Drug interactions
Azithromycin + Fexinidazole
Severity: Major
Azithromycin and Fexinidazole: 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
Fexinidazole is associated with QT prolongation, and azithromycin has similar effects. Combined use may increase the risk of torsades de pointes.
What this interaction means in plain words
Azithromycin and Fexinidazole 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.
Why it happens
Additive pharmacodynamic QT prolongation.
What to do
Avoid coadministration and use an antibiotic without QT effect. If unavoidable, obtain ECG monitoring 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 (class statement: medicinal products known to prolong the QT interval; "Azithromycin should be used with caution in patients receiving medicinal products known to prolong the QT interval") — 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
Frequently asked questions
Can I take Azithromycin with Fexinidazole?
MediHelp rates the interaction as major. Azithromycin and Fexinidazole 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. Fexinidazole is associated with QT prolongation, and azithromycin has similar effects. Combined use may increase the risk of torsades de pointes.
How serious is the interaction between Azithromycin and Fexinidazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid coadministration and use an antibiotic without QT effect. If unavoidable, obtain ECG monitoring 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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