Drug interactions
Azithromycin + Fluoxetine
Severity: Moderate
Azithromycin and Fluoxetine: 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
Both drugs can prolong the QT interval, so combined use may add to the risk of torsades de pointes. The absolute risk is low in patients without other risk factors but rises with electrolyte disturbance, structural heart disease or other QT-prolonging drugs.
What this interaction means in plain words
Azithromycin and Fluoxetine 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; Fluoxetine belongs to Central Nervous System.
Why it happens
Additive blockade of cardiac repolarizing potassium currents (hERG) leading to QTc prolongation.
What to do
Obtain a baseline ECG in patients with cardiac risk factors and correct potassium and magnesium before starting. Consider a non-macrolide antibiotic if the patient has known QT prolongation.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Azithromycin and Fluoxetine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline Contraindicated
Frequently asked questions
Can I take Azithromycin with Fluoxetine?
MediHelp rates the interaction as moderate. Azithromycin and Fluoxetine 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. Both drugs can prolong the QT interval, so combined use may add to the risk of torsades de pointes. The absolute risk is low in patients without other risk factors but rises with electrolyte disturbance, structural heart disease or other QT-prolonging drugs.
How serious is the interaction between Azithromycin and Fluoxetine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG in patients with cardiac risk factors and correct potassium and magnesium before starting. Consider a non-macrolide antibiotic if the patient has known QT prolongation.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
