Drug & supplement interaction

Aconite + Azithromycin

Azithromycin brand names: Zithromax, Zmax, Azasite.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Aconite and Azithromycin in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Aconite and Azithromycin

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Azithromycin and Aconite in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Aconite safety at a glance

Aconite overall Avoid Aconite is extremely toxic and can be fatal even in small amounts.
Pregnancy Unsafe When used orally or topically. Read the full pregnancy detail
Breastfeeding Unsafe When used orally or topically. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Azithromycin and Aconite? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Azithromycin

Interactions in our licensed database are recorded against drug classes, not just single drug names. Azithromycin is filed under 7 classifications — including macrolide antibiotics, qt interval-prolonging drugs, antibiotic drugs. Aconite has documented interactions with 2 drug classes — the most serious being anticoagulant/antiplatelet drugs (moderate) and stimulant drugs (moderate) — and none of Azithromycin’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Aconite Does Interact With Other Medications

Aconite has 278 moderate known drug interactions in our database — Azithromycin isn’t one of them. If you take anything else, check it against the full list below.

Moderate 278 No known interaction 2,552 (incl. Azithromycin)
Taking anything else?

Check Another of Your Medications Against Aconite

Covers the 2,830 medications we’ve checked against Aconite. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Aconite and Azithromycin May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 3 of them are worth acting on rather than waiting out — marked below.

  • An irregular heartbeat / Chest pain Worth acting on Additional detail

    Aconite

    “Orally and topically, aconite can cause hypotension, palpitations, chest tightness, pulmonary edema, arrhythmia, bradycardia, tachycardia, sustained or bidirectional ventricular tachycardia, ventricular fibrillation, and Torsade de pointes.”

    Aconite · Natural Medicines adverse-effect record, reported in arrhythmia.

    6 sources cited
    1. 558. Tai YT. Adverse effects from traditional Chinese medicine. Lancet 1993;341:892.
    2. 559. Tai YT, But PP, Young K, et al. Cardiotoxicity after accidental herb-induced aconite poisoning. Lancet 1992;340:1254-6. PubMed
    3. 561. Fatovich DM. Aconite: a lethal Chinese herb. Ann Emerg Med 1992;21:309-11. PubMed
    4. 562. Tomlinson B, Chan TY, Chan JC, Critchley JA. Herb-induced aconite poisoning. Lancet 1993;341:370-1. .
    5. 563. Chan TY, Tomlinson B, Critchley JA. Aconitine poisoning following the ingestion of Chinese herbal medicines: a report of eight cases. Aust N Z J Med 1993;23:268-71. PubMed
    6. 3490. But PP, Tai YT, Young K. Three fatal cases of herbal aconite poisoning. Vet Hum Toxicol 1994;36:212-5.

    Azithromycin

    Listed in the ADVERSE REACTIONS section of the FDA label for Azithromycin. Read the label on DailyMed ›

  • Seizures Worth acting on Additional detail

    Aconite

    “Orally, aconite can cause weakness, sweating, restlessness, dizziness, numbness, paresthesia, seizures, and reduced consciousness. Topically, aconite can cause generalized paresthesia, fatigue, sweating, dizziness and tongue numbness.”

    Aconite · Natural Medicines adverse-effect record, reported in epilepsy.

    6 sources cited
    1. 558. Tai YT. Adverse effects from traditional Chinese medicine. Lancet 1993;341:892.
    2. 559. Tai YT, But PP, Young K, et al. Cardiotoxicity after accidental herb-induced aconite poisoning. Lancet 1992;340:1254-6. PubMed
    3. 561. Fatovich DM. Aconite: a lethal Chinese herb. Ann Emerg Med 1992;21:309-11. PubMed
    4. 562. Tomlinson B, Chan TY, Chan JC, Critchley JA. Herb-induced aconite poisoning. Lancet 1993;341:370-1. .
    5. 563. Chan TY, Tomlinson B, Critchley JA. Aconitine poisoning following the ingestion of Chinese herbal medicines: a report of eight cases. Aust N Z J Med 1993;23:268-71. PubMed
    6. 3490. But PP, Tai YT, Young K. Three fatal cases of herbal aconite poisoning. Vet Hum Toxicol 1994;36:212-5.

    Azithromycin

    Listed in the ADVERSE REACTIONS section of the FDA label for Azithromycin. Read the label on DailyMed ›

  • Sweating / Anxiety or restlessness Additional detail

    Aconite

    Recorded for Aconite in the same Natural Medicines adverse-effect record shown under Seizures above.

