From the FDA Drug Label
Co-administration of azithromycin with efavirenz or fluconazole had a modest effect on the pharmacokinetics of azithromycin Fluconazole200 mg PO single dose1,200 mg PO single dose181.04 (0.98 to 1.11) 1.01 (0.97 to 1.05) The ratio (with/without azithromycin) of fluconazole pharmacokinetic parameters was 1.04 for Cmax and 1.01 for AUC
There is no specific information on when to take fluconazole after azithromycin to be safe. The data provided shows that co-administration of azithromycin and fluconazole has a modest effect on the pharmacokinetics of both drugs, but it does not provide guidance on the timing of administration. Therefore, no conclusion can be drawn regarding the safe timing of fluconazole administration after azithromycin use 1.
From the Research
It is generally safe to take fluconazole after completing your azithromycin course, with no specific waiting period required between the two medications, but to minimize potential interactions, waiting at least 24 hours after your last azithromycin dose is recommended. The provided evidence does not directly address the interaction between azithromycin and fluconazole, but it discusses the use of fluconazole in treating vaginal yeast infections and its efficacy and safety profile 2. When considering the potential for drug interactions, particularly those that may affect the heart, such as QT interval prolongation, it's crucial to exercise caution, especially in individuals with pre-existing heart conditions or those taking other medications that may affect heart rhythm 3, 4. However, for most healthy individuals, the interaction between azithromycin and fluconazole is not considered major.
Key Considerations
- The safety and efficacy of fluconazole in treating vaginal candidiasis are well-established, with it being a recommended treatment option for recurrent vulvovaginal candidiasis (RVVC) 2.
- The potential for fluconazole resistance, particularly in cases where there is frequent or inappropriate use of antifungal agents, is a concern that may impact treatment outcomes 4.
- Personalized medical advice is essential when combining medications, especially for individuals with specific health conditions or those taking other medications that could interact with azithromycin or fluconazole.
Recommendations for Use
- If you need to take both azithromycin and fluconazole, consider waiting at least 24 hours after your last azithromycin dose before starting fluconazole to minimize potential interactions.
- Consult your healthcare provider before taking these medications together, especially if you have heart conditions, take other medications that affect heart rhythm, or have liver or kidney problems.
- Always follow the prescribed treatment regimen and consult your healthcare provider if you have any concerns or questions about your medication.