Cholera vaccine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Antibacterial activity against the live attenuated vaccine strain reduces vaccine replication and immunogenicity.
What to do
Do not give the vaccine to patients who have taken systemic antibiotics in the preceding 14 days. Delay vaccination until after the antibiotic course, or revaccinate later if the vaccine was given during therapy.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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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
Frequently asked questions
Can I take Azithromycin with Cholera vaccine?
MediHelp rates the interaction as major. Azithromycin and Cholera vaccine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. The oral live attenuated cholera vaccine relies on viable bacteria colonizing the gut. Systemic antibiotics active against Vibrio cholerae may kill the vaccine strain and reduce the immune response.
How serious is the interaction between Azithromycin and Cholera vaccine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not give the vaccine to patients who have taken systemic antibiotics in the preceding 14 days. Delay vaccination until after the antibiotic course, or revaccinate later if the vaccine was given during therapy.
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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