Zithromax

1 What is Zithromax?

Brand: Zithromax, Zithromax Tri-Pak, Zithromax Z-Pak, Zmax

Generic: Azithromycin

Zithromax is a macrolide antibiotic that is used to treat bacterial infections. This medicine works by killing the bacteria and inhibiting bacterial growth.

Zithromax may mask or delay the symptoms of syphilis. It is not effective against syphilis infections. This product is available in:

  • tablet
  • capsule
  • powder for suspension

2 What to Know Before Using

Before using Zithromax, you must know all about the risks and complications associated with it. Tell to your doctor if you are allergic to Zithromax or to any other medications. You should also inform your healthcare providers if you are allergic to foods, dyes, or animals.

Safety and effectiveness have not been established for the treatment of sinusitis in children younger than 6 months of age. In addition, 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.

Although this medicine has not demonstrated geriatric-specific problems, older patients are more likely to have heart rhythm problems, which may require caution in patients receiving this medicine.

Pregnancy category B - No risks have been found in humans. This medication poses minimal risk to the infant when used during breastfeeding.

Taking this medicine with any of the following medicines is not recommended and you may not be required to receive this medication. Otherwise, alternative medicine may be prescribed for your other medications.

  • Amifampridine
  • Bepridil
  • Cisapride
  • Colchicine
  • Dihydroergotamine
  • Dronedarone
  • Ergoloid Mesylates
  • Ergonovine
  • Ergotamine
  • Methylergonovine
  • Methysergide
  • Pimozide
  • Piperaquine
  • Saquinavir
  • Sparfloxacin
  • Terfenadine
  • Thioridazine
  • Ziprasidone

Taking this medicine with any of the following medicines is usually not recommended, but with the exception in some cases. Dosage or frequency of one or both of your medicines may be changed if both medicines are prescribed together.

  • Acecainide
  • Afatinib
  • Alfuzosin
  • Amiodarone
  • Amitriptyline
  • Amoxapine
  • Anagrelide
  • Apixaban
  • Apomorphine
  • Aripiprazole
  • Arsenic Trioxide
  • Asenapine
  • Astemizole
  • Azimilide
  • Bretylium
  • Buserelin
  • Chloroquine
  • Chlorpromazine
  • Ciprofloxacin
  • Citalopram
  • Clarithromycin
  • Clomipramine
  • Clozapine
  • Crizotinib
  • Dabrafenib
  • Dasabuvir
  • Dasatinib
  • Degarelix
  • Delamanid
  • Desipramine
  • Deslorelin
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Domperidone
  • Donepezil
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Droperidol
  • Erythromycin
  • Escitalopram
  • Fingolimod
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Gatifloxacin
  • Gemifloxacin
  • Gonadorelin
  • Goserelin
  • Granisetron
  • Halofantrine
  • Haloperidol
  • Histrelin
  • Hydroxychloroquine
  • Ibutilide
  • Iloperidone
  • Imipramine
  • Ivabradine
  • Ketoconazole
  • Lapatinib
  • Leuprolide
  • Levofloxacin
  • Lopinavir
  • Lumefantrine
  • Mefloquine
  • Methadone
  • Metronidazole
  • Mifepristone
  • Morphine
  • Morphine Sulfate Liposome
  • Moxifloxacin
  • Nafarelin
  • Nilotinib
  • Norfloxacin
  • Nortriptyline
  • Octreotide
  • Ofloxacin
  • Ondansetron
  • Paliperidone
  • Panobinostat
  • Paritaprevir
  • Pasireotide
  • Pazopanib
  • Perflutren Lipid Microsphere
  • Pixantrone
  • Posaconazole
  • Procainamide
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Protriptyline
  • Quetiapine
  • Quinidine
  • Quinine
  • Ranolazine
  • Romidepsin
  • Salmeterol
  • Sematilide
  • Sevoflurane
  • Simvastatin
  • Sodium Phosphate
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate, Monobasic
  • Solifenacin
  • Sorafenib
  • Sotalol
  • Sunitinib
  • Tacrolimus
  • Tedisamil
  • Telithromycin
  • Tetrabenazine
  • Topotecan
  • Toremifene
  • Trazodone
  • Trifluoperazine
  • Trimipramine
  • Triptorelin
  • Vandetanib
  • Vardenafil
  • Vemurafenib
  • Vincristine
  • Vincristine Sulfate Liposome
  • Vinflunine
  • Voriconazole
  • Warfarin

Taking this medicine with any of the following medications may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. Your doctor may change the dose or how often you use one or both of the medicines if both medicines are prescribed together.

  • Atorvastatin
  • Digoxin
  • Fentanyl
  • Lovastatin
  • Nelfinavir
  • Rifabutin
  • Theophylline

Some medical conditions can interact with this medication.

