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Prednisone and azithromycin.The Efficacy of Prednisone and Azithromycin in the Treatment of Patients With Cat Scratch Disease
In our latest question and answer, our pharmacist discusses whether or not prednisone can safely be taken with azithromycin. I had COVID 6 days of moderate symptoms and was prescribed azithromycin, prednisone, famotidine, and fexofenadine, for allergies.
Can I take all these together? Also, is it better to wait and start prednisone after the Z-Pack since affects some antibiotics?
Don't want to decrease the effect of antibiotics. Answered by Dr. All the drugs you listed in your question azithromycin, prednisone, famotidine, and fexofenadine are considered safe to take together as there is no reported interaction between them.
I certainly understand your concern here with taking prednisone. Prednisone is the most commonly prescribed corticosteroid, and corticosteroids, as a class of drugs, are associated with immunosuppression , which is why you've probably heard not to take them with antibiotics since you are treating an infection with those. Additionally, several studies have noted that individuals taking corticosteroids consistently, at high doses to treat certain inflammatory conditions such as rheumatoid arthritis, Crohn's, and ulcerative colitis are more at risk for certain infections due to the immunosuppression prednisone causes, namely:.
Having said all this, the dose of prednisone you are taking and how long you are taking it is highly relevant. Although taking prednisone at any dose and duration can increase the risk of infection, generally, those who take high doses, consistently, are most at risk what a 'high dose' of prednisone is varies by source, but is generally around 40mg or more per day. Combining an antibiotic with prednisone for short-term treatment of a condition is really a question of if the positives outweigh the risks.
Azithromycin and prednisone are very commonly prescribed together for the short-term treatment of conditions like sinusitis and bronchitis since the benefit of therapy generally outweighs the risk of complications from the combination.
In fact, one of the most commonly prescribed combinations of medications used for the short-term treatment of sinus infections is a Medrol Dose Pack which contains methylprednisolone, a similar steroid to prednisone and a Z-Pak azithromycin. Several studies have published results showing preliminary positive benefits with short-term use of the combination:.
The point here is that, yes, there are concerns with taking a corticosteroid and how it can suppress the immune system, which increases the risk of infection. However, for many individuals, a short-term course, at a relatively low dose of a steroid, is considered safe, with the benefits outweighing the risk.
It is more commonly those that are taking steroids on a daily basis, or at high doses or both that we are more concerned about. So, overall, there is no specific interaction between azithromycin and prednisone, and the drugs don't interfere with one another. It's the conflict between immune suppression and treating an active infection that is the concern. As everyone's medical situation is different, I recommend talking to your doctor about what makes the most sense for you.
Brian has been practicing pharmacy for over 11 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Feel free to send him an email at Hello HelloPharmacist.
You can also connect with Dr. Brian Staiger on LinkedIn. I'm in a little bit of pain and want to take something for it. I'm always wary of medicine so prefer An abdominal ultra Facebook Email Twitter Copy Link. Question I had COVID 6 days of moderate symptoms and was prescribed azithromycin, prednisone, famotidine, and fexofenadine, for allergies.
Asked by Lane On Aug 13, Published Aug 16, Last updated Aug 16, Answer Thanks so much for reaching out to us and I hope that you are feeling better! You specifically mentioned azithromycin and prednisone, so I do want to focus on that part. Azithromycin With Prednisone I certainly understand your concern here with taking prednisone.
Additionally, several studies have noted that individuals taking corticosteroids consistently, at high doses to treat certain inflammatory conditions such as rheumatoid arthritis, Crohn's, and ulcerative colitis are more at risk for certain infections due to the immunosuppression prednisone causes, namely: Common viral infections e. Staphylococcus aureus Common fungal infections Candida species Having said all this, the dose of prednisone you are taking and how long you are taking it is highly relevant.
Several studies have published results showing preliminary positive benefits with short-term use of the combination: Current evidence suggests that oral corticosteroids as an adjunctive therapy to oral antibiotics are effective for short-term relief of symptoms in acute sinusitis The point here is that, yes, there are concerns with taking a corticosteroid and how it can suppress the immune system, which increases the risk of infection.
Final Words Thanks for your question and please feel free to reach back out in the future! Was this article helpful? About the Pharmacist Dr. Brian Staiger, PharmD Dr. Still Confused? Ask the pharmacist a question here! Recent Questions. Nov 17, We'll never share your email with anyone else. Submit Close.
❿Can You Take Steroids and Antibiotics Together?
- Can You Take Prednisone With Azithromycin? | HelloPharmacist
All corticosteroids, including prednisone, carry the risk of interacting with quinolone antibiotics levofloxacin, ciprofloxacin and causing a tendon tissue that connects muscle to bone to rupture. Mixing prednisone and penicillin antibiotics such as amoxicillin is considered safe, says Madison. Alcohol can increase your risk of side effects while on certain medications.
