Drug interactions
Azithromycin + Itraconazole
Severity: Major
Azithromycin and Itraconazole: major 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 together they may increase the risk of torsades de pointes. Itraconazole also inhibits CYP3A4 and has negative inotropic effects, which matters in patients with heart disease.
What this interaction means in plain words
Azithromycin and Itraconazole 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; Itraconazole belongs to Anti Fungals.
Why it happens
Additive QT prolongation through hERG potassium channel blockade.
What to do
Avoid the combination when alternatives exist. If both are required, check an ECG and electrolytes at baseline and monitor the QTc, particularly in patients with cardiac risk factors.
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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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 Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole Contraindicated
Frequently asked questions
Can I take Azithromycin with Itraconazole?
MediHelp rates the interaction as major. Azithromycin and Itraconazole 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 together they may increase the risk of torsades de pointes. Itraconazole also inhibits CYP3A4 and has negative inotropic effects, which matters in patients with heart disease.
How serious is the interaction between Azithromycin and Itraconazole?
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 the combination when alternatives exist. If both are required, check an ECG and electrolytes at baseline and monitor the QTc, particularly in patients with cardiac risk factors.
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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