Azithromycin Drug Interactions

Azithromycin Drug Interactions Explained

The following sections explain in detail how the drugs mentioned above can cause potentially negative interactions when combined with azithromycin.
QT-Prolonging Medications
Rarely, azithromycin can cause a change in the heart rhythm known as QT prolongation. For many individuals, this is minor and inconsequential. However, in some cases it can lead to a fatal arrhythmia. People who already have a long QT interval (due to genetics, heart problems, or other medications) are at highest risk for serious problems related to QT prolongation with azithromycin.
Warfarin (Coumadin, Jantoven)
If you are taking azithromycin and warfarin, your body may metabolize warfarin differently than intended, perhaps increasing the risk of bleeding. Your healthcare provider may choose to monitor your INR and prothrombin time more frequently and adjust accordingly. INR and prothrombin time are tests used to measure how well you blood is clotting.
Aluminum or Magnesium Antacids (Maalox, Mylanta, Riopan, Gelusil, Rolaids, ALternaGEL, Amphojel, and Others)
If you are taking both azithromycin and antacids made with aluminum or magnesium, azithromycin may not be absorbed into your body as well as usual. Be sure to take the antacids at least two hours before or two hours after taking azithromycin.
Digoxin (Digitek, Lanoxicaps, Lanoxin)
When taking azithromycin with digoxin, your body may metabolize digoxin differently than intended, increasing the risk of digoxin toxicity. You may wish to discuss this with your healthcare provider prior to starting azithromycin.
Tacrolimus (Prograf, Protopic)
If you are taking azithromycin and tacrolimus together, your body may metabolize tacrolimus differently than intended and significantly increase the levels of the drug in your system. Your healthcare provider may choose to monitor your progress and adjust your dose accordingly.
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Azithromycin Information

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