Drug & supplement interaction

Turpentine Oil + Azithromycin

Azithromycin brand names: Zithromax, Zmax, Azasite.

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

Turpentine Oil has a moderate interaction with Azithromycin. Some in vitro research shows that alpha-pinene, the major constituent of turpentine oil, does not increase the absorption of chlorpromazine or haloperidol when applied topically.

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

Turpentine Oil 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 Turpentine Oil interacts with.

Some in vitro research shows that alpha-pinene, the major constituent of turpentine oil, does not increase the absorption of chlorpromazine or haloperidol when applied topically. However, animal research shows that turpentine oil increases the absorption of ibuprofen when applied topically. Theoretically, applying turpentine oil to the skin along with other medications might increase the effects and side effects of these medications.
Severity Moderate Likelihood Possible Evidence D

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 honest picture for azithromycin: the interaction on file is about turpentine oil acting as a 'skin penetration helper,' meaning it can push some topically applied medicines deeper into the skin. The concern is theoretical and based only on lab and animal studies (one with ibuprofen), so it's pretty weak evidence.

The bigger reason not to lose sleep over this: azithromycin (Zithromax) is almost always taken as a pill or given by IV, not rubbed on the skin. Since turpentine oil mainly affects absorption through the skin, it isn't likely to change how your oral azithromycin works. If you happen to be using an azithromycin eye drop (Azasite), don't layer other products near your eyes without asking first. When in doubt, check with your pharmacist.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Jiang Q, Wu Y, Zhang H, et al. Development of essential oils as skin permeation enhancers: penetration enhancement effect and mechanism of action. Pharmaceutical Biol. 2017;55(1):1592-1600. PubMed
  2. Almirall M, Montana J, Excribano E, Obach R, Berrozpe JD. Effect of d-limonene, alpha-pinene, and cineole on in vitro transdermal human skin penetration of chlorpromazine and haloperidol. Arzneimittelforschung. 1996 Jul;46(7):676-80.

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

Turpentine Oil Also Interacts With Other Medications

Turpentine Oil has 197 moderate, 178 minor 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 197 Minor 178 No known interaction 2,455 (incl. Azithromycin)
Taking anything else?

Check Another of Your Medications Against Turpentine Oil

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

From our Q&A

Questions About Turpentine Oil 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 Turpentine Oil 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 Turpentine Oil 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 Turpentine Oil 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 Turpentine Oil
Top half

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

29 days ago today
Medication Azithromycin
Top 5%

#59 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 Turpentine Oil

What is Turpentine Oil?

Turpentine Oil
  • Muscle and joint aches (topical)
  • Cough and congestion (chest rubs)
  • Minor skin conditions
  • Antiseptic
  • Toothache (traditional)

Turpentine oil is a strong-smelling pine resin product used mostly in tiny amounts in topical rubs for muscle aches and congestion. It can be dangerous and even deadly if swallowed, and reliable evidence for health benefits is very limited. Never drink turpentine oil, and only use diluted, purified products on the skin with care.

Read the full Turpentine Oil 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 & Turpentine Oil

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

0Major
197Moderate
178Minor
2,454No known interaction
197 Moderate 178 Minor 2,454 No interaction
Moderate

197 interactions

Showing 60 of 197 moderate interactions — see all 197 on the Turpentine Oil page.

Minor

178 interactions

Showing 60 of 178 minor interactions — see all 178 on the Turpentine Oil page.

No interaction 2,454 drugs checked — show the list

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

Showing the 60 most looked-up of 2,454 medications checked with no known interaction — see the full Turpentine Oil list.

See the full Turpentine Oil 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
Turpentine Oil 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 Turpentine Oil and Azithromycin Together: Common Questions

Can you take Turpentine Oil 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 Turpentine Oil 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 Turpentine Oil?

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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.