Can You Take Magnesium Supplements With Azithromycin?
In our latest question and answer, the pharmacist discusses whether or not magnesium can be taken safely with azithromycin.
Can magnesium supplements be taken while taking azithromycin? What about vitamins? Are there any bad reactions or precautions or waiting time periods for taking them together?
Jul 29, 2022- Magnesium supplements should not be taken at the same time as azithromycin because magnesium binds to the antibiotic and reduces how well your body absorbs it.
- You can take azithromycin and magnesium on the same day if you separate them by at least 2 hours before or 4 to 6 hours after taking the antibiotic.
- This interaction applies to all magnesium-containing products including vitamins with magnesium and antacids like Maalox.
Answer
Thanks for your question!
Magnesium supplements should not be taken with azithromycin. They should be separated from one another. This includes really anything with magnesium in it, such as vitamins containing magnesium, and magnesium hydroxide, one of the active ingredients in Maalox.
Studies show that taking magnesium or aluminum-containing products could make azithromycin less effective. Essentially, both magnesium and aluminum bind to the azithromycin, which reduces overall absorption.
The prescribing information for azithromycin states very plainly to avoid the combination:
Patients should also be cautioned not to take aluminum- and magnesium-containing antacids and azithromycin simultaneously.
Studies show that when taken with magnesium, the peak concentration of azithromycin is decreased in the body, which again, may make it not work as well. One study, which tested aluminum and magnesium-containing antacids with azithromycin, found the following results:
There were no statistically significant differences in Tmax or AUC0-48 after administration of azithromycin alone or with [magnesium-containing] antacid, but mean values of Cmax [maximum concentration] were reduced by 24%.
How Long To Separate
In order to avoid the interaction between azithromycin and magnesium, you need to separate their administration.
In terms of how long, azithromycin should be taken at least 2 hours before, or 4-6 hours after magnesium-containing products.
So, overall, you can take azithromycin and magnesium on the same day, just not together (separate them as described above).
Final Words
Thanks again for your question and feel free to reach back out again in the future!
References & sources
Glossary — Terms in This Answer
- Azithromycin
- An antibiotic medication used to treat bacterial infections.
- Absorption
- The process by which a medication enters the bloodstream from the digestive system.
- Antacids
- Medications that reduce stomach acid and are used to relieve heartburn or indigestion.
- Peak concentration
- The highest level of a medication present in the body after it is taken.
- Cmax
- The maximum concentration, or highest amount of a drug measured in the bloodstream.
- Tmax
- The time it takes for a medication to reach its maximum concentration in the body.
- AUC
- A measure of the total amount of medication that reaches the bloodstream over a period of time.
- Statistically significant
- A difference in results that is large enough to be unlikely to have occurred by chance alone.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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