Discussing The Interaction Between Azithromycin And Hydroxychloroquine
In our latest question and answer, the pharmacist discusses the drug interaction between azithromycin and hydroxychloroquine.
I stopped taking Hydroxychloroquine 200mg yesterday and was prescribed Azithromycin today. Nothing was mentioned about interactions, but I see there is a risk of prolonged QT intervals. Should I wait to take the antibiotics?
Mar 04, 2024- Both azithromycin and hydroxychloroquine can prolong the QT interval on your heart's electrical system, which may increase the risk of a serious irregular heartbeat. The combination is generally not recommended, but your doctor may decide the benefits justify the risk depending on your health status and individual circumstances. You should discuss your concerns with your doctor before taking these medications together, as they can assess your personal risk factors and determine if close monitoring is needed.
Answer
Thank you for contacting us!
It's great that you're being mindful of potential interactions between your medications. I'm happy to help.
There is indeed an interaction between hydroxychloroquine and azithromycin, which poses the risk of 'QT prolongation'.
We (HelloPharmacist) categorize this interaction as 'major', though other sources may assign it a different severity level.
Interaction Details
You can find a detailed explanation of the interaction on the drug interaction section of our website. In summary, both azithromycin and hydroxychloroquine increase the risk of QT prolongation.
QT prolongation occurs when the QT interval on an electrocardiogram (ECG) is longer than normal. This can lead to a higher risk of developing a specific type of irregular heartbeat called torsades de pointes, which can be life-threatening.
As a general rule, it's not recommended to use hydroxychloroquine with other drugs that have the potential to prolong the QT interval (such as azithromycin).
However, it's important to note that the combination of hydroxychloroquine and azithromycin can be used at times, depending on the situation.
We are particularly concerned about this interaction in individuals at high risk for QT interval prolongation, such as those with COVID-19 infection, older adults, individuals with existing heart problems, low potassium levels, etc. If you are healthy and don't have these risk factors, it is generally considered safe to use the combination if the indication is justified and the benefits outweigh the risks. You may just have to be monitored more closely.
It's very important to discuss your concerns with your doctor and assess your individual risk before taking this combination of drugs, as everyone's medical situation is different. Your doctor can provide you with specific guidance and discuss with you whether or not you need specific monitoring.
Waiting After Stopping Hydroxychloroquine
I'd like to address the point you made about stopping hydroxychloroquine. You mentioned that you've recently stopped hydroxychloroquine and are considering waiting to take azithromycin. Unfortunately, as taking antibiotics is time-sensitive to treat your infection, waiting isn't an option here.
Hydroxychloroquine has a VERY long half-life, between 30 and 50 days after a single dose, so the drug remains in your system for a significant amount of time. Even waiting a few days after stopping it won't prevent an interaction with azithromycin.
Once again, please consult your doctor about your options.
Final Words
Thank you once again for reaching out. Please don't hesitate to contact us anytime. I hope this answer was informative.
References & sources
Glossary — Terms in This Answer
- QT prolongation
- A condition where the electrical signal in the heart takes longer than normal to complete, which can increase the risk of dangerous irregular heartbeats.
- Electrocardiogram (ECG)
- A test that records the electrical activity of the heart to check its rhythm and function.
- Torsades de pointes
- A serious type of irregular heartbeat that can be life-threatening and is associated with QT prolongation.
- Drug interaction
- A situation where two medications affect each other in a way that changes how they work in your body.
- Half-life
- The amount of time it takes for half of a drug to be removed from your body.
- Hydroxychloroquine
- A medication used to treat certain infections and autoimmune diseases.
- Azithromycin
- An antibiotic medication used to treat bacterial infections.
- Indication
- A medical reason or condition for which a particular treatment or medication is recommended.
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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