Gamma-hydroxybutyrate (ghb) + Azithromycin
Azithromycin brand names: Zithromax, Zmax, Azasite.
We found no known interaction between Gamma-hydroxybutyrate (ghb) 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.
Gamma-hydroxybutyrate (ghb) 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 Gamma-hydroxybutyrate (ghb) 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.
Gamma-hydroxybutyrate (ghb) safety at a glance
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.
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. Gamma-hydroxybutyrate (ghb) has documented interactions with 10 drug classes — the most serious being alcohol (ethanol) (major), cns depressants (major) and divalprox sodium (depakote) (major) — 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.
Gamma-hydroxybutyrate (ghb) Does Interact With Other Medications
Gamma-hydroxybutyrate (ghb) has 249 major, 21 moderate, 5 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.
Check Another of Your Medications Against Gamma-hydroxybutyrate (ghb)
We haven’t checked that one against Gamma-hydroxybutyrate (ghb) yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Gamma-hydroxybutyrate (ghb). Pick one to open its full report.
Gamma-hydroxybutyrate (ghb) in Pregnancy & Breastfeeding
When used orally. GHB has been associated with life-threatening toxicities.
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
Questions About Gamma-hydroxybutyrate (ghb) 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 Gamma-hydroxybutyrate (ghb) 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:
- Help Navigating Alternative Drug Options for Xifaxan ›
- Taking Tylenol With Azithromycin For A Sinus Infection ›
- Discussing The Interaction Between Azithromycin And Hydroxychloroquine ›
Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.
See Every Supplement That Interacts With Azithromycin
This page covers Gamma-hydroxybutyrate (ghb) 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
Where Gamma-hydroxybutyrate (ghb) 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.
#938 of 1,452 supplements looked up here in the last 7 days
#60 of 2,830 medications looked up here in the last 7 days
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 Gamma-hydroxybutyrate (ghb) reference on this page ↓
- Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Gamma-hydroxybutyrate (ghb) 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.
About Gamma-hydroxybutyrate (ghb)
What is Gamma-hydroxybutyrate (ghb)?
- Narcolepsy (cataplexy and excessive daytime sleepiness)
- Sleep aid
- Misused as a recreational 'party drug'
- Bodybuilding/muscle building (unproven)
- Alcohol withdrawal (in some countries)
GHB (gamma-hydroxybutyrate) is a powerful central nervous system depressant that is NOT a safe dietary supplement. In the U.S. it is a controlled substance, and only a tightly regulated prescription form (sodium oxybate) is legal for narcolepsy. Non-prescription GHB can cause coma, breathing failure, and death, and it is also a known 'date-rape' drug — it should not be taken outside of medical supervision.
Liquid solution, powder, prescription oral solution (sodium oxybate)
An interaction check asks whether these two react with each other — it does not ask whether Gamma-hydroxybutyrate (ghb) is a good idea for someone in your situation. Here is what our Gamma-hydroxybutyrate (ghb) record says about it on its own.
Gamma-hydroxybutyrate (ghb): dosing
There is no safe over-the-counter or supplement dose of GHB. Because illicit products are not standardized, there is no reliable way to measure a safe amount, and small differences can cause overdose.The only legitimate use is the prescription medication sodium oxybate, which is dosed and monitored by a doctor through a special safety program. Do not attempt to use GHB on your own.
From our Gamma-hydroxybutyrate (ghb) monograph — the full record covers uses, side effects and every documented interaction.
About Azithromycin
What Is Azithromycin Used For?
Brand names: Zithromax, Zmax, Azasite
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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.
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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.
