Interactions médicamenteuses
Azithromycin + Piperaquine
Gravité: Contre-indiquée
Azithromycin and Piperaquine: contraindicated interaction.
Dernière mise à jour Sources: US FDA label
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Résumé
Piperaquine, given as dihydroartemisinin-piperaquine, causes dose-related QTc prolongation, and azithromycin is also associated with QT prolongation and torsades de pointes. Combined use may produce additive effects with a risk of serious ventricular arrhythmia. The Eurartesim SmPC contraindicates use with other medicines that prolong the QT interval, including macrolide antibiotics.
Ce que signifie cette interaction, en termes simples
Azithromycin and Piperaquine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Pourquoi elle survient
Additive pharmacodynamic QT prolongation through IKr (hERG) potassium channel blockade; piperaquine also has a very long elimination half-life, prolonging the period of exposure.
Conduite à tenir
Do not co-administer; choose an antibiotic without QT liability or an antimalarial without piperaquine if azithromycin is essential. Avoid starting azithromycin for several weeks after piperaquine because of its long half-life.
Questions à poser à votre pharmacien
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Références
- Eurartesim (dihydroartemisinin/piperaquine phosphate) Summary of Product Characteristics - Contraindications and Interactions — EMA SmPC
- Zithromax (azithromycin) Prescribing Information - QT Prolongation — FDA Label
Autres interactions de Azithromycin
- Azithromycin + Cisapride Contre-indiquée
- Azithromycin + Domperidone Contre-indiquée
- Azithromycin + Dronedarone Contre-indiquée
- Azithromycin + Pimozide Contre-indiquée
- Azithromycin + Thioridazine Contre-indiquée
- Adagrasib + Azithromycin Majeure
Questions fréquentes
Can I take Azithromycin with Piperaquine?
MediHelp rates the interaction as contraindicated. Azithromycin and Piperaquine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Piperaquine, given as dihydroartemisinin-piperaquine, causes dose-related QTc prolongation, and azithromycin is also associated with QT prolongation and torsades de pointes. Combined use may produce additive effects with a risk of serious ventricular arrhythmia. The Eurartesim SmPC contraindicates use with other medicines that prolong the QT interval, including macrolide antibiotics.
How serious is the interaction between Azithromycin and Piperaquine?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not co-administer; choose an antibiotic without QT liability or an antimalarial without piperaquine if azithromycin is essential. Avoid starting azithromycin for several weeks after piperaquine because of its long half-life.
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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