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Macrolide antibiotic

Azithromycin with antibiotics: interactions and safety

Antibiotic courses are common, short-term and often combined with chronic medications such as Azithromycin (Azithromycin). Most antibiotics do not interfere meaningfully with Azithromycin at 250mg, 500mg, 600mg, but a few classes do, and a small number of combinations are best avoided.

Common antibiotic interactions

Macrolides (clarithromycin, erythromycin) and certain antifungals can inhibit hepatic metabolism (CYP3A4) and raise plasma levels of many medications including some Macrolide antibiotic agents. Rifampicin has the opposite effect, accelerating metabolism. Most penicillins, cephalosporins, fluoroquinolones and tetracyclines have no clinically meaningful interaction with Azithromycin at 250mg, 500mg, 600mg.

Practical guidance

According to the prescribing information for Azithromycin, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Azithromycin is co-administered. Adjusted 250mg, 500mg, 600mg dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.

Frequently asked questions

Can I take Azithromycin during an antibiotic course?

For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Azithromycin is metabolised and may need a temporary 250mg, 500mg, 600mg adjustment. The prescribing pharmacist should review any new antibiotic against the existing Azithromycin regimen.

Will antibiotics make Azithromycin stop working?

Most antibiotics do not affect Azithromycin efficacy. Rifampicin and a few others can lower Azithromycin levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.

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The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.