Drug interactions
Azithromycin + Ranolazine
Severity: Moderate
Azithromycin and Ranolazine: 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
Azithromycin may modestly raise ranolazine concentrations through P-glycoprotein inhibition. Ranolazine itself prolongs the QT interval in a dose-related way, so higher exposure and additive QT effects could be relevant.
What this interaction means in plain words
Azithromycin and Ranolazine 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; Ranolazine belongs to Cardiovascular.
Why it happens
Possible inhibition of P-glycoprotein efflux of ranolazine, plus additive QT prolongation.
What to do
Monitor for ranolazine adverse effects such as dizziness, nausea and QT prolongation, and consider an ECG in patients with other QT risk factors. Reduce the ranolazine dose if adverse effects occur.
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 Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine Contraindicated
Frequently asked questions
Can I take Azithromycin with Ranolazine?
MediHelp rates the interaction as moderate. Azithromycin and Ranolazine 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 may modestly raise ranolazine concentrations through P-glycoprotein inhibition. Ranolazine itself prolongs the QT interval in a dose-related way, so higher exposure and additive QT effects could be relevant.
How serious is the interaction between Azithromycin and Ranolazine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for ranolazine adverse effects such as dizziness, nausea and QT prolongation, and consider an ECG in patients with other QT risk factors. Reduce the ranolazine dose if adverse effects occur.
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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