You should avoid alcohol while taking certain antibiotics such as Flagyl metronidazole , Tindamax tinidazole , and Bactrim sulfamethoxazole. The combo can result in nausea, vomiting, rapid heart rate, and headaches. There are no known interactions between alcohol and steroids such as prednisone but drinking large amounts of alcohol may increase your side effects, including an upset stomach. To be safe, avoid drinking while taking oral steroids or at the very least, limit your intake.
Every drug carries a risk of side effects, and steroids and antibiotics are no different. But in the case of these two drugs, the gastrointestinal side effects can be worse when combined. For example, common side effects of antibiotics are nausea, diarrhea, and upset stomach. Corticosteroids can also cause an upset stomach and cramping , as they irritate the stomach lining.
So in short, combining antibiotics and steroids may increase the risk of stomach issues. Call your doctor right away if you or your child have a rash, itching, hives, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after you take this medicine. Serious skin reactions, including Stevens-Johnson syndrome, acute generalized exanthematous pustulosis, toxic epidermal necrolysis, and drug reaction with eosinophilia and systemic symptoms DRESS can occur with this medicine.
Check with your doctor right away if you or your child have black, tarry stools, blistering, peeling, or loosening of the skin, chest pain, chills, cough, diarrhea, itching, joint or muscle pain, painful or difficult urination, red irritated eyes, red skin lesions, often with a purple center, sore throat, sores, ulcers, or white spots in the mouth or on the lips, swollen glands, unusual bleeding or bruising or unusual tiredness or weakness while you are using this medicine.
Check with your doctor right away if you or your child have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem. Call your child's doctor right away if your child feels irritable or vomits after feeding. These may be symptoms of a condition called infantile hypertrophic pyloric stenosis. Azithromycin may cause diarrhea, and in some cases it can be severe.
It may occur 2 months or more after you stop using this medicine. Do not take any medicine to treat diarrhea without first checking with your doctor. Diarrhea medicines may make the diarrhea worse or make it last longer. If you or your child have any questions about this or if mild diarrhea continues or gets worse, check with your doctor.
This medicine can cause changes in heart rhythms, including QT prolongation. It may change the way your heart beats and cause fainting or serious side effects in some patients. Contact your doctor right away if you or your child have any symptoms of heart rhythm problems, including fast, pounding, or irregular heartbeats. This medicine may increase the risk of serious heart or blood vessel problems.
Call your doctor right away if you have blurred vision, chest pain, confusion, lightheadedness, dizziness, fainting, fast or irregular heartbeat, trouble breathing, or unusual tiredness or weakness.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription over-the-counter [OTC] medicines and herbal or vitamin supplements.
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:. Other side effects not listed may also occur in some patients. All the drugs you listed in your question azithromycin, prednisone, famotidine, and fexofenadine are considered safe to take together as there is no reported interaction between them.
I certainly understand your concern here with taking prednisone. Prednisone is the most commonly prescribed corticosteroid, and corticosteroids, as a class of drugs, are associated with immunosuppression , which is why you've probably heard not to take them with antibiotics since you are treating an infection with those.
Additionally, several studies have noted that individuals taking corticosteroids consistently, at high doses to treat certain inflammatory conditions such as rheumatoid arthritis, Crohn's, and ulcerative colitis are more at risk for certain infections due to the immunosuppression prednisone causes, namely:.
Having said all this, the dose of prednisone you are taking and how long you are taking it is highly relevant. Although taking prednisone at any dose and duration can increase the risk of infection, generally, those who take high doses, consistently, are most at risk what a 'high dose' of prednisone is varies by source, but is generally around 40mg or more per day.
Combining an antibiotic with prednisone for short-term treatment of a condition is really a question of if the positives outweigh the risks. Azithromycin and prednisone are very commonly prescribed together for the short-term treatment of conditions like sinusitis and bronchitis since the benefit of therapy generally outweighs the risk of complications from the combination. In fact, one of the most commonly prescribed combinations of medications used for the short-term treatment of sinus infections is a Medrol Dose Pack which contains methylprednisolone, a similar steroid to prednisone and a Z-Pak azithromycin.
Several studies have published results showing preliminary positive benefits with short-term use of the combination:. The point here is that, yes, there are concerns with taking a corticosteroid and how it can suppress the immune system, which increases the risk of infection. However, for many individuals, a short-term course, at a relatively low dose of a steroid, is considered safe, with the benefits outweighing the risk.
Check it out and tell us what you think! Hide glossary Glossary Study record managers: refer to the Data Element Definitions if submitting registration or results information. Search for terms. Save this study. Warning You have reached the maximum number of saved studies The Efficacy of Prednisone and Azithromycin in the Treatment of Patients With Cat Scratch Disease The safety and scientific validity of this study is the responsibility of the study sponsor and investigators.
