Drug interactions
Azithromycin + Topotecan
Severity: Moderate
Azithromycin and Topotecan: 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
Topotecan is a P-glycoprotein substrate, and P-gp inhibitors may raise its exposure, increasing the risk of myelosuppression. Azithromycin is a relatively weak P-gp inhibitor, so the effect is probably modest, but labeling advises caution with oral topotecan.
What this interaction means in plain words
Azithromycin and Topotecan 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; Topotecan belongs to Oncology.
Why it happens
Inhibition of P-glycoprotein efflux by azithromycin may increase topotecan absorption and reduce its clearance.
What to do
Monitor blood counts closely, especially with oral topotecan. Consider an alternative antibiotic if myelosuppression worsens.
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 Topotecan
- Adenovirus types 4 and 7 live + Topotecan Contraindicated
- Amiodarone + Topotecan Major
- Cisplatin + Topotecan Major
- Cobicistat + Topotecan Major
- Cyclosporin + Topotecan Major
- Darunavir + Topotecan Major
Frequently asked questions
Can I take Azithromycin with Topotecan?
MediHelp rates the interaction as moderate. Azithromycin and Topotecan 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. Topotecan is a P-glycoprotein substrate, and P-gp inhibitors may raise its exposure, increasing the risk of myelosuppression. Azithromycin is a relatively weak P-gp inhibitor, so the effect is probably modest, but labeling advises caution with oral topotecan.
How serious is the interaction between Azithromycin and Topotecan?
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 blood counts closely, especially with oral topotecan. Consider an alternative antibiotic if myelosuppression worsens.
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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