Cinazith/Cinazith-DS Drug Interactions

Nelfinavir: side effects of Azithromycin, such as liver enzyme abnormalities and hearing impairment, is warranted.
Azithromycin did not affect the prothrombin time response to a single dose of Warfarin. However, prudent medical practice dictates careful monitoring of prothrombin time in all patients treated with Azithromycin and Warfarin concomitantly. Concurrent use of macrolides and Warfarin in clinical practice has been associated with increased anticoagulant effects. Drug interaction studies were performed with Azithromycin and other drugs likely to be coadministered.
When used in therapeutic doses, Azithromycin had a modest effect on the pharmacokinetics of atorvastatin, carbamazepine, cetirizine, didanosine, efavirenz, fluconazole indinavir, midazolam, rifabutin, sildenafil, theophylline (intravenous and oral), triazolam, trimethoprim/sulfamethoxazole or zidovudine. Co-administration with efavirenz or fluconazole had a modest effect on the pharmacokinetics of Azithromycin. No dosage adjustment of either drug is recommended when Azithromycin is co-administered with any of the above agents. Interactions with the drugs listed as follows have not been reported in clinical trials with Azithromycin; however, no specific drug interaction studies have been performed to evaluate potential drug-drug interaction. Nonetheless, they have been observed with macrolides products. Until further data are developed regarding drug interactions when Azithromycin and these drugs are used concomitantly, careful monitoring of patients is advised: Digoxin: elevated digoxin concentrations.
Ergotamine or dihydroergotamine: acute ergot toxicity characterized by severe peripheral vasospasm and dysesthesia.
Theophylline: There is no evidence of any pharmacokinetic interaction when azithromycin and theophylline are co-administered to healthy volunteers Terfenadine. No clinically significant pharmacokinetic interactions observed.
Ergot: The theoretical possibility of ergotism contraindicates the concurrent use of azithromycin with ergot derivatives.
Cyclosporine: Caution should be exercised before concurrent administration of azithromycin and Cyclosporine levels should be monitored and the dose should be adjusted accordingly.
Digoxin: Some of the macrolide antibiotics have been reported to impair the metabolism of digoxin. In patients receiving concomitant Azithromycin and digoxin the possibility of raised digoxin levels should be borne in mind. However, no interactions have been reported so far.
Antacids: Azithromycin and antacids should not be taken simultaneously. Antacids reduce peak serum concentrations by up to 30%, although overall bioavailability is unaffected.
Cimetidine: No alterations of Azithromycin pharmacokinetics were seen.