Ergotamine types: Considering the theoretical possibility of ergotism, brand new concurrent accessibility azithromycin having ergot derivatives isn’t needed (get a hold of part 4.4).
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Though neutropenia might have been with the usage of rifabutin, an effective causal link to consolidation with azithromycin wasn’t established (see Section cuatro
Warning is preferred from the co-administration of these drugs that have Azithromycin from the understood boosting effectation of such medication whenever put additionally to your macrolid antibiotic erythromycin.
Co-administration out-of atorvastatin (ten mg each and every day) and you may azithromycin (five-hundred milligrams daily) failed to change the plasma levels out of atorvastatin (centered on a beneficial HMG CoA-reductase inhibition assay). However, post-sales cases of rhabdomyolysis in the customers receiving azithromycin which have statins features come stated.
Within the a pharmacokinetic telecommunications studies during the compliment volunteers, no significant impression is observed for the plasma quantities of carbamazepine otherwise their productive metabolite from inside the people getting concomitant azithromycin.
In the event a good causal matchmaking hasn’t been mainly based, idea is supplied to the newest frequency off overseeing prothrombin big date when azithromycin is utilized during the people receiving coumarin-sort of oral anticoagulants
Cisapride try metabolized on the liver by chemical CYP 3A4. Because the macrolides restrict it enzyme, concomitant management from cisapride may cause the rise from QT interval prolongation, ventricular arrhythmias and you will torsades de- pointes.
Inside a good pharmacokinetic studies examining the consequences of one dose of cimetidine, offered couple of hours prior to azithromycin, to your pharmacokinetics from azithromycin, no customization of azithromycin pharmacokinetics is actually seen.
Within the an excellent pharmacokinetic communications study, azithromycin failed to alter the anticoagulant aftereffect of an individual fifteen mg amount off warfarin applied so you’re able to fit volunteers. There were profile acquired on article-revenue period of potentiated anticoagulation after co-administration out of azithromycin and you can coumarin-style of dental anticoagulants.
In a pharmacokinetic study with healthy volunteers that were administered a 500 mg/day oral dose of azithromycin for 3 days and were then administered a single 10 mg/kg oral dose of cyclosporin, the resulting cyclosporin Cmaximum and AUC0-5 were found to be significantly elevated. Consequently, caution should be exercised before considering concurrent administration of these drugs. If co-administration of these drugs is necessary, cyclosporin levels should be monitored and the dose adjusted accordingly.
Co-management from a great 600 milligrams unmarried amount out of azithromycin and eight hundred mg efavirenz every day to have 1 week did not result in any medically high pharmacokinetic relationships.
Co-administration of a single dose of 1200 mg azithromycin did not alter the pharmacokinetics of a single dose of 800 mg fluconazole. Total exposure and half-life of azithromycin were unchanged by the co-administration of fluconazole, however, a clinically insignificant decrease in Cmax (18%) of azithromycin was observed.
Co-administration of one dose away from 1200 milligrams azithromycin didn’t come with statistically tall influence on the brand new pharmacokinetics from indinavir given as the 800 milligrams 3 times daily for 5 months.
From inside the healthy volunteers, co-government out of azithromycin five hundred milligrams/date to own 3 days didn’t lead to clinically tall changes in the new pharmacokinetics and you will pharmacodynamics of a single fifteen mg amount of midazolam.
Co-administration from azithromycin (1200 mg) and you will nelfinavir on steady-state (750 milligrams three times each day) lead to improved azithromycin concentrations. Zero medically extreme negative effects were observed and no dose changes is required.
In normal healthy male volunteers, there was no evidence of an effect of azithromycin (500 mg daily for 3 days) on the AUC and Cmax of sildenafil or its major circulating metabolite.
Pharmacokinetic research has stated zero evidence of a discussion between azithromycin and you may terfenadine. There had been infrequent cases reported where the likelihood of such as for example a conversation could not become entirely excluded; although not there can be no particular research one to instance an interacting with each other had occurred.