Drug interactions
Azithromycin + Imipramine
Severity: Moderate
Azithromycin and Imipramine: 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
Imipramine can prolong the QRS and QT intervals, especially at higher concentrations, and azithromycin adds further QT risk. Arrhythmia risk is increased in patients with heart disease or electrolyte disturbances.
What this interaction means in plain words
Azithromycin and Imipramine 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; Imipramine belongs to Central Nervous System.
Why it happens
Additive effects on cardiac repolarization via potassium channel blockade, plus sodium channel effects of the tricyclic.
What to do
Obtain a baseline ECG and correct electrolytes in at-risk patients, and monitor the QTc during combined use. Consider an alternative antibiotic in patients with prolonged QT or cardiac disease.
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 Imipramine
- Dronedarone + Imipramine Contraindicated
- Imipramine + Isocarboxazid Contraindicated
- Imipramine + Phenelzine Contraindicated
- Imipramine + Pimozide Contraindicated
- Imipramine + Rasagiline Contraindicated
- Imipramine + Safinamide Contraindicated
Frequently asked questions
Can I take Azithromycin with Imipramine?
MediHelp rates the interaction as moderate. Azithromycin and Imipramine 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. Imipramine can prolong the QRS and QT intervals, especially at higher concentrations, and azithromycin adds further QT risk. Arrhythmia risk is increased in patients with heart disease or electrolyte disturbances.
How serious is the interaction between Azithromycin and Imipramine?
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 and correct electrolytes in at-risk patients, and monitor the QTc during combined use. Consider an alternative antibiotic in patients with prolonged QT or cardiac disease.
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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