Drug interactions
Azithromycin + Dabigatran
Severity: Moderate
Azithromycin and Dabigatran: 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
Azithromycin may inhibit P-glycoprotein and increase dabigatran exposure, raising bleeding risk. The risk is most relevant in patients with renal impairment, in whom dabigatran clearance is already reduced.
What this interaction means in plain words
Azithromycin and Dabigatran 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.
Why it happens
Inhibition of P-glycoprotein efflux of dabigatran etexilate, increasing absorption.
What to do
Assess renal function and follow labeled restrictions on P-gp inhibitors at low creatinine clearance. Monitor for signs of bleeding.
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
Frequently asked questions
Can I take Azithromycin with Dabigatran?
MediHelp rates the interaction as moderate. Azithromycin and Dabigatran 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. Azithromycin may inhibit P-glycoprotein and increase dabigatran exposure, raising bleeding risk. The risk is most relevant in patients with renal impairment, in whom dabigatran clearance is already reduced.
How serious is the interaction between Azithromycin and Dabigatran?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Assess renal function and follow labeled restrictions on P-gp inhibitors at low creatinine clearance. Monitor for signs of bleeding.
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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