Listing a study does not mean it has been evaluated by the U. Federal Government. Read our disclaimer for details. Recruitment status was: Not yet recruiting First Posted : November 10, Last Update Posted : November 11, View this study on Beta.
Study Description. Corticosteroids may be effective in the treatment of CSD for the following reasons: Many experts believe that host response is involved in the pathogenesis of CSD and is responsible for the clinical manifestations rather than the direct effect of B. The absence of viable organisms in affected lymph nodes in the presence of positive PCR for B.
Corticosteroids have been anecdotally reported to have been administered to patients with CSD, apparently with some success. The purpose of this study is to evaluate the efficacy of corticosteroids in addition to azithromycin in CSD.
Drug information provided by: IBM Micromedex. Azithromycin is used to treat certain bacterial infections in many different parts of the body. This medicine may mask or delay the symptoms of syphilis. It is not effective against syphilis infections. Azithromycin belongs to the class of drugs known as macrolide antibiotics. It works by killing bacteria or preventing their growth. However, this medicine will not work for colds, flu, or other virus infections.
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make.
For this medicine, the following should be considered:. Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals.
For non-prescription products, read the label or package ingredients carefully. Appropriate studies have not been performed on the relationship of age to the effects of azithromycin to treat sinusitis in children or to treat pneumonia in children younger than 6 months of age.
Safety and efficacy have not been established. Appropriate studies have not been performed on the relationship of age to the effects of azithromycin oral suspension and tablets to treat pharyngitis or tonsillitis in children younger than 2 years of age.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of azithromycin in the elderly. However, elderly patients are more likely to have heart rhythm problems eg, torsades de pointes which may require caution in patients receiving azithromycin. There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below.
The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you.
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco. The presence of other medical problems may affect the use of this medicine.
Make sure you tell your doctor if you have any other medical problems, especially:. Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.
This medicine comes with a patient information leaflet. Read and follow the instructions carefully. Ask your doctor if you have any questions. Measure your dose correctly with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid. You or your child must take this medicine within 12 hours after it has been mixed with water. If your child does not use all of the medicine in the bottle, throw it away after you give the dose.
Keep using this medicine for the full treatment time, even if you or your child feel better after the first few doses. Your infection may not clear up if you stop using the medicine too soon. These medicines may keep azithromycin from working properly.
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine.
If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine.
Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.
Do not double doses. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
After water has been added to the powder, use the dose within 12 hours and throw away any unused liquid after your dose. Do not freeze the bottle. Do not keep the oral liquid for more than 10 days. Throw away any unused liquid after all doses are completed. It is very important that your doctor check the progress of you or your child at regular visits to make sure this medicine is working properly.
Blood and urine tests may be needed to check for unwanted effects. If you or your child's symptoms do not improve within a few days, or if they become worse, check with your doctor. This medicine may cause serious allergic reactions, including anaphylaxis and angioedema, which can be life-threatening and require immediate medical attention. Call your doctor right away if you or your child have a rash, itching, hives, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after you take this medicine.
Serious skin reactions, including Stevens-Johnson syndrome, acute generalized exanthematous pustulosis, toxic epidermal necrolysis, and drug reaction with eosinophilia and systemic symptoms DRESS can occur with this medicine. Check with your doctor right away if you or your child have black, tarry stools, blistering, peeling, or loosening of the skin, chest pain, chills, cough, diarrhea, itching, joint or muscle pain, painful or difficult urination, red irritated eyes, red skin lesions, often with a purple center, sore throat, sores, ulcers, or white spots in the mouth or on the lips, swollen glands, unusual bleeding or bruising or unusual tiredness or weakness while you are using this medicine.
Check with your doctor right away if you or your child have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin.
These could be symptoms of a serious liver problem. Call your child's doctor right away if your child feels irritable or vomits after feeding. These may be symptoms of a condition called infantile hypertrophic pyloric stenosis. Azithromycin may cause diarrhea, and in some cases it can be severe. It may occur 2 months or more after you stop using this medicine.
Do not take any medicine to treat diarrhea without first checking with your doctor. Diarrhea medicines may make the diarrhea worse or make it last longer. If you or your child have any questions about this or if mild diarrhea continues or gets worse, check with your doctor. This medicine can cause changes in heart rhythms, including QT prolongation. It may change the way your heart beats and cause fainting or serious side effects in some patients.
Contact your doctor right away if you or your child have any symptoms of heart rhythm problems, including fast, pounding, or irregular heartbeats. This medicine may increase the risk of serious heart or blood vessel problems. Call your doctor right away if you have blurred vision, chest pain, confusion, lightheadedness, dizziness, fainting, fast or irregular heartbeat, trouble breathing, or unusual tiredness or weakness.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription over-the-counter [OTC] medicines and herbal or vitamin supplements.
