Moderate
Suspected
Description
Azithromycin inhibits CYP3A4-mediated aripiprazole metabolism, potentially increasing aripiprazole exposure; both drugs have modest QT-prolonging effects.
Mechanism
Azithromycin is a mild-to-moderate CYP3A4 inhibitor; aripiprazole is metabolized by CYP3A4 and CYP2D6; increased plasma levels and additive QT effects may result.
Clinical Significance
The QT prolongation risk is lower for aripiprazole than other antipsychotics, but the pharmacokinetic interaction can increase aripiprazole exposure meaningfully.
Management
Monitor for aripiprazole adverse effects (akathisia, sedation); an ECG is reasonable if prolonged co-administration is anticipated.