Drug interactions
Azithromycin + Ergotamine
Severity: Moderate
Azithromycin and Ergotamine: 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
Macrolides have been linked to ergotism, though azithromycin is a weak CYP3A4 inhibitor and the risk is much lower than with clarithromycin or erythromycin. Ergotamine toxicity causes vasospasm and ischemia.
What this interaction means in plain words
Azithromycin and Ergotamine 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 belongs to Anti Bacterial; Ergotamine belongs to Central Nervous System.
Why it happens
Mechanism is not well established; possible minor CYP3A4 inhibition by azithromycin reducing ergotamine clearance.
What to do
Monitor for peripheral ischemia, paresthesias or severe headache; consider avoiding the combination if alternatives exist and stop ergotamine if vasospasm occurs.
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 Ergotamine
- Almotriptan + Ergotamine Contraindicated
- Atazanavir + Ergotamine Contraindicated
- Clarithromycin + Ergotamine Contraindicated
- Cobicistat + Ergotamine Contraindicated
- Darunavir + Ergotamine Contraindicated
- Dihydroergotamine intranasal + Ergotamine Contraindicated
Frequently asked questions
Can I take Azithromycin with Ergotamine?
MediHelp rates the interaction as moderate. Azithromycin and Ergotamine 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. Macrolides have been linked to ergotism, though azithromycin is a weak CYP3A4 inhibitor and the risk is much lower than with clarithromycin or erythromycin. Ergotamine toxicity causes vasospasm and ischemia.
How serious is the interaction between Azithromycin and Ergotamine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for peripheral ischemia, paresthesias or severe headache; consider avoiding the combination if alternatives exist and stop ergotamine if vasospasm occurs.
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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