Other Drugs & Gamma-hydroxybutyrate (ghb)
Browse every other medication we’ve checked against Gamma-hydroxybutyrate (ghb) — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
249 interactions
- Diphenhydramine ›
- Flurazepam ›
- Triazolam ›
- Zopiclone ›
- Fentanyl ›
- Oxycodone ›
- Phenytoin ›
- Temazepam ›
- Carbamazepine ›
- Morphine Sulfate ›
- Nitrazepam ›
- Buprenorphine ›
- Diazepam ›
- Lofepramine ›
- Meprobamate ›
- Oxymorphone ›
- Propoxyphene ›
- Topiramate ›
- Aripiprazole ›
- Cetirizine ›
- Clobazam ›
- Clonazepam ›
- Clorazepate ›
- Desipramine ›
- Doxepin ›
- Hydromorphone ›
- Levetiracetam ›
- Metoclopramide ›
- Midazolam ›
- Phenobarbital ›
- Tramadol ›
- Valproic Acid ›
- Zolpidem ›
- Acetazolamide ›
- Alprazolam ›
- Aripiprazole Lauroxil ›
- Buprenorphine Hydrochloride ›
- Butabarbital Sodium ›
- Chlorpromazine ›
- Dexmedetomidine ›
- Gabapentin ›
- Hexobarbital ›
- Hydrocodone ›
- Hydrocodone Bitartrate ›
- Lithium Carbonate (prescription Drug) ›
- Loxapine ›
- Magnesium Sulfate (prescription Drug) ›
- Meperidine ›
- Oxcarbazepine ›
- Oxycodone Hydrochloride ›
- Pregabalin ›
- Tasimelteon ›
- Zaleplon ›
- Zonisamide ›
- Acepromazine ›
- Alfentanil ›
- Aminoglutethimide ›
- Amitriptyline ›
- Amobarbital ›
- Brexanolone ›
Showing 60 of 249 major interactions — see all 249 on the Gamma-hydroxybutyrate (ghb) page.
21 interactions
- Amphetamine ›
- Naloxone ›
- Amphetamine Sulfate ›
- Naloxone Hydrochloride ›
- Saquinavir ›
- Dexamfetamine ›
- Dextroamphetamine ›
- Dextroamphetamine (patch) ›
- Dextroamphetamine Sulphate ›
- Hethylphenidate Hcl ›
- Lisdexamfetamine ›
- Methamphetamine ›
- Methoxyamphetamine ›
- Ritonavir ›
- Amphetamine Aspartate, Amphetamine Sulfate, Dextroamphetamine Saccharate, Dextroamphetamine Sulfate ›
- Darunavir, Ritonavir ›
- Dasabuvir Sodium, Ombitasvir, Paritaprevir, Ritonavir ›
- Lopinavir, Ritonavir ›
- Nirmatrelvir, Ritonavir ›
- Ombitasvir, Paritaprevir Ritonavir ›
- Ombitasvir, Paritaprevir, Ritonavir, Dasabuvir ›
5 interactions
No interaction 2,554 drugs checked — show the list
We also checked Gamma-hydroxybutyrate (ghb) against these medications and found no known interaction in our sources. Open any page to confirm.
- Apixaban ›
- Levothyroxine ›
- Amlodipine ›
- Methylphenidate ›
- Warfarin ›
- Sertraline ›
- Testosterone ›
- Losartan Potassium ›
- Metoprolol ›
- Aspirin ›
- Ivermectin ›
- Rivaroxaban ›
- Rosuvastatin ›
- Escitalopram ›
- Tadalafil ›
- Acetaminophen ›
- Clopidogrel ›
- Valacyclovir ›
- Atorvastatin ›
- Docusate ›
- Hydroxyurea ›
- Abemaciclib ›
- Sumatriptan ›
- Ibuprofen ›
- Semaglutide ›
- Tirzepatide ›
- Warfarin Sodium ›
- Prednisone ›
- Propranolol ›
- Acyclovir ›
- Bupropion ›
- Metformin ›
- Amoxicillin ›
- Lisinopril ›
- Bendamustine ›
- Doxycycline ›
- Fluoxetine ›
- Methotrexate ›
- Isotretinoin ›
- Quetiapine ›
- Omeprazole ›
- Amlodipine Besylate ›
- Methylene Blue ›
- Duloxetine ›
- Letrozole ›
- Buspirone ›
- Citalopram ›
- Ciprofloxacin ›
- Naproxen ›
- Bisoprolol ›
- Levothyroxine, Liothyronine ›
- Dapsone ›
- Cyclopentolate ›
- Candesartan Cilexetil ›
- Mannitol ›
- Cephalexin ›
- Roxithromycin ›
- Pegunigalsidase Alfa-iwxj ›
- Atorvastatin Calcium ›
- Daptomycin ›
Showing the 60 most looked-up of 2,554 medications checked with no known interaction — see the full Gamma-hydroxybutyrate (ghb) list.
