Drug & supplement interaction

Dimethylsulfoxide (dmso) + Azithromycin

Azithromycin brand names: Zithromax, Zmax, Azasite.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Dimethylsulfoxide (dmso) has a moderate interaction with Azithromycin. Topical DMSO might increase the effects and adverse effects of topical drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Dimethylsulfoxide (dmso) and Azithromycin

Here is the interaction we found between these two, with the evidence behind it.

Moderate

TOPICAL DRUGS

Why this applies to Azithromycin

Azithromycin falls under TOPICAL DRUGS — the group Dimethylsulfoxide (dmso) interacts with.

Topical DMSO might increase the effects and adverse effects of topical drugs.
Evidence from animal studies and limited human studies suggests that DMSO may potentiate the action of numerous topical medications by increasing their absorption through the skin. This increase in absorption seems to depend on the concentration of DMSO and the molecular weight of the medication.
Severity Moderate Likelihood Possible Evidence B

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing to know: this interaction is really about topical medicines you put on your skin. DMSO can act like a carrier, pushing whatever it's mixed with deeper through the skin and into the body. That matters for creams and ointments, but azithromycin (Zithromax) is almost always taken as a pill or given by IV, not rubbed on your skin.

So for the typical patient swallowing an azithromycin tablet, DMSO on the skin isn't going to boost your antibiotic in any meaningful way. The one spot worth a quick mention is AzaSite, the azithromycin eye drop. I wouldn't apply DMSO anywhere near your eyes or right where an eye medicine goes. If you're using any topical product alongside DMSO, run it by your pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Jacob SW, Herschler R. Pharmacology of DMSO. Cryobiology 1986;23:14-27. PubMed
  2. Capriotti K, Capriotti JA. Dimethyl sulfoxide: history, chemistry, and clinical utility in dermatology. J Clin Aesthet Dermatol. 2012;5(9):24-6.
  3. DOMOSO SOLUTION (90% Dimethyl Sulfoxide). Fort Dodge Animal Health, Fort Dodge, Iowa. Avaliable at: https://www.zoetisus.com/_locale-assets/mcm-portal-assets/products/pdf/domoso_solution_pi.pdf. Accessed 8/3/2020.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Dimethylsulfoxide (dmso) Also Interacts With Other Medications

Dimethylsulfoxide (dmso) has 338 moderate known drug interactions in our database — the Azithromycin one above is one of them. If you take anything else, check it against the full list below.

Moderate 338 No known interaction 2,492 (incl. Azithromycin)
Taking anything else?

Check Another of Your Medications Against Dimethylsulfoxide (dmso)

Covers the 2,830 medications we’ve checked against Dimethylsulfoxide (dmso). Pick one to open its full report.

From our Q&A

Questions About Dimethylsulfoxide (dmso) 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 Dimethylsulfoxide (dmso) 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 Dimethylsulfoxide (dmso) 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

How much people look this up

Where Dimethylsulfoxide (dmso) 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 Dimethylsulfoxide (dmso)
Top half

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

29 days ago today
Medication Azithromycin
Top 5%

#56 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.

Supplement

About Dimethylsulfoxide (dmso)

What is Dimethylsulfoxide (dmso)?

Dimethylsulfoxide (dmso)
  • Muscle and joint pain
  • Arthritis
  • Sprains and strains
  • Interstitial cystitis (bladder pain)
  • Skin penetration enhancer for other medicines

DMSO is a colorless liquid solvent that people apply to the skin for pain and inflammation, and it is FDA-approved (as a prescription) only for interstitial cystitis placed directly into the bladder. Most over-the-counter uses for pain and arthritis have limited or low-quality evidence, and DMSO can carry impurities or push other chemicals through your skin. Talk to your pharmacist or doctor before using it, and avoid industrial-grade products.

Read the full Dimethylsulfoxide (dmso) 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.

See full Azithromycin drug information
Keep checking

Other Drugs & Dimethylsulfoxide (dmso)

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

0Major
338Moderate
0Minor
2,491No known interaction
338 Moderate 2,491 No interaction
Moderate

338 interactions

Showing 60 of 338 moderate interactions — see all 338 on the Dimethylsulfoxide (dmso) page.

No interaction 2,491 drugs checked — show the list

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

Showing the 60 most looked-up of 2,491 medications checked with no known interaction — see the full Dimethylsulfoxide (dmso) list.

See the full Dimethylsulfoxide (dmso) interactions page
See every supplement checked against Azithromycin, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Dimethylsulfoxide (dmso) monograph › Uses, safety, and every drug interaction in one place Azithromycin supplement interactions › Every supplement checked against Azithromycin, ranked by severity Azithromycin drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Dimethylsulfoxide (dmso) and Azithromycin Together: Common Questions

Can you take Dimethylsulfoxide (dmso) with Azithromycin?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Dimethylsulfoxide (dmso) and Azithromycin interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Azithromycin and Dimethylsulfoxide (dmso)?

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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.