Drug interactions
Azithromycin + Hydroxyzine
Severity: Moderate
Azithromycin and Hydroxyzine: 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
Hydroxyzine has been associated with QT prolongation and torsades de pointes, and azithromycin adds to this effect. The combination is of greater concern in older patients and those with cardiac disease or electrolyte abnormalities.
What this interaction means in plain words
Azithromycin and Hydroxyzine 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; Hydroxyzine belongs to Respiratory.
Why it happens
Additive QT prolongation through cardiac potassium channel blockade.
What to do
Use the lowest effective hydroxyzine dose, correct potassium and magnesium, and obtain an ECG in patients with risk factors. Prefer an alternative agent in patients with 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?
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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 Hydroxyzine
- Droperidol + Hydroxyzine Contraindicated
- Hydroxyzine + Pimozide Contraindicated
- Hydroxyzine + Thioridazine Contraindicated
- Hydroxyzine + Vandetanib Contraindicated
- Alfentanil + Hydroxyzine Major
- Amiodarone + Hydroxyzine Major
Frequently asked questions
Can I take Azithromycin with Hydroxyzine?
MediHelp rates the interaction as moderate. Azithromycin and Hydroxyzine 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. Hydroxyzine has been associated with QT prolongation and torsades de pointes, and azithromycin adds to this effect. The combination is of greater concern in older patients and those with cardiac disease or electrolyte abnormalities.
How serious is the interaction between Azithromycin and Hydroxyzine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective hydroxyzine dose, correct potassium and magnesium, and obtain an ECG in patients with risk factors. Prefer an alternative agent in patients with 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.
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