Drug & supplement interaction

Sida Cordifolia + Azithromycin

Azithromycin brand names: Zithromax, Zmax, Azasite.

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

Sida Cordifolia has a major interaction with Azithromycin. Theoretically, Sida cordifolia might increase the risk of additive QT interval prolongation when taken with QT interval-prolonging drugs.

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

Sida Cordifolia and Azithromycin

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

Major

QT INTERVAL-PROLONGING DRUGS

Why this applies to Azithromycin

Azithromycin falls under QT INTERVAL-PROLONGING DRUGS — the group Sida Cordifolia interacts with.

Theoretically, Sida cordifolia might increase the risk of additive QT interval prolongation when taken with QT interval-prolonging drugs.
Sida cordifolia contains ephedrine. Clinical research shows that ephedrine from another herb, ephedra, can prolong the QT interval.
Severity Major Likelihood Probable Evidence B

Interaction 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..

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

Here's the concern with pairing these two. Azithromycin can affect your heart's electrical rhythm, lengthening what we call the QT interval. Sida cordifolia naturally contains ephedrine, a stimulant that can also nudge the QT interval in the same direction. Stack them together and you may get an additive effect, which in rare cases can lead to a dangerous irregular heartbeat. Ephedrine also tends to raise heart rate and blood pressure on its own.

I'll be honest, this is largely theoretical and based on limited evidence, so I don't want to scare you. But azithromycin already carries a known heart-rhythm warning, so this isn't a combination I'd take lightly. Please check with your pharmacist or doctor before using Sida cordifolia, especially if you have any heart conditions.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. McBride BF, Karapanos AK, Krudysz A, et al. Electrocardiographic and hemodynamic effects of a multicomponent dietary supplement containing ephedra and caffeine: a randomized controlled trial. JAMA 2004;291:216-21. PubMed

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

Sida Cordifolia Also Interacts With Other Medications

Sida Cordifolia has 336 major, 108 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.

Major 336 Moderate 108 No known interaction 2,386 (incl. Azithromycin)
Taking anything else?

Check Another of Your Medications Against Sida Cordifolia

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

From our Q&A

Questions About Sida Cordifolia 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 Sida Cordifolia 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 Sida Cordifolia 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 Sida Cordifolia as Part of a Dietary Supplement Product? Check It for Interactions

We hold 48 real supplement products containing Sida Cordifolia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sida Cordifolia. Your product may carry other ingredients that interact with Azithromycin too, on top of Sida Cordifolia — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Sida Cordifolia 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 Sida Cordifolia
Top half

#446 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 Sida Cordifolia

What is Sida Cordifolia?

Sida Cordifolia
  • Weight loss and energy
  • Asthma and breathing problems
  • Joint and muscle pain
  • Fever and cough
  • General fatigue or 'tonic'

Sida cordifolia (bala or country mallow) is a traditional Ayurvedic plant that naturally contains ephedrine, a powerful stimulant. Because of this, many supplements containing it have been banned or restricted, and it carries real risks to the heart and blood pressure. There is little reliable human evidence that it works, so most people should avoid it and talk with a pharmacist or doctor first.

Read the full Sida Cordifolia 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 & Sida Cordifolia

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

336Major
108Moderate
0Minor
2,385No known interaction
336 Major 108 Moderate 2,385 No interaction
Major

336 interactions

Showing 60 of 336 major interactions — see all 336 on the Sida Cordifolia page.

Moderate

108 interactions

Showing 60 of 108 moderate interactions — see all 108 on the Sida Cordifolia page.

No interaction 2,385 drugs checked — show the list

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

Showing the 60 most looked-up of 2,385 medications checked with no known interaction — see the full Sida Cordifolia list.

See the full Sida Cordifolia 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
Sida Cordifolia 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 Sida Cordifolia and Azithromycin Together: Common Questions

Can you take Sida Cordifolia with Azithromycin?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Sida Cordifolia and Azithromycin interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

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

Still Have a Question About Azithromycin and Sida Cordifolia?

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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.