Drug interactions
Azithromycin + Lithium
Severity: Moderate
Azithromycin and Lithium: 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
Lithium has been linked to QT changes and azithromycin prolongs QT, so combined use may add to arrhythmia risk. The effect is mainly relevant with toxic lithium levels, electrolyte disturbance or heart disease.
What this interaction means in plain words
Azithromycin and Lithium 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; Lithium belongs to Central Nervous System.
Why it happens
Additive effects on cardiac repolarization leading to QTc prolongation.
What to do
Obtain an ECG in patients with cardiac risk factors and keep lithium levels within the therapeutic range. Correct electrolytes and consider an alternative antibiotic if QTc is prolonged.
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 Lithium
- Lithium + Thioridazine Contraindicated
- Lithium + Vandetanib Contraindicated
- Aceclofenac + Lithium Major
- Acemetacin + Lithium Major
- Amisulpride + Lithium Major
- Amlodipine-benazepril + Lithium Major
Frequently asked questions
Can I take Azithromycin with Lithium?
MediHelp rates the interaction as moderate. Azithromycin and Lithium 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. Lithium has been linked to QT changes and azithromycin prolongs QT, so combined use may add to arrhythmia risk. The effect is mainly relevant with toxic lithium levels, electrolyte disturbance or heart disease.
How serious is the interaction between Azithromycin and Lithium?
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 an ECG in patients with cardiac risk factors and keep lithium levels within the therapeutic range. Correct electrolytes and consider an alternative antibiotic if QTc is prolonged.
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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