This article describes possible interactions with azithromycin oral tablet. Interactions can cause a drug to have a different effect on the body than expected. Interactions can occur due to medications, alcohol, or certain health conditions. Keep reading to learn about what not to take with azithromycin.
Azithromycin comes as tablets that you’ll swallow. It’s also available as a suspension (type of liquid mixture) that you’ll swallow and a solution that’s injected into a vein. Interactions of azithromycin aren’t expected to vary depending on the form of azithromycin you’re prescribed.
Other drugs and azithromycin
The drugs in the list below may interact with azithromycin oral tablet. This article doesn’t include all drugs that may interact with azithromycin.
Drug classes or drugs that may interact with azithromycin oral tablet include:
- certain antacids:
- drug examples: aluminum hydroxide, magnesium hydroxide
- what might happen: can make azithromycin less effective
- certain antipsychotics:
- drug examples: thioridazine, ziprasidone (Geodon)
- what might happen: can increase the risk of side effects of azithromycin and the antipsychotic drug
- certain antiarrhythmics (drugs used to treat irregular heart rhythm):
- drug examples: dronedarone (Multaq), sotalol (Betapace, Sotylize, Sorine)
- what might happen: can increase the risk of side effects of azithromycin and the antiarrhythmic drug
- certain antibiotics:
- drug examples: levofloxacin, metronidazole (Flagyl)
- what might happen: can increase the risk of side effects of azithromycin and the antibiotic drug
- certain antidepressants:
- drug examples: venlafaxine (Effexor XR), sertraline (Zoloft)
- what might happen: can increase the risk of side effects of azithromycin and the antidepressant drug
- certain antifungals:
- drug examples: ketoconazole, itraconazole (Sporanox, Tolsura)
- what might happen: can increase the risk of side effects of azithromycin and the antifungal drug
- colchicine (Colcrys, others):
- what might happen: can increase the risk of side effects of colchicine
- digoxin (Lanoxin):
- what might happen: can increase the effect and risk of side effects of digoxin
- nelfinavir (Viracept):
- what might happen: can increase the risk of side effects of azithromycin
- warfarin (Jantoven):
- what might happen: can increase the risk of side effects of warfarin and azithromycin
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Other interactions and azithromycin
Interactions can occur with supplements, foods, vaccines, and some lab tests. Below you can learn whether azithromycin oral tablet has these interactions.
The information below doesn’t include all other possible interactions possible with azithromycin.
Azithromycin and supplements
Before taking azithromycin oral tablet, tell your doctor and pharmacist about any herbs you take, as well as vitamins and supplements. Doing so may help you avoid interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Azithromycin interactions with herbs
Azithromycin oral tablet isn’t known to interact with any herbs. But this doesn’t mean interactions with herbs can’t happen or won’t be identified later.
Because of this, ask your doctor or pharmacist before taking any of these products while taking azithromycin oral tablet.
Azithromycin interactions with vitamins
Azithromycin oral tablet isn’t known to interact with any vitamins. But this doesn’t mean interactions with vitamins can’t happen or won’t be identified later.
Because of this, ask your doctor or pharmacist before taking any of these products while taking azithromycin oral tablet.
Azithromycin and food
There aren’t known azithromycin interactions with food at this time. But this doesn’t mean interactions with foods can’t happen or won’t be identified later.
Because of this, talk with your doctor or pharmacist about what not to eat while taking azithromycin oral tablet.
Azithromycin and vaccines
Azithromycin oral tablet may interact with the cholera vaccine. This vaccine is used to prevent cholera, which is an infection that can cause diarrhea and dehydration (low fluid level).
If you receive a cholera vaccine within 14 days of taking azithromycin, the vaccine may not work as well. This is because azithromycin can kill the cholera bacteria in the vaccine before it works with your immune system to protect against cholera.
Because of this, talk with your doctor or pharmacist before receiving any vaccines while taking azithromycin oral tablet.
Azithromycin and lab tests
Azithromycin oral tablet isn’t known to interact with lab tests. But this doesn’t mean interactions with lab tests can’t happen or won’t be identified later.
Because of this, talk with your doctor or pharmacist before having any tests while taking azithromycin oral tablet.
Azithromycin and cannabis or CBD
Azithromycin oral tablet isn’t known to interact with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But this doesn’t mean interactions can’t happen or won’t be identified later.
As with any drug or supplement, tell your doctor before taking cannabis with azithromycin.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Alcohol and azithromycin
Azithromycin oral tablet is not known to interact with alcohol.
If you have side effects from azithromycin, though, drinking alcohol could worsen them. Examples of these side effects include headache, fatigue (low energy level), and vomiting.
Talk with your doctor if you have additional questions about azithromycin interactions with alcohol.
When to avoid azithromycin
Certain health conditions or other factors could increase some risks with azithromycin oral tablet. Because of this, doctors may not prescribe azithromycin in these cases. These health conditions or other factors are called contraindications.
Here’s a list of contraindications for azithromycin oral tablet:
- Past liver-related side effects due to taking azithromycin: If you have experienced liver-related side effects after taking azithromycin in the past, taking azithromycin oral tablet may cause these side effects again.
- Past allergic reaction to azithromycin: If you’ve ever had an allergic reaction to azithromycin oral tablet, taking it again may cause another allergic reaction.
Before you start taking azithromycin, tell your doctor if anything listed above relates to you. They can recommend whether you should take azithromycin.
Health factors and azithromycin
Certain medical conditions or other health factors may increase the risk of interactions with azithromycin oral tablet. Keep in mind that interactions could lead to side effects or affect how well the drug works. Before taking azithromycin, tell your doctor about your health history. They’ll determine whether azithromycin is right for you.
These health conditions or other factors might interact with azithromycin oral tablet:
Preventing azithromycin interactions
You may be able to help avoid certain interactions with azithromycin oral tablet. Before taking this drug, you may want to discuss possible interactions with your doctor and pharmacist.
Things to consider include:
- Whether you drink alcohol or use cannabis.
- Other medications and herbs you take, as well as vitamins and supplements. Your doctor or pharmacist can help you fill out a medication list.
- What to do if you’re prescribed a new drug while taking azithromycin oral tablet.
Taking azithromycin exactly as prescribed can also help prevent interactions.
What to ask your doctor
If you have questions about azithromycin and possible interactions, talk with your doctor.
Questions you may want to ask your doctor include:
- What else should I know about what not to take with azithromycin?
- Does my risk for interactions depend on whether I’m taking azithromycin short term or long term?
- Are calcium antacids safer to take with azithromycin than aluminum- or magnesium-based antacids?
- If I take azithromycin and have an irregular heart rhythm, will I be monitored more closely during treatment?
Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
