Drug interactions
Azithromycin + Methadone
Severity: Moderate
Azithromycin and Methadone: 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
Both methadone and azithromycin can prolong the QT interval, so combined use may increase the risk of torsades de pointes. The absolute risk is low with azithromycin but is higher in patients on higher methadone doses or with electrolyte disturbances or cardiac disease.
What this interaction means in plain words
Azithromycin and Methadone 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; Methadone belongs to Musculoskeletal.
Why it happens
Additive QT prolongation through cardiac potassium channel blockade.
What to do
Consider an alternative antibiotic in patients with QT risk factors. If combined, check an ECG and correct potassium and magnesium.
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 Methadone
- Alvimopan + Methadone Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Methadone Contraindicated
- Droperidol + Methadone Contraindicated
- Ibutilide + Methadone Contraindicated
- Isocarboxazid + Methadone Contraindicated
- Lefamulin + Methadone Contraindicated
Other interactions of Azithromycin
- Azithromycin + Cisapride Contraindicated
- Azithromycin + Domperidone Contraindicated
- Azithromycin + Dronedarone Contraindicated
- Azithromycin + Pimozide Contraindicated
- Azithromycin + Piperaquine Contraindicated
- Azithromycin + Thioridazine Contraindicated
Frequently asked questions
Can I take Azithromycin with Methadone?
MediHelp rates the interaction as moderate. Azithromycin and Methadone 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. Both methadone and azithromycin can prolong the QT interval, so combined use may increase the risk of torsades de pointes. The absolute risk is low with azithromycin but is higher in patients on higher methadone doses or with electrolyte disturbances or cardiac disease.
How serious is the interaction between Azithromycin and Methadone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider an alternative antibiotic in patients with QT risk factors. If combined, check an ECG and correct potassium and magnesium.
What other medicines interact with Methadone?
MediHelp also lists interactions of Methadone with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Droperidol. The full list is on the Methadone page.
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