藥物交互作用
Azithromycin + Piperaquine
嚴重程度: 禁忌併用
Azithromycin and Piperaquine: contraindicated interaction.
最後更新 來源: US FDA label
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摘要
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.
用白話說明這項交互作用的意義
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.
為什麼會發生
Additive pharmacodynamic QT prolongation through IKr (hERG) potassium channel blockade; piperaquine also has a very long elimination half-life, prolonging the period of exposure.
處置方式
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.
可向藥師詢問的問題
- 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?
參考資料
- Eurartesim (dihydroartemisinin/piperaquine phosphate) Summary of Product Characteristics - Contraindications and Interactions — EMA SmPC
- Zithromax (azithromycin) Prescribing Information - QT Prolongation — FDA Label
Azithromycin 的其他交互作用
常見問題
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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