Drug interactions
Azithromycin + Ziprasidone
Severity: Major
Azithromycin and Ziprasidone: major interaction.
Last updated Sources: UK SmPC
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
Ziprasidone prolongs the QT interval and its labeling advises against combining it with other QT-prolonging drugs. Azithromycin adds to this effect and increases the risk of torsades de pointes.
What this interaction means in plain words
Azithromycin and Ziprasidone 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; Ziprasidone belongs to Central Nervous System.
Why it happens
Additive QT prolongation via hERG potassium channel blockade.
What to do
Avoid the combination where possible and use a non-QT-prolonging antibiotic. If needed, monitor the ECG and keep potassium and magnesium normal.
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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References
- Azithromycin 200mg/5ml Powder for Oral Suspension - SmPC sections 4.3/4.5 (class statement: antipsychotic agents; "antipsychotic agents (e.g. pimozide)") — electronic medicines compendium (UK SmPC)
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 Ziprasidone
- Amiodarone + Ziprasidone Contraindicated
- Amitriptyline + Ziprasidone Contraindicated
- Arsenic trioxide + Ziprasidone Contraindicated
- Bedaquiline + Ziprasidone Contraindicated
- Chloroquine + Ziprasidone Contraindicated
- Citalopram + Ziprasidone Contraindicated
Frequently asked questions
Can I take Azithromycin with Ziprasidone?
MediHelp rates the interaction as major. Azithromycin and Ziprasidone 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. Ziprasidone prolongs the QT interval and its labeling advises against combining it with other QT-prolonging drugs. Azithromycin adds to this effect and increases the risk of torsades de pointes.
How serious is the interaction between Azithromycin and Ziprasidone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible and use a non-QT-prolonging antibiotic. If needed, monitor the ECG and keep potassium and magnesium normal.
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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