Gamma-hydroxybutyrate (ghb) References
The 31 references that drive our Gamma-hydroxybutyrate (ghb) 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.
- Harrington RD, Woodward JA, Hooton TM, et al. Life-threatening interactions between HIV-1 protease inhibitors and the illicit drugs MDMA and gamma-hydroxybutyrate. Arch Intern Med 1999;159:2221-4.
- Anon. FDA alert on misuse of consumer products containing GHB, GBL and BD. Food and Drug Administration, Rockville, MD. June 15, 1999.
- Anon. Important message for health professionals: Report serious adverse events associated with dietary supplements containing GBL, GHB or BD. Food and Drug Administration, Rockville, MD. August 25, 1999. Available at: http://vm.cfsan.fda.gov/~dms/mwg
- Otto A. Acquaintance rape drug may one day help instead of hurt (news). Pharmacy Today. American Pharmaceutical Association, Washington, DC. April 2000:17.
- Anon. Multistate outbreak of poisonings associated with illicit use of gamma hydroxy butyrate. JAMA 1991;265:447-8. DOI
- Dyer JE. Gamma-Hydroxybutyrate: a health-food product producing coma and seizure-like activity (abstract). Am J Emerg Med 1991;9:321-4.
- FDA Talk Paper. FDA Warns About GBL-Related Products. 1999. Available at: vm.cfsan.fda.gov/~lrd/tpgbl2.html
- Timby N, Eriksson A. Gamma-Hydroxybutyrate-Associated Deaths. Am J Med 2000;108:518. PubMed
- Galloway GP, Frederick SL, Staggers FE Jr, et al. Gamma-hydroxybutyrate: an emerging drug of abuse that causes physical dependence. Addiction 1997;92:89-96. DOI
- Price G. In-patient detoxification after GHB dependence. Br J Psychiatry 2000;177:181. PubMed
- Dyer J, Roth B, Hyma B. Gamma-Hydroxybutyrate withdrawal syndrome. Ann Emerg Med 2001;37:147-53.. PubMed
- Ingels M, Rangan C, Bellezzo J, Clark R. Coma and respiratory depression following the ingestion of GHB and its precursors: Three cases. J Emerg Med 2000;19:47-50.. PubMed
- Mason P, Kerns II W. Gamma Hydroxybutyric Acid (GHB) Intoxication. Acad Emerg Med 2002;9:730-39.. DOI
- Abanades S, Farré M, Segura M, et al. Gamma-hydroxybutyrate (GHB) in humans: pharmacodynamics and pharmacokinetics. Ann N Y Acad Sci. 2006 Aug;1074:559-76. PubMed
- Boscolo-Berto R, Viel G, Montagnese S, Raduazzo DI, Ferrara SD, Dauvilliers Y. Narcolepsy and effectiveness of gamma-hydroxybutyrate (GHB): a systematic review and meta-analysis of randomized controlled trials. Sleep Med Rev. 2012 Oct;16(5):431-43. PubMed
- Kuiper MA, Peikert N, Boerma EC. Gamma-hydroxybutyrate withdrawal syndrome: a case report. Cases J. 2009 Mar 25;2:6530. DOI
- Leone MA, Vigna-Taglianti F, Avanzi G, Brambilla R, Faggiano F. Gamma-hydroxybutyrate (GHB) for treatment of alcohol withdrawal and prevention of relapses. Cochrane Database Syst Rev. 2010 Feb 17;(2):CD006266. PubMed
- Nimmerrichter AA, Walter H, Gutierrez-Lobos KE, Lesch OM. Double-blind controlled trial of gamma-hydroxybutyrate and clomethiazole in the treatment of alcohol withdrawal. Alcohol Alcohol. 2002 Jan-Feb;37(1):67-73. PubMed
- Stomberg MW, Knudsen K, Stomberg H, Skärsäter I. Symptoms and signs in interpreting gamma-hydroxybutyrate (GHB) intoxication - an explorative study. Scand J Trauma Resusc Emerg Med. 2014 Apr 23;22:27. PubMed
