Quinidine; Quinine/Azithromycin; Erythromycin; Troleandomycin
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Medical warning:
Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Your antibiotic may slow down how quickly your liver processes quinidine or quinine.
What might happen:
The amount of quinidine or quinine in your blood may increase and cause serious side effects, such as an irregular heartbeat.
What you should do about this interaction:
Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Let your doctor know right away if you notice an irregular heartbeat or have any dizziness or fainting episodes.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
References:
1.Qualaquin (quinine sulfate) US prescribing information. AR Scientific, Inc. February, 2013.
2.Zhao XJ, Ishizaki T. A further interaction study of quinine with clinically important drugs by human liver microsomes: determinations of inhibition constant (Ki) and type of inhibition. Eur J Drug Metab Pharmacokinet 1999 Jul-Sep;24(3):272-8.
3.Zithromax (azithromycin oral) US prescribing information. Pifzer Labs February 19, 2013.
4.E.E.S. (erythromycin ethylsuccinate) US prescribing information. Arbor Pharmaceuticals, Inc. January, 2012.
5.Drew BJ, Ackerman MJ, Funk M, Gibler WB, Kligfield P, Menon V, Philippides GJ, Roden DM, Zareba W. Prevention of torsade de pointes in hospital settings: a scientific statement from the American Heart Association and the American College of Cardiology Foundation. J Am Coll Cardiol 2010 Mar 2;55(9):934-47.
6.Damkier P, Hansen LL, Brosen K. Effect of diclofenac, disulfiram, itraconazole, grapefruit juice and erythromycin on the pharmacokinetics of quinidine. Br J Clin Pharmacol 1999 Dec;48(6):829-38.
7.Lin JC, Quasny HA. QT prolongation and development of torsades de pointes with the concomitant administration of oral erythromycin base and quinidine. Pharmacotherapy 1997 May-Jun;17(3):626-30.
8.Spinler SA, Cheng JW, Kindwall KE, Charland SL. Possible inhibition of hepatic metabolism of quinidine by erythromycin. Clin Pharmacol Ther 1995 Jan;57(1):89-94.
