Drug interactions
Azithromycin + Propafenone
Severity: Major
Azithromycin and Propafenone: 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
Propafenone is a class IC antiarrhythmic that prolongs the QRS and can prolong the QT interval, and azithromycin adds QT risk. Combining them may increase proarrhythmic risk, especially in patients with structural heart disease.
What this interaction means in plain words
Azithromycin and Propafenone 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; Propafenone belongs to Cardiovascular.
Why it happens
Additive effects on cardiac conduction and repolarization, with sodium channel blockade from propafenone and potassium channel blockade from azithromycin.
What to do
Prefer a non-QT-prolonging antibiotic. If the combination is necessary, obtain an ECG at baseline and during therapy, and correct electrolytes.
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 Propafenone
- Dofetilide + Propafenone Contraindicated
- Dronedarone + Propafenone Contraindicated
- Nilotinib + Propafenone Contraindicated
- Nirmatrelvir / ritonavir + Propafenone Contraindicated
- Nirmatrelvir + Propafenone Contraindicated
- Pimozide + Propafenone Contraindicated
Frequently asked questions
Can I take Azithromycin with Propafenone?
MediHelp rates the interaction as major. Azithromycin and Propafenone 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. Propafenone is a class IC antiarrhythmic that prolongs the QRS and can prolong the QT interval, and azithromycin adds QT risk. Combining them may increase proarrhythmic risk, especially in patients with structural heart disease.
How serious is the interaction between Azithromycin and Propafenone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer a non-QT-prolonging antibiotic. If the combination is necessary, obtain an ECG at baseline and during therapy, and correct electrolytes.
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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