Drug & supplement interaction

Eurycoma Longifolia + 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 Eurycoma Longifolia 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

Eurycoma Longifolia 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 Eurycoma Longifolia 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.

Eurycoma Longifolia safety at a glance

Eurycoma Longifoli... overall Use caution Generally tolerated short-term in studies, but long-term safety and product quality are uncertain.
Pregnancy Avoid Not enough safety data and possible hormonal effects, so avoid during pregnancy.
Breastfeeding Avoid No reliable safety information, so it is best to avoid while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Pharmacist analysis

Although there is no known interaction in this case, Eurycoma longifolia, most commonly known as Tongkat Ali, does have some potential interactions that are important to be aware of.

For example, it may interact with the following:

  • CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
  • CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES
  • CYTOCHROME P450 2A6 (CYP2A6) SUBSTRATES
  • Propranolol
  • Testosterone

Tongkat Ali has been reported to inhibit certain metabolizing enzymes in the liver (the ones mentioned above) and therefore, may increase the levels of substances metabolized by those enzymes. This could potentially affect the way these substances work or how long they stay in your system.

In regard to propranolol, some studies show that Tongkat Ali decreases how well propranolol is absorbed in the gut and could reduce its effects. It is not known if separating administration will prevent this interaction/

Lastly, testosterone, Tongkat Ali may theoretically further increase levels of testosterone, a hormone responsible for various functions in the body. You should be cautious combining the two.

—

Still wondering about combining Azithromycin and Eurycoma Longifolia? 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. Eurycoma Longifolia has documented interactions with 5 drug classes — the most serious being propranolol (inderal) (moderate), cytochrome p450 1a2 (cyp1a2) substrates (minor) and cytochrome p450 2a6 (cyp2a6) substrates (minor) — 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

Eurycoma Longifolia Does Interact With Other Medications

Eurycoma Longifolia has 3 moderate, 245 minor 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 3 Minor 245 No known interaction 2,582 (incl. Azithromycin)
Taking anything else?

Check Another of Your Medications Against Eurycoma Longifolia

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

What to actually watch for

No Interaction Found — But Data Suggests Eurycoma Longifolia and Azithromycin May Share a Side Effect

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. One of them is worth acting on rather than waiting out — marked below.

  • Liver problems Worth acting on Additional detail

    Eurycoma Longifolia

    “Some research in both humans and animals suggests that Eurycoma longifolia might increase testosterone levels. If testosterone levels are increased beyond the normal range, there is risk of testosterone-related side effects which could include acne, insulin resistance, hepatotoxicity, and others.”

    Eurycoma Longifolia · Natural Medicines adverse-effect record, reported in acne.

    1 source cited
    1. 17924. Tambi MI, Imran MK, Henkel RR. Standardised water-soluble extract of Eurycoma longifolia, Tongkat ali, as testosterone booster for managing men with late-onset hypogonadism? Andrologia 2011 Jun 15. doi: 10.1111/j.1439-0272.2011.01168.x. [Epub ahead of pri PubMed

    Azithromycin

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

Reported for Eurycoma Longifolia but not commonly for Azithromycin: acne.

Effects for Azithromycin come from the ADVERSE REACTIONS section of its FDA label; effects for Eurycoma Longifolia 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.

From our Q&A

Questions About Eurycoma Longifolia 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 Eurycoma Longifolia 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 Eurycoma Longifolia 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 Eurycoma Longifolia as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1,122 real supplement products containing Eurycoma Longifolia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Eurycoma Longifolia. Even though Eurycoma Longifolia 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 Eurycoma Longifolia 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 Eurycoma Longifolia
Top 10%

#128 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 Eurycoma Longifolia reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Eurycoma Longifolia 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 Eurycoma Longifolia

What is Eurycoma Longifolia?

Eurycoma Longifolia
  • Low testosterone or low libido in men
  • Male fertility support
  • Athletic performance and muscle strength
  • Energy and fatigue
  • Stress and mood
  • General male enhancement

Eurycoma longifolia (tongkat ali) is a Southeast Asian herb most popular for supporting testosterone, libido, and male fertility, with some small human studies suggesting possible benefits. However, the overall evidence is still limited and product quality varies widely, so talk with your pharmacist or doctor before using it, and avoid it if you are pregnant or breastfeeding.

Eurycoma longifolia · Simaroubaceae · Root (and root extracts) · Capsules, tablets, powder, extracts, teas, and blended supplement products

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

Eurycoma Longifolia: dosing

There is no official or universally agreed-upon dose for Eurycoma longifolia. Studies have used different standardized extracts at different strengths, which makes it hard to recommend one specific amount.The best approach is to follow the directions on the product label and not exceed them.

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

Read the full Eurycoma Longifolia 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 & Eurycoma Longifolia

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

0Major
3Moderate
245Minor
2,581No known interaction
3 Moderate 245 Minor 2,581 No interaction
Moderate

3 interactions

Minor

245 interactions

Showing 60 of 245 minor interactions — see all 245 on the Eurycoma Longifolia page.

No interaction 2,581 drugs checked — show the list

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

Showing the 60 most looked-up of 2,581 medications checked with no known interaction — see the full Eurycoma Longifolia list.

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

Eurycoma Longifolia References

The 4 references that drive our Eurycoma Longifolia 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. Salman SA, Amrah S, Wahab MS, et al. Modification of propranolol's bioavailability by Eurycoma longifolia water-based extract. J Clin Pharm Ther 2010;35:691-6. PubMed
  2. Tambi MI, Imran MK, Henkel RR. Standardised water-soluble extract of Eurycoma longifolia, Tongkat ali, as testosterone booster for managing men with late-onset hypogonadism? Andrologia 2011 Jun 15. doi: 10.1111/j.1439-0272.2011.01168.x. [Epub ahead of pri PubMed
  3. Han YM, Kim IS, Rehman SU, Choe K, Yoo HH. In vitro evaluation of the effects of Eurycoma longifolia extract on CYP-mediated drug metabolism. Evid Based Complement Alternat Med 2015;2015:631329.
  4. Chinnappan SM, George A, Pandey P, Narke G, Choudhary YK. Effect of Eurycoma longifolia standardised aqueous root extract-Physta ® on testosterone levels and quality of life in ageing male subjects: a randomised, double-blind, placebo-controlled multicent

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 Eurycoma Longifolia and Azithromycin Together: Common Questions

Is it safe to take Eurycoma Longifolia with Azithromycin?
We do not list a known interaction between Eurycoma Longifolia 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 Eurycoma Longifolia and Azithromycin have any of the same side effects?
Yes — our sources link each of them separately to one 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.
How was the Eurycoma Longifolia and Azithromycin combination checked?
Interactions in our licensed database are recorded against drug classes. Azithromycin is filed under 7 classifications, and Eurycoma Longifolia has documented interactions with 5 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 Eurycoma Longifolia interact with any other medications?
Yes. Eurycoma Longifolia has 248 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 — Eurycoma Longifolia 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

Eurycoma Longifolia 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 4 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Azithromycin and Eurycoma Longifolia?

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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.