Does Azithromycin interact with Citalopram? (+1 interaction)

In this article, we will discuss the interaction between Azithromycin and Citalopram, and the potential adverse effects that may occur by taking these medications together. Further, we will discuss how to manage the side effects of citalopram and azithromycin when taken together.

Does Azithromycin interact with Citalopram?

Yes, Azithromycin can interact with Citalopram. Although this interaction is uncommon, it can cause serious adverse effects in susceptible populations.

Azithromycin is a macrolide antimicrobial medication primarily used to treat bacterial infections such as community-acquired pneumonia, acute bronchitis, sexually transmitted diseases, and other infections of the skin, throat, ear, and reproductive organs. It works by inhibiting the bacterial protein synthesis (1).

Citalopram, on the other hand, is an SSRI antidepressant drug that is indicated in the treatment and management of OCD, depression, and anxiety. It works by increasing the level of serotonin in the brain which in turn reduces the symptoms of depression (2).

Interactions between Azithromycin and Citalopram

There are a few adverse effects that are common with the use of both azithromycin and citalopram. The possible interaction between these drugs might be due to the potentiation of these adverse effects.

Rare/severe interaction

Both Citalopram and Azithromycin have the potential to prolong QT interval in susceptible populations (3,4). When combined the risk may be elevated.

This interaction between Azithromycin and citalopram is generally considered to be low. The adverse effects may vary among individuals depending on their age, dosage, and other individual factors.

QT prolongation

QT prolongation is a condition characterized by an abnormality in the ECG reading, which indicates a lengthened QT interval. The QT interval signifies the time required for the ventricles of the heart to contract and reset for the next heartbeat (5).

Prolongation of this interval can augment the risk of irregular heartbeats, particularly a specific type known as Torsade de Pointes, which can result in life-threatening arrhythmias (5).

Citalopram and azithromycin independently have a QT interval prolongation effect, and when these drugs are taken together, the risk of QT prolongation and potential cardiac arrhythmias or sudden cardiac death may increase further.

Risk factors for QT prolongation

Although not everyone who concurrently takes citalopram and azithromycin experiences QT prolongation, certain risk factors can predispose individuals to this adverse effect. These risk factors include (6):

•  preexisting cardiac conditions such as congestive heart failure, myocardial infarction, or ventricular hypertrophy
• female gender
• age over 65 years
• hyperthyroidism
• electrolyte imbalances ( hypokalemia, hypocalcemia, hypomagnesemia)

While serious complications from drug-induced QT interval prolongation are rare, identifying patients at risk can aid in preventing such events.

Common additive side effects of citalopram and azithromycin

The concurrent use of citalopram and azithromycin may result in additive side effects. Understanding these effects is crucial for both healthcare providers and patients to ensure the safe and effective use of these medications when prescribed together.

Common side effects of citalopram and azithromycin may cause:

• Diarrhea
• GIT discomfort
• Nausea
• Headache
• Palpitations
• Vomiting

Both citalopram and azithromycin can individually cause GIT side effects, combining these medications could intensify these effects, so it’s advisable to discuss this combination with your healthcare provider and monitor your well-being closely while on this medication regimen (7).

How to manage the additive side effects of citalopram and azithromycin?

It is important to manage potential additive side effects when taking citalopram and azithromycin together to ensure the safety and effectiveness of your treatment. Here are some professional recommendations to help you manage the side effects effectively:

Consult Your Healthcare Provider: It is important to maintain open communication with your healthcare provider and inform them of any unusual symptoms or concerns regarding side effects. Your provider can make necessary adjustments to your treatment plan to minimize side effects.

Adhere to Prescribed Dosages: Follow your healthcare provider’s instructions strictly and do not alter your medication dosages or schedules without professional guidance. This will help to ensure the safety and effectiveness of your treatment.

Symptomatic treatment: Your healthcare provider may provide you with a symptomatic treatment plan for managing the side effects that may occur by concomitant use of azithromycin and citalopram.

Stay Hydrated: Drinking plenty of water can mitigate potential gastrointestinal side effects such as abdominal discomfort.

Monitor Your Health: Keep a vigilant eye on your health and well-being. Recognize and report any unusual side effects or symptoms to your healthcare provider promptly.

Consistency in Medication Schedule: Maintaining a consistent schedule for taking your medications helps stabilize blood levels and reduce the likelihood of side effects.

Remember, personalized guidance from your healthcare provider is crucial for safe and effective management of side effects. Always consult your healthcare provider for advice on managing side effects.

Conclusion

In this article, we have discussed the potential interactions between azithromycin and citalopram and what should we do to manage the additive side effects of these medications.

References