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:.
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below.
Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission. Mayo Clinic does not endorse any of the third party products and services advertised. A single copy of these materials may be reprinted for noncommercial personal use only.
The purpose of this study is to evaluate the efficacy of corticosteroids in addition to azithromycin in CSD. The study hypothesis is that corticosteroids will. Prednisone, a corticosteroid, can suppress the immune system and. the drugs in the study (prednisone, azithromycin or hydroxychloroquine). 1) or standard outpatient treatment plus prednisone (group 2). Glucocorticoids and azithromycin are drugs that may be effective in the treatment. the corticosteroids and azithromycin stand out. No interactions were found between azithromycin and prednisone. However, this does not necessarily mean no interactions exist. Search for terms. Can the steroid enhance the antibiotic? Patients for whom azithromycin or corticosteroids is contra-indicated. Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission.In low doses, steroids can help ease joint pain from your RA. When taking a steroid, though, you need to be cautious about combining it with other medications, like antibiotics. Many people wonder: Is it okay to take antibiotics with steroids? Can the steroid enhance the antibiotic? We asked top medical experts to set the record straight about taking steroids and antibiotics together.
Steroids also known as corticosteroids are medications that decrease inflammation in the body. Doctors often prescribe them to treat joint inflammation and swelling, like that which results from RA. Steroids are also used to treat allergic reactions, help with breathing conditions such as asthma, and calm an overactive immune system in people with autoimmune diseases such as lupus and RA, where the immune system mistakenly attacks healthy tissue.
Some common types of oral corticosteroids are prednisone, methylprednisolone, dexamethasone, and cortisone. Antibiotics work a bit differently. So, for example, you might take an antibiotic to fight an infection such as strep throat, an ear infection, or a sinus infection. There are many different classes and types of antibiotics; talk with your doctor about the right one for you. The answer to this question depends on the specific steroid, antibiotic, and the infection—but yes, in some cases, your physician may prescribe both drugs at the same time.
The antibiotic targets bacteria and the steroid controls inflammation and resulting pain. For example, the steroid dexamethasone has proven effective in adults with bacterial meningitis, according to a study in The New England Journal of Medicine. The two are also often prescribed together for certain infections.
Still, there are some potential interactions you should be aware of when taking both oral steroids and antibiotics. Here are common ones to be mindful of. Always talk with your provider if you are unsure about drug interactions or have follow-up questions. There is a potential interaction between dexamethasone, a type of steroid, and certain antibiotics. The antibiotic erythromycin can raise the amount of dexamethasone in your system, increasing your risk of side effects. All corticosteroids, including prednisone, carry the risk of interacting with quinolone antibiotics levofloxacin, ciprofloxacin and causing a tendon tissue that connects muscle to bone to rupture.
Mixing prednisone and penicillin antibiotics such as amoxicillin is considered safe, says Madison. Alcohol can increase your risk of side effects while on certain medications. You should avoid alcohol while taking certain antibiotics such as Flagyl metronidazole , Tindamax tinidazole , and Bactrim sulfamethoxazole.
The combo can result in nausea, vomiting, rapid heart rate, and headaches. There are no known interactions between alcohol and steroids such as prednisone but drinking large amounts of alcohol may increase your side effects, including an upset stomach.
To be safe, avoid drinking while taking oral steroids or at the very least, limit your intake. Every drug carries a risk of side effects, and steroids and antibiotics are no different. But in the case of these two drugs, the gastrointestinal side effects can be worse when combined.
For example, common side effects of antibiotics are nausea, diarrhea, and upset stomach. Corticosteroids can also cause an upset stomach and cramping , as they irritate the stomach lining. So in short, combining antibiotics and steroids may increase the risk of stomach issues.
This is meant to speed up your healing. Some research has suggested that the two medications work better together than either one alone in treating certain infections. For example, a recent review found that corticosteroids and antibiotics were more effective together in treating bacterial meningitis. Research on mice has also shown that taking steroids and antibiotics together improved recovery time for those with pneumonia.
Steroids, Antibiotics, and Meningitis: Plos One. Prednisone Uses and Interactions: MedlinePlus. Alcohol and Antibiotics: Mayo Clinic. Krista Bennett DeMaio has well over a decade of editorial experience. The former magazine-editor-turned-freelance writer regularly covers skincare, health, beauty, and lifestyle topics. Her work has appeared in national more.
What can we help you find? Rheumatoid Arthritis. Research suggests the two might work better together to fight certain infections. May 23, Medical Reviewer. What to Read Next. Start Survey.
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