Drug & supplement interaction

Osteopathic Manipulation + 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 Osteopathic Manipulation 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.

Know someone interested in this? Share
Facebook Post Reddit Email
On this page
Interaction report

Osteopathic Manipulation 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 Osteopathic Manipulation in our sources. This does not guarantee that the combination is completely free of risk — research on Osteopathic Manipulation alongside specific medications may be limited.

Worth understanding: our licensed dataset holds no drug-interaction record for Osteopathic Manipulation at all — not against Azithromycin, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

Osteopathic Manipulation is a treatment rather than something you take. Tell whoever provides it which medicines you use, and ask your prescriber whether it is appropriate for your health and treatment. 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.

Osteopathic Manipulation safety at a glance

Osteopathic Manipu... overall Use caution Generally low-risk when performed by a trained provider, but not appropriate for everyone.
Pregnancy Possibly Safe When osteopathic manipulation is administered appropriately by a trained professional, short-term. Some research shows that osteopathic manipulation given for 2... Read the full pregnancy detail
Breastfeeding Possibly Safe When osteopathic manipulation is administered appropriately by a trained professional, short-term. Some research shows that osteopathic manipulation given for 2... 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 Osteopathic Manipulation? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

No Interaction Found — But Data Suggests Osteopathic Manipulation 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 having Osteopathic Manipulation while taking the medicine can make those effects more likely to turn up, and harder to pin on one or the other if they do.

  • Headache Additional detail

    Osteopathic Manipulation

    “Osteopathic manipulative treatment seems to be well tolerated. Adverse effects have not been reported often in clinical trials. However, osteopathic manipulation can cause post-treatment headache or musculoskeletal soreness and pain.”

    Osteopathic Manipulation · Natural Medicines adverse-effect record, reported in cluster headache.

    5 sources cited
    1. 98759. Lanaro D, Ruffini N, Manzotti A, Lista G. Osteopathic manipulative treatment showed reduction of length of stay and costs in preterm infants: A systematic review and meta-analysis. Medicine (Baltimore). 2017;96(12):e6408. PubMed
    2. 98766. Wyatt K, Edwards V, Franck L, et al. Cranial osteopathy for children with cerebral palsy: a randomised controlled trial. Arch Dis Child. 2011;96(6):505-12. PubMed
    3. 98757. Franke H, Franke JD, Fryer G. Osteopathic manipulative treatment for nonspecific low back pain: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2014;15:286. PubMed
    4. 104077. Noll DR, Degenhardt BF, Morley TF, et al. Efficacy of osteopathic manipulation as an adjunctive treatment for hospitalized patients with pneumonia: a randomized controlled trial. Osteopath Med Prim Care. 2010;4:2. PubMed
    5. 109293. Cholewicki J, Popovich JM Jr, Reeves NP, et al. The effects of osteopathic manipulative treatment on pain and disability in patients with chronic neck pain: A single-blinded randomized controlled trial. PM R 2021. PubMed

    “Osteopathic manipulation can cause post-treatment headache.”

    Osteopathic Manipulation · Natural Medicines adverse-effect record, reported in cluster headache.

    1 source cited
    1. 109293. Cholewicki J, Popovich JM Jr, Reeves NP, et al. The effects of osteopathic manipulative treatment on pain and disability in patients with chronic neck pain: A single-blinded randomized controlled trial. PM R 2021. PubMed

    Azithromycin

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

Effects for Azithromycin come from the ADVERSE REACTIONS section of its FDA label; effects for Osteopathic Manipulation 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

Osteopathic Manipulation in Pregnancy & Breastfeeding

Pregnancy And Lactation Possibly Safe

When osteopathic manipulation is administered appropriately by a trained professional, short-term. Some research shows that osteopathic manipulation given for 20 minutes seven times during the third trimester of pregnancy is safe with regard to labor and delivery outcomes.

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 Osteopathic Manipulation 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. Osteopathic Manipulation is a treatment: what follows is what researchers have looked at it for, and how strong that evidence is.

Osteopathic Manipulation has been studied for:

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

    Osteopathic Manipulation for pneumonia

    Evidence for the use of osteopathic manipulation in hospitalized elderly patients with pneumonia is conflicting. Small pilot studies in patients 60 years and older who were hospitalized for acute pneumonia showed mixed results on duration of hospital stay and antibiotic use when patients received either regular care or osteopathic manipulation for 10-15 minutes twice daily for up to 7 days.

    4 sources cited
    1. 88709. Noll DR, Shores JH, Gamber RG, et al. Benefits of osteopathic manipulative treatment for hospitalized elderly patients with pneumonia. J Am Osteopath Assoc 2000;100(12):776-82.
    2. 88710. Noll DR, Shores J, Bryman PN, Masterson EV. Adjunctive osteopathic manipulative treatment in the elderly hospitalized with pneumonia: a pilot study. J Am Osteopath Assoc 1999;99(3):143-6, 151-2. PubMed
    3. 104077. Noll DR, Degenhardt BF, Morley TF, et al. Efficacy of osteopathic manipulation as an adjunctive treatment for hospitalized patients with pneumonia: a randomized controlled trial. Osteopath Med Prim Care. 2010;4:2. PubMed
    4. 104071. Noll DR, Degenhardt BF, Johnson JC. Multicenter Osteopathic Pneumonia Study in the Elderly: Subgroup Analysis on Hospital Length of Stay, Ventilator-Dependent Respiratory Failure Rate, and In-hospital Mortality Rate. J Am Osteopath Assoc. 2016;116(9):574- PubMed

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 Osteopathic Manipulation for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

From our Q&A

Questions About Osteopathic Manipulation 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 Osteopathic Manipulation 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 Osteopathic Manipulation 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 Osteopathic Manipulation 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 Osteopathic Manipulation
Steady interest

#1,408 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 Osteopathic Manipulation reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Osteopathic Manipulation 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 .
Treatment approach

About Osteopathic Manipulation

What is Osteopathic Manipulation?

