From the Guidelines
Terbinafine and azithromycin can generally be taken together as there is no significant interaction between these medications. Terbinafine (commonly sold as Lamisil) is an antifungal medication that treats conditions like athlete's foot, ringworm, and nail fungus, while azithromycin (often sold as Zithromax) is an antibiotic used for bacterial infections such as respiratory infections, skin infections, and certain STIs. When taking these medications together, you should follow the specific dosing instructions for each medication as prescribed by your healthcare provider. Terbinafine is typically taken once daily for 1-12 weeks depending on the infection type, while azithromycin is often prescribed as a 5-day course or sometimes as a single dose depending on the infection. Both medications can cause digestive side effects like nausea or stomach upset, so taking them with food may help reduce these effects. If you experience unusual side effects when taking these medications together, contact your healthcare provider. The medications work through different mechanisms - terbinafine inhibits fungal cell membrane formation while azithromycin prevents bacterial protein synthesis - which is why they don't typically interfere with each other's effectiveness 1. It's essential to note that while there are no significant interactions between terbinafine and azithromycin, other medications or health conditions may affect their use or efficacy, so it's crucial to inform your healthcare provider about all medications you're taking and any health conditions you have. In general, the most recent and highest quality study on the topic of medication interactions and effectiveness is prioritized, and in this case, the studies referenced support the safe co-administration of terbinafine and azithromycin 1. However, always consult with your healthcare provider before starting any new medication regimen, especially if you have concerns about potential interactions or side effects.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Drug Interactions
- Terbinafine and azithromycin can be taken together, but caution is advised due to potential interactions with other medications 2, 3.
- Terbinafine is associated with few interactions with other drugs, making it a suitable option for older and multimorbid patients 3.
- Azithromycin is considered unlikely to interact with warfarin, but close monitoring of INR is recommended when the agents are given together 4.
Specific Interactions
- Terbinafine does not affect the hepatic metabolism of cyclosporin, suggesting it is a safe systemic antifungal treatment for patients taking cyclosporin 5.
- Terbinafine can cause severe acute liver injury, although this is a rare complication, and liver function assessment is recommended before and during treatment 6.
Monitoring and Precautions
- When combining terbinafine with other medications, such as tricyclic antidepressants or selective serotonin reuptake inhibitors, clinical response and potential side effects must be monitored 3.
- The use of terbinafine with tamoxifen should be avoided due to the potential for diminished efficacy of tamoxifen 3.
- Close monitoring of INR is recommended when azithromycin is given with warfarin, and warfarin dosage adjustment may be necessary 4.