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Can I Have Azithromycin Along With Flecainide?

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Posted on Tue, 5 May 2015
Question: Hi! I'm taking flecainide 50 wife a day for WPW syndrome. Can I take azithromycin?
thank you.
best regards
doctor
Answered by Dr. Ilir Sharka (2 hours later)
Brief Answer:
You need to discuss with your attendind physician about the best strategy.

Detailed Answer:
Hello! Thank you for asking on HCM! Regarding your concern I would like to explain that there exist a minor possibility of interaction between flecainide and azithromycin, when used concomitantly, leading to increased blood levels for both of the drugs. This may increase the potential for QT prolongation on ECG and predispose for life-threatening arrhythmia (such as torsades de pointes, VT). If azithromycine is highly preferred because of a specific indication (as guided by antibiogram), then careful attention should be paid during the concomitant use, checking frequently ECG, and possibly flecainide blood leve, or even lowering flecainide daily dose temporarily.
If a strong indication for azithromycin use doesn't exist, then other more safe profile drugs can be used (those antibiotics that are not metabolised by liver cytochrome P450 pathway, as flecainide does). You may try other antibiotics that do not interact with flecainide, such as doxycycline, cefuroxime, etc).
I would highly recommed you to discuss with your attending physician about the necessity of using azithromycine, and the possibility to change for another more safe antibiotics, or to build a careful scheduled work up strategy to prevent complication during azithromycin use.
Hope to have been helpful
Feel free to ask me whenever you nee. Greetings! Dr. Iliri
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Ilir Sharka (1 hour later)
Thank you very much, Dr. Sharka!
You gave me some good advices and I will talk certainly with my physician about alternative antibiotic therapy. Your words made me more quiet because I was so stressed about the perspective of trying azithromycine :) Where are you writing from?
Kindest regards from Italy
doctor
Answered by Dr. Ilir Sharka (8 hours later)
Brief Answer:
You are welcome!

Detailed Answer:

Hello again XXXXX!

I am glad to hear you feel more relaxed now.

Just ask me again, if you have any uncertainties!

Greetings from Tirana! Dr. Iliri


Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Ilir Sharka (17 hours later)
Hi, again. I have another question.
I asked to you about antibiotics because soon I have to do a tooth extraction.
I will take 1) tetracycline (my physician told me in the morning to try Bassado, doxiciclina iclato), 2) flecainide and 3) anesthesia without adrenalin. Are there any problem of interaction with this mix? If I will be nervous about surgery, can I take one pill of 4) etizolam?
Thank you very much for reply.
doctor
Answered by Dr. Ilir Sharka (11 hours later)
Brief Answer:
No dangerous interactions from that combination.

Detailed Answer:
Hello XXXXX!

As you are going through a tooth extraction procedure, which is performed with a local anesthesia, it doesn't seem to be a problem, since low doses of anesthetics are used in general.

Regarding etizolam, you can have it, till no medical records exist on potential serious interactions.

Wish you a good health! Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9545 Questions

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Can I Have Azithromycin Along With Flecainide?

Brief Answer: You need to discuss with your attendind physician about the best strategy. Detailed Answer: Hello! Thank you for asking on HCM! Regarding your concern I would like to explain that there exist a minor possibility of interaction between flecainide and azithromycin, when used concomitantly, leading to increased blood levels for both of the drugs. This may increase the potential for QT prolongation on ECG and predispose for life-threatening arrhythmia (such as torsades de pointes, VT). If azithromycine is highly preferred because of a specific indication (as guided by antibiogram), then careful attention should be paid during the concomitant use, checking frequently ECG, and possibly flecainide blood leve, or even lowering flecainide daily dose temporarily. If a strong indication for azithromycin use doesn't exist, then other more safe profile drugs can be used (those antibiotics that are not metabolised by liver cytochrome P450 pathway, as flecainide does). You may try other antibiotics that do not interact with flecainide, such as doxycycline, cefuroxime, etc). I would highly recommed you to discuss with your attending physician about the necessity of using azithromycine, and the possibility to change for another more safe antibiotics, or to build a careful scheduled work up strategy to prevent complication during azithromycin use. Hope to have been helpful Feel free to ask me whenever you nee. Greetings! Dr. Iliri