- Thai D, Dyer JE, Benowitz NL, Haller CA. Gamma-hydroxybutyrate and ethanol effects and interactions in humans. J Clin Psychopharmacol. 2006 Oct;26(5):524-9. PubMed
- Weiss T, Müller D, Marti I, Happold C, Russmann S. Gamma-hydroxybutyrate (GHB) and topiramate--clinically relevant drug interaction suggested by a case of coma and increased plasma GHB concentration. Eur J Clin Pharmacol. 2013 May;69(5):1193-4. PubMed
- Liakoni E, Dempsey DA, Meyers M, et al. Effect of ?-hydroxybutyrate (GHB) on driving as measured by a driving simulator. Psychopharmacology (Berl) 2018;235(11):3223-32. doi: 10.1007/s00213-018-5025-2. PubMed
- Xu XM, Wei YD, Liu Y, Li ZX. Gamma-hydroxybutyrate (GHB) for narcolepsy in adults: an updated systematic review and meta-analysis. Sleep Med 2019;64:62-70. doi: 10.1016/j.sleep.2019.06.017. PubMed
- Product information for Xyrem. Jazz Pharmaceuticals, Inc. Palo Alto, CA. March 2022.
- Aronsen AC, Brekke M, Vallersnes OM. Acute poisoning with gamma-hydroxybutyrate. Tidsskr Nor Laegeforen 2020;140(10). PubMed
- Lee S, Boyce SL, Southwell J. Case of gamma-hydroxybutyrate poisoning in an infant. J Paediatr Child Health 2022;58(5):909-910. PubMed
- Abid M, Kietzerow J, Iwersen-Bergmann S, Schnitgerhans T, Andresen-Streichert H. Characteristics and dose-effect relationship of clinical gamma-hydroxybutyrate intoxication: A case series. J Forensic Sci 2022;67(1):416-427. PubMed
- Rodriguez-Cruz V, Ren T, Morris ME. Drug-drug interaction between diclofenac and gamma-hydroxybutyric acid. Biopharm Drug Dispos 2021;42(8):351-358. PubMed
- Wolf CJH, Beurmanjer H, Dijkstra BAG, et al. Characterization of the GHB Withdrawal Syndrome. J Clin Med 2021;10(11):2333. PubMed
- Chien-Po H, An-Yi W. Amphetamine toxicity masked by concomitant ?-hydroxybutyrate (GHB) ingestion. Am J Emerg Med 2022;58:338-339. PubMed
- Siefried KJ, Freeman G, Roberts DM, et al. Inpatient GHB withdrawal management in an inner-city hospital in Sydney, Australia: a retrospective medical record review. Psychopharmacology (Berl) 2022. PubMed
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.
Azithromycin Is Linked to Lower Levels of 7 Nutrients
Natural Medicines records Azithromycin as a medicine that can lower these. This is not an interaction with Gamma-hydroxybutyrate (ghb) — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
Read the full Azithromycin nutrient depletion report ›
Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.
Taking Gamma-hydroxybutyrate (ghb) and Azithromycin Together: Common Questions
Is it safe to take Gamma-hydroxybutyrate (ghb) with Azithromycin?
Do Gamma-hydroxybutyrate (ghb) and Azithromycin have any of the same side effects?
How was the Gamma-hydroxybutyrate (ghb) and Azithromycin combination checked?
Does Gamma-hydroxybutyrate (ghb) interact with any other medications?
Does Azithromycin interact with any supplements?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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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.