  • Low back pain
  • Neck pain
  • Tension headaches
  • Muscle and joint stiffness
  • General musculoskeletal discomfort

Osteopathic manipulative treatment (OMT) is a hands-on therapy used mainly for musculoskeletal pain such as low back pain. The best evidence supports modest, short-term relief for some types of pain, while benefits for non-musculoskeletal conditions are not well proven. It is generally low-risk when done by a trained provider, but you should discuss it with your doctor first.

Not applicable (a hands-on manual therapy, not a plant or supplement) · Hands-on treatment performed by a trained osteopathic physician (DO) or other qualified provider

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

Osteopathic Manipulation: dosing

There is no standardized "dose" for OMT. The number and frequency of sessions depend on your condition, your response, and your provider's judgment. Some people feel better after one or a few visits, while others need ongoing care.Because OMT is a hands-on medical treatment rather than a product, the best approach is to discuss a treatment plan directly with a licensed osteopathic physician or qualified provider. Ask how many sessions they recommend and when you should expect to see improvement.

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

Read the full Osteopathic Manipulation 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 & Osteopathic Manipulation

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

0Major
0Moderate
0Minor
2,829No known interaction
2,829 No interaction
No interaction 2,829 drugs checked — show the list

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

Showing the 60 most looked-up of 2,829 medications checked with no known interaction — see the full Osteopathic Manipulation list.

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

Osteopathic Manipulation References

The 52 references that drive our Osteopathic Manipulation 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. Guiney PA, Chou R, Vianna A, Lovenheim J. Effects of osteopathic manipulative treatment on pediatric patients with asthma: a randomized controlled trial. J Am Osteopath Assoc 2005;105(1):7-12.
  2. Plotkin BJ, Rodos JJ, Kappler R, et al. Adjunctive osteopathic manipulative treatment in women with depression: a pilot study. J Am Osteopath Assoc 2001;101(9):517-23.
  3. Gamber RG, Shores JH, Russo DP, et al. Osteopathic manipulative treatment in conjunction with medication relieves pain associated with fibromyalgia syndrome: results of a randomized clinical pilot project. J Am Osteopath Assoc 2002;102(6):321-5.
  4. Hayden C, Mullinger B. A preliminary assessment of the impact of cranial osteopathy for the relief of infantile colic. Complement Ther Clin Pract 2006;12(2):83-90. PubMed
  5. Williams NH, Wilkinson C, Russell I, et al. Randomized osteopathic manipulation study (ROMANS): pragmatic trial for spinal pain in primary care. Fam Pract 2003;20(6):662-9. PubMed
  6. Noll DR, Shores JH, Gamber RG, et al. Benefits of osteopathic manipulative treatment for hospitalized elderly patients with pneumonia. J Am Osteopath Assoc 2000;100(12):776-82.
  7. Noll DR, Shores J, Bryman PN, Masterson EV. Adjunctive osteopathic manipulative treatment in the elderly hospitalized with pneumonia: a pilot study. J Am Osteopath Assoc 1999;99(3):143-6, 151-2. PubMed
  8. Goldstein FJ, Jeck S, Nicholas AS, et al. Preoperative intravenous morphine sulfate with postoperative osteopathic manipulative treatment reduces patient analgesic use after total abdominal hysterectomy. J Am Osteopath Assoc 2005;105(6):273-9.
  9. Yurvati AH, Carnes MS, Clearfield MB, et al. Hemodynamic effects of osteopathic manipulative treatment immediately after coronary artery bypass graft surgery. J Am Osteopath Assoc 2005;105(10):475-81.
  10. Jarski RW, Loniewski EG, Williams J, et al. The effectiveness of osteopathic manipulative treatment as complementary therapy following surgery: a prospective, match-controlled outcome study. Altern Ther Health Med 2000;6(5):77-81.
  11. Licciardone JC, Stoll ST, Cardarelli KM, et al. A randomized controlled trial of osteopathic manipulative treatment following knee or hip arthroplasty. J Am Osteopath Assoc 2004;104(5):193-202.
  12. Eisenhart AW, Gaeta TJ, Yens DP. Osteopathic manipulative treatment in the emergency department for patients with acute ankle injuries. J Am Osteopath Assoc 2003;103(9):417-21.
  13. Geldschlager S. [Osteopathic versus orthopedic treatments for chronic epicondylopathia humeri radialis: a randomized controlled trial]. Forsch Komplementarmed Klass Naturheilkd 2004;11(2):93-7.
  14. Anderson RE, Seniscal C. A comparison of selected osteopathic treatment and relaxation for tension-type headaches. Headache 2006;46(8):1273-80. PubMed
  15. Noll DR, Degenhardt BF, Johnson JC, Burt SA. Immediate effects of osteopathic manipulative treatment in elderly patients with chronic obstructive pulmonary disease. J Am Osteopath Assoc 2008;108(5):251-9.

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

Having Osteopathic Manipulation While Taking Azithromycin: Common Questions

Is it safe to have Osteopathic Manipulation while taking Azithromycin?
We do not list a known interaction between Osteopathic Manipulation 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 Osteopathic Manipulation 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.
Are Osteopathic Manipulation 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 Osteopathic Manipulation in each. That is a conversation for your prescriber, especially if Azithromycin is being adjusted to a target.
Does Azithromycin interact with any supplements?
Yes. Azithromycin has documented interactions with 92 supplements in our database — Osteopathic Manipulation 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

Osteopathic Manipulation 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 52 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Azithromycin and Osteopathic Manipulation?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.