Drug interactions
Azithromycin + Donepezil
Severity: Major
Azithromycin and Donepezil: 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
Both drugs can prolong the QT interval, so together they may raise the risk of torsades de pointes. Donepezil can also cause bradycardia, which adds to the proarrhythmic risk.
What this interaction means in plain words
Azithromycin and Donepezil 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; Donepezil belongs to Central Nervous System.
Why it happens
Additive QTc prolongation through cardiac repolarization effects, with donepezil-related bradycardia as an additional contributor.
What to do
Prefer a non-QT-prolonging antibiotic when feasible. If combined, obtain a baseline ECG, correct potassium and magnesium, and monitor QTc and heart rate.
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
Other interactions of Donepezil
- Donepezil + Dronedarone Contraindicated
- Donepezil + Pimozide Contraindicated
- Donepezil + Thioridazine Contraindicated
- Donepezil + Vandetanib Contraindicated
- Amiodarone + Donepezil Major
- Amisulpride + Donepezil Major
Frequently asked questions
Can I take Azithromycin with Donepezil?
MediHelp rates the interaction as major. Azithromycin and Donepezil 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 can prolong the QT interval, so together they may raise the risk of torsades de pointes. Donepezil can also cause bradycardia, which adds to the proarrhythmic risk.
How serious is the interaction between Azithromycin and Donepezil?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer a non-QT-prolonging antibiotic when feasible. If combined, obtain a baseline ECG, correct potassium and magnesium, and monitor QTc and heart rate.
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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