Interactions with azithromycin

What are the interactions with azithromycin?

Tell your doctor about all the medicines you are taking

It is important that you tell your health professional about all the medicines you are taking — including prescription, over-the-counter and complementary medicines (herbal, ‘natural’, vitamin and mineral supplements). This is because all medicines, including herbal and natural medicines, can cause side effects and may interact with azithromycin.

Tell your health professional if you are taking medicines containing any of the following active ingredients

  • Colchicine (used to prevent and treat gout): azithromycin may increase the concentration of colchicine in your blood, which can be toxic, especially if you have kidney problems. These two medicines should not be taken together if possible.
  • Rifabutin (an antibiotic used to treat tuberculosis): rifabutin taken with azithromycin can increase the risk of side effects, including stomach symptoms, muscle weakness, and decreased white blood cell count (neutropenia).
  • Digoxin (used to treat congestive heart failure): azithromycin may increase the amount of digoxin in your system, so your doctor may need to alter your dose of digoxin.
  • Disopyramide (used to treat irregular heart beat): azithromycin may increase the concentration of disopramide in your blood.
  • Theophylline (used for respiratory conditions such as chronic obstructive pulmonary disease [COPD] and asthma): azithromycin can increase theophylline concentration in your body, which can increase the risk of toxic effects.
  • Warfarin (used to prevent blood clots): azythromycin may affect the way warfarin is taken up by the body, increasing the risk of bleeding. You may need to take another type of antibiotic. Alternatively, your doctor will monitor your blood clotting, and your dose of warfarin may need to be adjusted.

Azithromycin is broken down and removed from the body slowly, so there is still a chance of interactions happening for a few days after you have stopped taking azithromycin.

Medicinewise tip

To check if your medicine contains this active ingredient, look on the packaging of your medicine for the active ingredient name, or use our Medicines Finder.

Can I drink alcohol if I am taking azithromycin?

Drinking alcohol in moderation is unlikely to interact with azithromycin or cause additional side effects.

Find out more about drinking alcohol when you are taking antibiotics.

Will azithromycin affect my contraceptive?

Azithromycin won’t affect your hormone contraceptive.

Rifampicin and rifabutin are the only types of antibiotic that are known to interact with some forms of hormone contraceptives, such as the combined contraceptive pill, making it less effective.

Find out more about antibiotics and contraception.

Phone for medicines information

Call NPS Medicines Line on 1300 MEDICINE (1300 633 424) to get information about your prescription, over-the-counter and complementary medicines (herbal, ‘natural’, vitamins and mineral supplements) from a pharmacist. Your call will be answered by healthdirect Australia.

  • Rossi S, ed. Australian Medicines Handbook [online]. Adelaide: AMH, July 2012.
  • Sweetman S, ed. Martindale: The complete drug reference [online]. London: Pharmaceutical Press (accessed 18 October 2011).
  • Antibiotic Expert Group. Therapeutic Guidelines: Azithromycin. Melbourne: Therapeutic Guidelines Limited, 2012 (accessed 27 March 2012).