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Azithromycin Drug Interactions

azithromycin drug interactions

What is azithromycin?

Azithromycin is a prescription drug. It’s available as an:

  • oral tablet
  • oral suspension
  • extended-release oral suspension
  • eye drop
  • intravenous form that a healthcare provider can give

The oral tablet is available as a generic drug as well as the brand-name drug Zithromax. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in all strengths or forms as the brand-name drug.

Why it’s used

Azithromycin is used to treat certain infections caused by bacteria. It should not be used to treat infections caused by viruses, such as the common cold. Azithromycin may be used in combination with other antibiotics when it’s used to treat mycobacterium avium complex infection.

Azithromycin may interact with other medications

Azithromycin oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. If you have questions about whether a drug you're taking might interact with azithromycin, talk to your doctor or pharmacist.

Azithromycin Dosage

Azithromycin is taken as a pill or liquid. It's also given as intravenous (IV) injection in hospitals. Packets of powder are mixed with water to create the liquid solution.

Azithromycin may be taken with or without food.

Doctors sometimes prescribe azithromycin for shorter periods than they do for other antibiotics, such as in a one-day "mega-dose," or for three or five days, using the Z-Pak, which starts at a higher dose than longer regimens.

The dosage and length of time for azithromycin treatment vary according to the type of infection:

Infections of the skin and skin tissues: One dose of 500 milligrams (mg), then 250 mg per day for four days

Infection of the throat and tonsils: One dose of 500 mg; then 250 mg per day for four days

Community Acquired Pneumonia (CAP): One dose of 500 mg, then 250 mg per day for four days

Genital Ulcer Disease: 1 gram (g), one time

Sinus infections caused by bacteria: 500 mg a day for three days or 2 g as a one-time dose

Azithromycin Overdose

If you suspect an overdose, you should contact a poison-control center or emergency room immediately.

You can get in touch with a poison control center at (800) 222-1222.

Missed Dose of Azithromycin

If you miss a dose of Azithromycin, try to take it as soon as you remember, unless it is almost time for the next dose.

Then skip the missed dose and take your next dose at the regular time.

Do not take two doses of the medication at the same time.

A family or class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Azithromycin belongs to a drug class called macrolide antibiotics. Antibiotics are drugs used to treat infections caused by bacteria. Each antibiotic only works against infections caused by certain types of bacteria, so there are many classes and types of antibiotics.

Macrolide antibiotics are typically used to treat infections such as strep throat, syphilis, Lyme disease, and respiratory infections. They’re also used to treat infections caused by organisms called mycoplasma, which can cause conditions such as pneumonia. The other macrolide antibiotics available in the United States are clarithromycin and erythromycin.

Azithromycin Interactions

It is always important to share with your doctor and pharmacist all of the medications you are taking.

This includes not only all of your prescription medicine, but also products that may not seem like medication, such as over-the-counter drugs, vitamins and other dietary supplements (nutritional shakes, protein powders, etc.), and herbals along with any legal or illegal recreational drugs.

You should not take Azithromycin if you are taking

Pimozide (Orap)

BCG live (Theracrys)

Dronedarone (Multaq)

Talk to your doctor about the possibility of prescribing a different antibiotic than azithromycin if you are taking any of the following drugs:

  • Blood thinners like enoxaparin (Lovenox), fondaparinux (Arixta), heparin, warfarin (Coumadin or Jantoven)
  • Medications used to prevent blood clots, for instance during or after surgery or in life-threatening situations: antithrombin III (Thrombin), bivalirudin (Angiomax), dalteparin (Fragmin)
  • Amiodarone (Cordarone, Pacerone, or Nextarone)
  • Digoxin (Lanoxin)
  • Live typhoid vaccine (Vivotif)
  • Quinidine

Azithromycin and Alcohol

Alcohol may increase or worsen certain side effects caused by azithromycin, such as dizziness and upset stomach.

Azithromycin and Grapefruit Juice

Grapefruit and azithromycin are both broken down the same way by the liver, so interactions are possible, although they are thought to be uncommon.

To be safe, avoid all grapefruit products while taking this drug.

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