Лекарственные взаимодействия
Azithromycin + Piperaquine
Тяжесть: Противопоказано
Azithromycin and Piperaquine: contraindicated interaction.
Последнее обновление Источники: US FDA label
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Кратко
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.
Что означает это взаимодействие простыми словами
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.
Почему это происходит
Additive pharmacodynamic QT prolongation through IKr (hERG) potassium channel blockade; piperaquine also has a very long elimination half-life, prolonging the period of exposure.
Что делать
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.
О чём спросить фармацевта
- 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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Источники
- Eurartesim (dihydroartemisinin/piperaquine phosphate) Summary of Product Characteristics - Contraindications and Interactions — EMA SmPC
- Zithromax (azithromycin) Prescribing Information - QT Prolongation — FDA Label
Другие взаимодействия Azithromycin
- Azithromycin + Cisapride Противопоказано
- Azithromycin + Domperidone Противопоказано
- Azithromycin + Dronedarone Противопоказано
- Azithromycin + Pimozide Противопоказано
- Azithromycin + Thioridazine Противопоказано
- Adagrasib + Azithromycin Тяжёлое
Частые вопросы
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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