Drug interactions
Azithromycin + Gemifloxacin
Severity: Major
Azithromycin and Gemifloxacin: 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, so combined use may add to the risk of torsades de pointes. The risk is greater with electrolyte disturbances, bradycardia or underlying heart disease.
What this interaction means in plain words
Azithromycin and Gemifloxacin 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; Gemifloxacin belongs to Anti Bacterial.
Why it happens
Additive blockade of cardiac potassium (hERG) channels leading to delayed repolarization.
What to do
Choose a non-QT-prolonging antibiotic if possible. If both are needed, obtain a baseline ECG, correct potassium and magnesium, and monitor the QTc.
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: fluoroquinolones; "fluoroquinolones (e.g. moxifloxacin and levofloxacin)") — 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 Gemifloxacin
- Arsenic trioxide + Gemifloxacin Contraindicated
- Dofetilide + Gemifloxacin Contraindicated
- Gemifloxacin + Ibutilide Contraindicated
- Gemifloxacin + Pimozide Contraindicated
- Gemifloxacin + Thioridazine Contraindicated
- Gemifloxacin + Vandetanib Contraindicated
Frequently asked questions
Can I take Azithromycin with Gemifloxacin?
MediHelp rates the interaction as major. Azithromycin and Gemifloxacin 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 combined use may add to the risk of torsades de pointes. The risk is greater with electrolyte disturbances, bradycardia or underlying heart disease.
How serious is the interaction between Azithromycin and Gemifloxacin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Choose a non-QT-prolonging antibiotic if possible. If both are needed, obtain a baseline ECG, correct potassium and magnesium, and monitor the QTc.
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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