    Azithromycin

    Listed in the ADVERSE REACTIONS section of the FDA label for Azithromycin. Read the label on DailyMed ›

  • A fast or pounding heartbeat Additional detail

    Aconite

    “Orally and topically, aconite has been reported to cause death in both adults and children. In one case report, topical application of aconite to an infant led to cardiogenic shock with multi-organ failure and death. Poisoning has been reported in 15 patients after consuming a homemade liquor containing aconite.”

    Aconite · Natural Medicines adverse-effect record, reported in nausea and vomiting.

    6 sources cited
    1. 559. Tai YT, But PP, Young K, et al. Cardiotoxicity after accidental herb-induced aconite poisoning. Lancet 1992;340:1254-6. PubMed
    2. 3490. But PP, Tai YT, Young K. Three fatal cases of herbal aconite poisoning. Vet Hum Toxicol 1994;36:212-5.
    3. 3491. Feldkamp A, Koster B, Weber HP. [Fatal poisoning caused by aconite monk's hood]. Monatsschr Kinderheilkd 1991;139:366-7.
    4. 30301. Sorensen, B. [Poisoning with Aconitum napellus (monkshood)]. Ugeskr.Laeger 5-12-2003;165(20):2109-2110.
    5. 30334. Dickens, P., Tai, Y. T., But, P. P., Tomlinson, B., Ng, H. K., and Yan, K. W. Fatal accidental aconitine poisoning following ingestion of Chinese herbal medicine: a report of two cases. Forensic Sci Int 6-28-1994;67(1):55-58. PubMed
    6. 30341. Yoshioka, N., Gonmori, K., Tagashira, A., Boonhooi, O., Hayashi, M., Saito, Y., and Mizugaki, M. A case of aconitine poisoning with analysis of aconitine alkaloids by GC/SIM. Forensic Sci.Int. 8-15-1996;81(2-3):117-123. PubMed

    Azithromycin

    Listed in the ADVERSE REACTIONS section of the FDA label for Azithromycin. Read the label on DailyMed ›

  • Numbness or tingling Additional detail

    Aconite

    Recorded for Aconite in the same Natural Medicines adverse-effect record shown under Seizures above.

    Azithromycin

    Listed in the ADVERSE REACTIONS section of the FDA label for Azithromycin. Read the label on DailyMed ›

  • Low blood pressure / Swelling Additional detail

    Aconite

    Recorded for Aconite in the same Natural Medicines adverse-effect record shown under An irregular heartbeat / Chest pain above.

    Azithromycin

    Listed in the ADVERSE REACTIONS section of the FDA label for Azithromycin. Read the label on DailyMed ›

  • Diarrhea reported in 4.9% of FDA reports for Azithromycin Additional detail

    Aconite

    “Orally, aconite can cause nausea, vomiting, diarrhea, and gastric pain. Topically, aconite can cause nausea and vomiting.”

    Aconite · Natural Medicines adverse-effect record, reported in diarrhea.

    6 sources cited
    1. 563. Chan TY, Tomlinson B, Critchley JA. Aconitine poisoning following the ingestion of Chinese herbal medicines: a report of eight cases. Aust N Z J Med 1993;23:268-71. PubMed
    2. 30297. Lin, C. C., Chou, H. L., and Lin, J. L. Acute aconitine poisoned patients with ventricular arrhythmias successfully reversed by charcoal hemoperfusion. Am J Emerg.Med 2002;20(1):66-67. PubMed
    3. 30341. Yoshioka, N., Gonmori, K., Tagashira, A., Boonhooi, O., Hayashi, M., Saito, Y., and Mizugaki, M. A case of aconitine poisoning with analysis of aconitine alkaloids by GC/SIM. Forensic Sci.Int. 8-15-1996;81(2-3):117-123. PubMed
    4. 92277. Chan TY. Aconitum Alkaloid Poisoning Because of Contamination of Herbs by Aconite Roots. Phytother Res. 2016 Jan;30(1):3-8.
    5. 92278. Li H, Liu L, Zhu S, Liu Q. Case reports of aconite poisoning in mainland China from 2004 to 2015: A retrospective analysis. J Forensic Leg Med. 2016 May 25;42:68-73. PubMed
    6. 92276. Chan TY. Aconite poisoning following the percutaneous absorption of Aconitum alkaloids. Forensic Sci Int. 2012 Nov 30;223(1-3):25-7. PubMed

    Azithromycin

    Listed in the ADVERSE REACTIONS section of the FDA label for Azithromycin, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

Showing the 10 most notable of 14 shared effects — ranked by how unusual each one is, not just whether both lists mention it.

