Drug General Information (ID: DDISULHAY5)
Drug Name			Azithromycin		Drug Info		Amiodarone		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Macrolides				Antiarrhythmic Agents
Structure

Mechanism of Azithromycin-Amiodarone Interaction (Severity Level: Major)
Increased risk of prolong QT interval Click to Show/Hide Mechanism Graph
Drug Name		Azithromycin				Amiodarone
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 Amiodarone

Recommended Action
Management		The concurrent use of amiodarone with other medications that can prolong the QT interval should generally be avoided unless benefits are anticipated to outweigh the risks. Caution and clinical monitoring are recommended if these agents are prescribed together, especially to patients with underlying risk factors. 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.

References
1	Nattel S, Ranger S, Talajic M, et al "Erythromycin-induced long QT syndrome: concordance with quinidine and underlying cellular electrophysiologic mechanism." Am J Med 89 (1990): 235-8. [PMID: 2382671]
2	Product Information. Azithromycin Product Information (azithromycin). Pfizer US Pharmaceuticals, New York, NY.
3	Product Information. Cordarone (amiodarone). Wyeth-Ayerst Laboratories, Philadelphia, PA.
4	Product Information. Erythrocin Lactobionate (erythromycin). Abbott Pharmaceutical, Abbott Park, IL.
5	Samarendra P, Kumari S, Evans SJ, Sacchi TJ, Navarro V "QT prolongation associated with azithromycin/amiodarone combination." Pacing Clin Electrophysiol 24 (2001): 1572-4. [PMID: 11707055]
6	Trivier JM, Libersa C, Belloc C, Lhermitte M "Amiodarone N-deethylation in human liver microsomes: involvement of cytochrome P450 3A enzymes (first report)." Life Sci 52 (1993): pl91-6. [PMID: 8445979]
7	Yamreudeewong W, DeBisschop M, Martin L, Lower D "Potentially Significant Drug Interactions of Class III Antiarrhythmic Drugs." Drug Saf 26 (2003): 421-38. [PMID: 12688833]