Drug Interaction Report

Triazolam and Azithromycin: Interaction Details

A pharmacist-reviewed analysis of the Triazolam and Azithromycin interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Triazolam

Halcion
+

Azithromycin

AzaSite Zithromax Zithromax® Zithromax® Single Dose Packets Zithromax® Tri-Paks® Zithromax® Z-Paks® Zmax®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Jul 11, 2026
Editorial policy · Data sources
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Interaction severity
Minor
Usually limited clinical impact.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 39 documented Triazolam interactions, 2 are rated minor — including this one.
Onset
unspecified
Evidence
probable
Severity
Minor

What happens

Decreased clearance of triazolam and increased pharmacologic effect of triazolam

Interaction Deep Dive

A decrease in triazolam clearance may increase the pharmacologic effect of triazolam2. A study comparing the pharmacokinetics of triazolam given concurrently with macrolide antibiotics determined that azithromycin demonstrated no significant effects on the maximum concentration, time to maximum concentration, half-life, area under the concentration-time curve, or oral clearance of triazolam 1.

Why it happens (mechanism)

Unknown

Literature reports

1 report — tap to read

a) A study comparing the pharmacokinetics of triazolam given concurrently with macrolide antibiotics determined that erythromycin and clarithromycin increased triazolam peak concentrations two-fold in 12 healthy volunteers. Azithromycin was also included in the study, but demonstrated no significant effects on the maximum concentration, time to maximum concentration, half-life, area under the concentration-time curve, or oral clearance of triazolam 1.

Common questions

Can I take Triazolam and Azithromycin together?

Decreased clearance of triazolam and increased pharmacologic effect of triazolam Always confirm with your pharmacist or prescriber before making any change.

How serious is the Triazolam and Azithromycin interaction?

It is rated minor. Usually limited clinical impact.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "probable". Good supporting evidence, though not definitively proven.

Questions for your pharmacist

  • Does my dose of Triazolam or Azithromycin need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there anything you'd monitor while I'm on both?

References (2)

  1. Greenblatt DJ, von Moltke LL, Harmatz JS, et al: Inhibition of triazolam clearance by macrolide antimicrobial agents: In vitro correlates and dynamic consequences. Clin Pharmacol Ther 1998; 64:278-285. PubMed
  2. Product Information: Zithromax(R), azithromycin. Pfizer Labs, NY, NY, 2001. DailyMed
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Triazolam

Keep reading about Triazolam

All Triazolam interactions (39)
Also serious with: Ketoconazole Topical Hydromorphone Rectal Cetirizine Ophthalmic Mitapivat
Azithromycin

Keep reading about Azithromycin

All Azithromycin interactions (299) Azithromycin drug information
Also serious with: Pimozide Mesoridazine Levoketoconazole Colchicine
Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Triazolam + 1,4-butanediol Activated Charcoal Beer Gamma-hydroxybutyrate (ghb) Grapefruit Kava L-tryptophan St. John's Wort + 189 more
Azithromycin + Activated Charcoal American Hellebore Arsenic Cesium Ephedra Grapefruit Oleander Sida Cordifolia + 84 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.