Reported for Aconite but not commonly for Azithromycin: a slow heartbeat and low potassium.

Effects for Azithromycin come from the ADVERSE REACTIONS section of its FDA label; effects for Aconite come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 59,712 voluntary FDA FAERS reports for Azithromycin that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Aconite in Pregnancy & Breastfeeding

Pregnancy And Lactation Unsafe

When used orally or topically.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

Overlapping uses

What Azithromycin Is Prescribed For, and What Aconite Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Azithromycin is a prescription medicine with approved uses on its FDA label. Aconite is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Aconite has been studied for:

  • Pneumonia studied, not established Aconite has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Aconite for pneumonia

    Injectable aconite has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Oral aconite has not been evaluated for this use.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Azithromycin on your own; if you are taking Aconite for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

From our Q&A

Questions About Aconite or Azithromycin

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Aconite or Azithromycin, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Azithromycin

This page covers Aconite only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Azithromycin page lists 92 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 8 major · 71 moderate · 13 minor.

From our pharmacist’s overview on the Azithromycin page

“A five-day Z-Pak for a sinus or chest infection seems too brief to fuss over, but azithromycin (Zithromax, Zmax) deserves genuine caution around supplements, and the eight major-rated entries on this list are the ones to understand first. Most of those involve the heart.”

Reviewed by 2 · Jul 18, 2026

Open the Azithromycin interaction page

One more smart check

Taking Aconite as Part of a Dietary Supplement Product? Check It for Interactions

We hold 56 real supplement products containing Aconite, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Aconite. Even though Aconite itself has no known interaction with Azithromycin, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Aconite and Azithromycin Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Aconite
Steady interest

#855 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Azithromycin
Top 5%

#60 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Aconite reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Aconite and Azithromycin records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Aconite

What is Aconite?

Aconite
  • Pain and nerve pain
  • Fever and cold or flu symptoms
  • Anxiety and restlessness (homeopathic use)
  • Inflammation and joint pain
  • Heart-related complaints (traditional use)

Aconite is a highly poisonous plant, and even small amounts of the raw or improperly processed root can cause severe, life-threatening reactions. There is no good scientific evidence that it safely treats any condition, and the only forms generally considered acceptable are extremely diluted homeopathic preparations. We strongly recommend avoiding raw or unprocessed aconite entirely and talking to a pharmacist or doctor before using any product containing it.

Aconitum napellus · Ranunculaceae · Root (and sometimes leaves), usually after processing · Highly diluted homeopathic pellets and liquids; processed roots in some traditional Asian medicine systems

An interaction check asks whether these two react with each other — it does not ask whether Aconite is a good idea for someone in your situation. Here is what our Aconite record says about it on its own.

Aconite: dosing

There is no safe, established standard dose of aconite for any condition. The line between a "traditional" amount and a deadly amount is extremely thin, which is a major reason this plant is considered so dangerous.The only forms generally considered acceptable are extremely diluted homeopathic products, which contain little or no actual plant material. If you choose to use such a product, follow the label exactly and do not exceed it.

From our Aconite monograph — the full record covers uses, side effects and every documented interaction.

Read the full Aconite monograph & all interactions
Medication

About Azithromycin

What Is Azithromycin Used For?

Brand names: Zithromax, Zmax, Azasite

  • Azithromycin is used to treat certain bacterial infections, such as bronchitis; pneumonia; sexually transmitted diseases (STD); and infections of the ears, lungs, sinuses, skin, throat, and reproductive organs. Azithromycin also is used to treat or prevent disseminated Mycobacterium avium complex (MAC) infection [a type of lung infection that often affects people with human immunodeficiency virus (HIV)]. Azithromycin is in a class of medications called macrolide antibiotics. It works by stopping the growth of bacteria.

  • Antibiotics such as azithromycin will not work for colds, flu, or other viral infections. Using antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.

Most-Reported Side Effects for Azithromycin

From FAERS, the FDA’s public side-effect reporting system (59,712 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Dyspnea 4,651 reports
Nausea 3,461 reports
Pneumonia 3,225 reports
Cough 3,120 reports
Drug hypersensitivity 2,991 reports
See full Azithromycin drug information
Keep checking

Other Drugs & Aconite

Browse every other medication we’ve checked against Aconite — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
278Moderate
0Minor
2,551No known interaction
278 Moderate 2,551 No interaction
Moderate

278 interactions

Showing 60 of 278 moderate interactions — see all 278 on the Aconite page.

