Drug interactions
Azithromycin + Escitalopram
Severity: Major
Azithromycin and Escitalopram: 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 can prolong the QT interval, and escitalopram has dose-dependent QT effects. Together they may increase the risk of torsades de pointes, particularly with other risk factors.
What this interaction means in plain words
Azithromycin and Escitalopram 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; Escitalopram belongs to Central Nervous System.
Why it happens
Additive QTc prolongation via effects on cardiac repolarization.
What to do
Consider a non-macrolide antibiotic where possible. If used together, check ECG and electrolytes and keep escitalopram at the lowest effective dose.
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 (class statement: antidepressants; "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 Escitalopram
- Cisapride + Escitalopram Contraindicated
- Citalopram + Escitalopram Contraindicated
- Escitalopram + Isocarboxazid Contraindicated
- Escitalopram + Methylene blue Contraindicated
- Escitalopram + Phenelzine Contraindicated
- Escitalopram + Pimozide Contraindicated
Frequently asked questions
Can I take Azithromycin with Escitalopram?
MediHelp rates the interaction as major. Azithromycin and Escitalopram 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, and escitalopram has dose-dependent QT effects. Together they may increase the risk of torsades de pointes, particularly with other risk factors.
How serious is the interaction between Azithromycin and Escitalopram?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider a non-macrolide antibiotic where possible. If used together, check ECG and electrolytes and keep escitalopram at the lowest effective dose.
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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