Drug interactions
Azithromycin + Moxifloxacin
Severity: Major
Azithromycin and Moxifloxacin: major interaction.
Last updated Sources: UK SmPC
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 prolong the QT interval, and moxifloxacin carries one of the larger QT effects among fluoroquinolones. Combined use raises the risk of torsades de pointes, particularly with hypokalemia, bradycardia or structural heart disease.
What this interaction means in plain words
Azithromycin and Moxifloxacin 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; Moxifloxacin belongs to Anti Bacterial.
Why it happens
Additive hERG potassium channel blockade causing delayed repolarization.
What to do
Avoid the combination and choose antibiotics without additive QT effects where possible. If it cannot be avoided, correct electrolytes and monitor ECG and QTc.
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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References
- Azithromycin 200mg/5ml Powder for Oral Suspension - SmPC sections 4.3/4.5 (names the partner; "e) and III (e.g. dofetilide, amiodarone and sotalol), antipsychotic agents (e.g. pimozide), antidepressants (e.g. citalopram), fluoroquinolones (e.g. moxifloxac") — electronic medicines compendium (UK SmPC)
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 Moxifloxacin
- Amiodarone + Moxifloxacin Contraindicated
- Arsenic trioxide + Moxifloxacin Contraindicated
- Disopyramide + Moxifloxacin Contraindicated
- Dofetilide + Moxifloxacin Contraindicated
- Dronedarone + Moxifloxacin Contraindicated
- Droperidol + Moxifloxacin Contraindicated
Frequently asked questions
Can I take Azithromycin with Moxifloxacin?
MediHelp rates the interaction as major. Azithromycin and Moxifloxacin 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 prolong the QT interval, and moxifloxacin carries one of the larger QT effects among fluoroquinolones. Combined use raises the risk of torsades de pointes, particularly with hypokalemia, bradycardia or structural heart disease.
How serious is the interaction between Azithromycin and Moxifloxacin?
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 and choose antibiotics without additive QT effects where possible. If it cannot be avoided, correct electrolytes and monitor ECG and QTc.
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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