No interaction 2,551 drugs checked — show the list

We also checked Aconite against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,551 medications checked with no known interaction — see the full Aconite list.

See the full Aconite interactions page
See every supplement checked against Azithromycin, ranked by severity
Evidence & sources

Aconite References

The 33 references that drive our Aconite monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Tai YT. Adverse effects from traditional Chinese medicine. Lancet 1993;341:892.
  2. Tai YT, But PP, Young K, et al. Cardiotoxicity after accidental herb-induced aconite poisoning. Lancet 1992;340:1254-6. PubMed
  3. Fatovich DM. Aconite: a lethal Chinese herb. Ann Emerg Med 1992;21:309-11. PubMed
  4. Tomlinson B, Chan TY, Chan JC, Critchley JA. Herb-induced aconite poisoning. Lancet 1993;341:370-1. .
  5. Chan TY, Tomlinson B, Critchley JA. Aconitine poisoning following the ingestion of Chinese herbal medicines: a report of eight cases. Aust N Z J Med 1993;23:268-71. PubMed
  6. Yeih DF, Chiang FT, Huang SKS. Successful treatment of aconitine induced life threatening ventricular tachyarrhythmia with amiodarone. Heart 2000;84:E8. PubMed
  7. But PP, Tai YT, Young K. Three fatal cases of herbal aconite poisoning. Vet Hum Toxicol 1994;36:212-5.
  8. Feldkamp A, Koster B, Weber HP. [Fatal poisoning caused by aconite monk's hood]. Monatsschr Kinderheilkd 1991;139:366-7.
  9. Lin CC, Chan TY, Deng JF. Clinical features and management of herb-induced aconitine poisoning. Ann Emerg Med 2004;43:574-9. PubMed
  10. Poon WT, Lai CK, Ching CK, et al. Aconite poisoning in camouflage. Hong Kong Med J 2006;12:456-9.
  11. Guha, S., Dawn, B., Dutta, G., Chakraborty, T., and Pain, S. Bradycardia, reversible panconduction defect and syncope following self-medication with a homeopathic medicine. Cardiology 1999;91(4):268-271. PubMed
  12. Imazio, M., Belli, R., Pomari, F., Cecchi, E., Chinaglia, A., Gaschino, G., Ghisio, A., Trinchero, R., and Brusca, A. Malignant ventricular arrhythmias due to Aconitum napellus seeds. Circulation 12-5-2000;102(23):2907-2908.
  13. Telang, B. V. and Ng'ang'a, J. N. Involvement of Central adrenergic mechanisms in the induction of cardiac arrhythmias by aconitine nitrate administered intraventricularly. Indian J Physiol Pharmacol. 1975;19(1):1-10.
  14. Lin, C. C., Chou, H. L., and Lin, J. L. Acute aconitine poisoned patients with ventricular arrhythmias successfully reversed by charcoal hemoperfusion. Am J Emerg.Med 2002;20(1):66-67. PubMed
  15. Gaibazzi, N., Gelmini, G. P., Montresor, G., Canel, D., Comini, T., Fracalossi, C., Martinetti, C., Poeta, M. L., and Ziacchi, V. [Long QRS tachycardia secondary to Aconitum napellus alkaloid ingestion]. Ital.Heart J.Suppl 2002;3(8):874-877.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Aconite and Azithromycin Together: Common Questions

Is it safe to take Aconite with Azithromycin?
We do not list a known interaction between Aconite and Azithromycin. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Aconite and Azithromycin have any of the same side effects?
Yes — our sources link each of them separately to 10 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Are Aconite and Azithromycin used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Aconite in each. That is a conversation for your prescriber, especially if Azithromycin is being adjusted to a target.
How was the Aconite and Azithromycin combination checked?
Interactions in our licensed database are recorded against drug classes. Azithromycin is filed under 7 classifications, and Aconite has documented interactions with 2 drug classes — none of Azithromycin's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Aconite interact with any other medications?
Yes. Aconite has 278 documented drug interactions in our database — Azithromycin is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Azithromycin interact with any supplements?
Yes. Azithromycin has documented interactions with 92 supplements in our database — Aconite is not one of them. The Azithromycin interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Aconite monograph Uses, safety profile, and every drug interaction in one place Azithromycin drug information The full plain-English guide to this medication Azithromycin supplement interactions Every supplement checked against Azithromycin, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 33 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Azithromycin and Aconite?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.