Drug interactions
Azithromycin + Rifaximin
Severity: Minor
Azithromycin and Rifaximin: minor 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 inhibit P-glycoprotein and increase systemic absorption of rifaximin. Because rifaximin has minimal systemic exposure normally, the clinical effect is usually small, though it may matter with severe liver impairment or a damaged gut barrier.
What this interaction means in plain words
Azithromycin and Rifaximin have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Azithromycin belongs to Anti Bacterial; Rifaximin belongs to Anti Bacterial.
Why it happens
Possible inhibition of intestinal P-glycoprotein efflux of rifaximin, raising its systemic absorption.
What to do
No routine adjustment is needed. Monitor for rifaximin adverse effects in patients with severe hepatic impairment.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Azithromycin and Rifaximin, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Rifaximin
- Cholera vaccine + Rifaximin Major
- Microbiota + Rifaximin Major
- Amiodarone + Rifaximin Moderate
- Bcg intravesical live + Rifaximin Moderate
- Cyclosporin + Rifaximin Moderate
- Dronedarone + Rifaximin Moderate
Frequently asked questions
Can I take Azithromycin with Rifaximin?
MediHelp rates the interaction as minor. Azithromycin and Rifaximin have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Azithromycin may inhibit P-glycoprotein and increase systemic absorption of rifaximin. Because rifaximin has minimal systemic exposure normally, the clinical effect is usually small, though it may matter with severe liver impairment or a damaged gut barrier.
How serious is the interaction between Azithromycin and Rifaximin?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No routine adjustment is needed. Monitor for rifaximin adverse effects in patients with severe hepatic impairment.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
