Details of Drug Interaction

Details of Drug-Drug Interaction

 Drug General Information (ID: DDI3NZGXVA)
  Drug Name Azithromycin Drug Info Tacrolimus Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Macrolides Immunosuppressive Agents
  Structure

 Mechanism of Azithromycin-Tacrolimus Interaction (Severity Level: Moderate)
     Increased risk of prolong QT interval Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Azithromycin Tacrolimus
      Mechanism Prolong QT interval Prolong QT interval
      Key Mechanism Factor 1
Factor Name QT interval
Factor Description Long QT syndrome is a heart signaling disorder that can cause a fast, chaotic heartbeat (arrhythmia). Many people may not exhibit symptoms, and usually the condition is detected during routine medical tests. In others, the most common symptoms include: sudden fainting, palpitations, dizziness, seizures, sudden death.
      Mechanism Description
  • Increased risk of prolong QT interval by the combination of Azithromycin and Tacrolimus 

Recommended Action
      Management Caution and clinical monitoring are recommended when azithromycin and tacrolimus are prescribed in combination. Patients should be advised to seek medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitations, irregular heartbeat, shortness of breath, or syncope. It may be appropriate to monitor tacrolimus levels more closely following the initiation or discontinuation of azithromycin.

References
1 Ibrahim RB, Abella EM, Chandrasekar PH "Tacrolimus-clarithromycin interaction in a patient receiving bone marrow transplantation." Ann Pharmacother 36 (2002): 1971-1972. [PMID: 12452763]
2 Mori T, Aisa Y, Nakazato T, Yamazaki R, Ikeda Y, Okamoto S "Tacrolimus-azithromycin interaction in a recipient of allogeneic bone marrow transplantation." Transpl Int 18 (2005): 757-8. [PMID: 15910307]
3 Product Information. Zithromax (azithromycin). Pfizer US Pharmaceuticals, New York, NY.
4 Shullo MA, Schonder K, Teuteberg JJ "Elevated tacrolimus levels associated with intravenous azithromycin and ceftriaxone: a case report." Transplant Proc 42 (2010): 1870-2. [PMID: 20620540]