Major
Probable
Description
Azithromycin and escitalopram each prolong the QT interval; co-administration meaningfully increases the risk of torsades de pointes.
Mécanisme
Both agents block cardiac hERG (IKr) channels; additive QTc prolongation may exceed the threshold for proarrhythmic risk.
Signification clinique
FDA QT safety communications exist for both agents independently; case reports link the combination to arrhythmic events.
Prise en charge
Avoid concurrent use when possible; if unavoidable, obtain ECG, correct hypokalemia/hypomagnesemia, and limit duration of azithromycin course.