Drug interactions
Azithromycin + Citalopram
Severity: Major
Azithromycin and Citalopram: major interaction.
Last updated Sources: UK SmPC
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 prolong the QT interval in a dose-related manner, so combined use may increase the risk of torsades de pointes. Citalopram has dose limits because of this risk.
What this interaction means in plain words
Azithromycin and Citalopram 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.
Azithromycin belongs to Anti Bacterial; Citalopram belongs to Central Nervous System.
Why it happens
Additive QT prolongation through effects on cardiac repolarization.
What to do
Use an alternative antibiotic where possible. If combined, keep citalopram within its labeled maximum dose, check ECG and correct electrolytes.
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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References
- Azithromycin 200mg/5ml Powder for Oral Suspension - SmPC sections 4.3/4.5 (names the partner; "s IA (e.g. quinidine and procainamide) and III (e.g. dofetilide, amiodarone and sotalol), antipsychotic agents (e.g. pimozide), antidepressants (e.g. citalopram") — electronic medicines compendium (UK SmPC)
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 Citalopram
- Cisapride + Citalopram Contraindicated
- Citalopram + Dronedarone Contraindicated
- Citalopram + Escitalopram Contraindicated
- Citalopram + Isocarboxazid Contraindicated
- Citalopram + Methylene blue Contraindicated
- Citalopram + Phenelzine Contraindicated
Frequently asked questions
Can I take Azithromycin with Citalopram?
MediHelp rates the interaction as major. Azithromycin and Citalopram 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. Both drugs prolong the QT interval in a dose-related manner, so combined use may increase the risk of torsades de pointes. Citalopram has dose limits because of this risk.
How serious is the interaction between Azithromycin and Citalopram?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use an alternative antibiotic where possible. If combined, keep citalopram within its labeled maximum dose, check ECG and correct electrolytes.
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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