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Haldol Decanoate and Zithromax IV

Determining the interaction of Haldol Decanoate and Zithromax IV and the possibility of their joint administration.

Check result:
Haldol Decanoate <> Zithromax IV
Relevance: 20.11.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Using haloperidol together with azithromycin can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

MONITOR CLOSELY: Haloperidol can cause dose-related prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may result in additive effects and increased risk of ventricular arrhythmias including torsade de pointes and sudden death. Haloperidol treatment alone has been associated with a number of reported cases of torsade de pointes and sudden death. The majority of cases involved intravenous administration or use of higher than recommended dosages. In general, the risk of an individual agent or a combination of agents causing ventricular arrhythmia in association with QT prolongation is largely unpredictable but may be increased by certain underlying risk factors such as congenital long QT syndrome, cardiac disease, and electrolyte disturbances (e.g., hypokalemia, hypomagnesemia). The extent of drug-induced QT prolongation is dependent on the particular drug(s) involved and dosage(s) of the drug(s). In addition, certain agents with anticholinergic properties (e.g., sedating antihistamines; antispasmodics; neuroleptics; phenothiazines; skeletal muscle relaxants; tricyclic antidepressants) may have additive parasympatholytic and central nervous system-depressant effects when used in combination with haloperidol. Excessive parasympatholytic effects may include paralytic ileus, hyperthermia, mydriasis, blurred vision, tachycardia, urinary retention, psychosis, and seizures.

MANAGEMENT: Caution is recommended if haloperidol is used in combination with other drugs that can prolong the QT interval, particularly when administered intravenously or at higher than recommended dosages. Haloperidol is not approved by the FDA for intravenous administration. Patients should be advised to seek prompt medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitation, irregular heart rhythm, shortness of breath, or syncope. In addition, if combination therapy with agents with anticholinergic properties is required, caution is advised, particularly in the elderly and those with underlying organic brain disease. Patients should be advised to notify their physician promptly if they experience potential symptoms of anticholinergic intoxication such as abdominal pain, fever, heat intolerance, blurred vision, confusion, and/or hallucinations. Ambulatory patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them. A reduction in anticholinergic dosages may be necessary if excessive adverse effects develop.

References
  • "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical, Raritan, NJ.
  • Huyse F, van Schijndel RS "Haloperidol and cardiac arrest." Lancet 2 (1988): 568-9
  • Canadian Pharmacists Association "e-CPS. Available from: URL: http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink."
  • Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  • Cerner Multum, Inc. "Australian Product Information." O 0
  • O'Brien JM, Rockwood RP, Suh KI "Haloperidol-induced torsade de pointes." Ann Pharmacother 33 (1999): 1046-9
  • Hatta K, Takahashi T, Nakamura H, Yamashiro H, Asukai N, Matsuzaki I, Yonezawa Y "The association between intravenous haloperidol and prolonged QT interval." J Clin Psychopharmacol 21 (2001): 257-61
  • Wilt JL, Minnema AM, Johnson RF, Rosenblum AM "Torsade de pointes associated with the use of intravenous haloperidol." Ann Intern Med 119 (1993): 391-4
  • Metzger E, Friedman R "Prolongation of the corrected QT and torsades de pointes cardiac arrhythmia associated with intravenous haloperidol in the medically ill." J Clin Psychopharmacol 13 (1993): 128-32
  • EMA. European Medicines Agency. European Union "EMA - List of medicines under additional monitoring. Available from: URL: http://www.ema.europa.eu/ema/index.jsp?curl=pages/regulation/document_listing/document_listing_000366.jsp&mid=WC0b01ac058067c852" ([2013 - ]):
Haldol Decanoate

Generic Name: haloperidol

Brand name: Haldol, Haldol Decanoate

Synonyms: n.a.

Zithromax IV

Generic Name: azithromycin

Brand name: Zithromax, Zmax, AzaSite, Azithromycin 3 Day Dose Pack, Azithromycin 5 Day Dose Pack, Zithromax Tri-Pak, Zithromax Z-Pak, Zithromax IV

Synonyms: Zithromax

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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