Drug interactions
Azithromycin + Verapamil
Severity: Moderate
Azithromycin and Verapamil: 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 increase verapamil exposure, possibly leading to bradycardia, hypotension or AV block. Case reports describe hypotension and conduction disturbances, though the effect is less pronounced than with clarithromycin or erythromycin.
What this interaction means in plain words
Azithromycin and Verapamil 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; Verapamil belongs to Cardiovascular.
Why it happens
Possible inhibition of P-glycoprotein-mediated efflux of verapamil, with a minor CYP3A4 contribution.
What to do
Monitor heart rate, blood pressure and ECG conduction intervals during co-therapy. Reduce the verapamil dose if bradycardia or hypotension develops.
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 Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil Major
Frequently asked questions
Can I take Azithromycin with Verapamil?
MediHelp rates the interaction as moderate. Azithromycin and Verapamil 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 increase verapamil exposure, possibly leading to bradycardia, hypotension or AV block. Case reports describe hypotension and conduction disturbances, though the effect is less pronounced than with clarithromycin or erythromycin.
How serious is the interaction between Azithromycin and Verapamil?
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 heart rate, blood pressure and ECG conduction intervals during co-therapy. Reduce the verapamil dose if bradycardia or hypotension develops.
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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