Tell your doctor if you have any of the following conditions:

  • Allergy to any macrolide and ketolide antibiotic - should not be used in patients with this condition.
  • Weakened physical condition — Zithromax® should not be used in patients with these conditions to treat pneumonia.
  • Hypomagnesemia - use is not recommended in patients with these conditions.
  • Bacteremia
  • Cystic fibrosis
  • Infections, nosocomial or hospital-acquired
  • Weak immune system
  • Bradycardia
  • Hypokalemia
  • Congestive heart failure
  • Diarrhea
  • Heart disease
  • Heart rhythm problems
  • Myasthenia gravis
  • Kidney disease
  • Liver disease

3 Proper Usage

To use Zithromax properly, you must follow all instructions given by your doctor. Excessive use of medication is not recommended. This medicine may be taken with or without food.

If you are using the Zithromax® oral liquid, shake the bottle well and pour it into a measuring spoon or cup before taking it.

The extended-release oral liquid is best to take the extended-release oral liquid on an empty stomach or at least 1 hour before or 2 hours after a meal. You should measure it in a measuring spoon, syringes, or cup. You or your child must take this medicine within 12 hours after it has been mixed with water.

Call your doctor immediately if you or your child vomits within one hour of taking the extended-release oral liquid to ask how much medicine is needed to be taken again.

Continue using this medication for the full time of treatment. Do not stop using this medication unless your doctor told you to do so.

Tell your doctor if you are currently taking aluminum or magnesium-containing antacids. These medicines may keep azithromycin from working properly.

Recommended dosage for treatment of pneumonia using extended-release suspension:

  • Adults—2 grams once as a single dose.
  • Children weighing 75 pounds (34 kg) or more—2 g once as a single dose.
  • Children and infants 6 months of age and older weighing less than 75 pounds (34 kg)—Dose is based on body weight and must be determined by your doctor. The dose is usually 60 milligrams per kilogram of body weight once as a single dose.

Recommended dosage for treatment of sinusitis using extended-release suspension:

  • Adults—2 grams once a day as a single dose.
  • Children—Use and dose must be determined by your doctor.

Recommended dosage for treatment of infections using suspension or tablets:

  • Adults—500 to 2000 milligrams once a day, taken as a single dose. Depending on the type of infection, this may be followed with doses of 250 to 500 mg once a day for several days.
  • Children and infants 6 months of age and older—Dose is based on body weight and must be determined by your doctor. The dose is usually 10 to 30 milligrams per kilogram of body weight once a day, taken as a single dose. Depending on the type of infection, this may be followed with doses of 5 to 10 mg/kg of body weight once a day for several days.
  • Infants younger than 6 months of age—Use and dose must be determined by your doctor.

Recommended dosage for treatment of pharyngitis or tonsillitis using suspension or tablets:

  • Adults—500 milligrams on Day1, taken as a single dose. Then, 250 mg on Day 2 through Day 5.
  • Children 2 years of age and older—Dose is based on body weight and must be determined by your doctor. The dose is usually 12 milligrams per kilogram of body weight once a day for 5 days.
  • Children younger than 2 years of age—Use and dose must be determined by your doctor.

If you miss a dose of this medicine, skip the missed dose and start again to your regular dosing schedule. Do not take a double dose to make up for a missed one.

Store the medication in a closed container at room temperature, away from heat, moisture, and direct light. Keep out of reach of children. Do not keep expired medications. Do not keep the oral liquid for more than 10 days.

Extended-release oral liquid should not be refrigerated. Once the water has been added to the powder, use the dose within 12 hours and throw away any unused liquid after your dose.

4 Precautions to Take

Before using Zithromax, there are some precautions you must take. Your doctor will be checking you regularly for the effectiveness of the medication. Blood tests may be ordered as well for undesirable effects.

Check with your doctor with you or your child’s symptoms did not improve or have worsened within a few days. Check with your doctor immediately if you have developed any signs of allergic reactions or serious skin reactions.

Discontinue this medication and check with your doctor immediately 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
  • yellow eyes or skin

These could be symptoms of a serious liver problem. Azithromycin injection may cause diarrhea and it may occur 2 months or more after you stop taking this medicine. Check first with your doctor before taking any antidiarrheal medicine.

Azithromycin injection may cause changes in heart rhythms, such as a condition called QT prolongation. Check with your doctor immediately if you have any symptoms of heart rhythm problems, such as fast, pounding, or irregular heartbeats. Talk to your doctor if you are planning to take any other medication.

5 Potential Side Effects

Make sure you meet with your doctor in using Zithromax to avoid unwanted potential side effects.

If any of the following side effects occur, check with your doctor right away:

  • Diarrhea
  • Loose stools
  • Blistering, crusting, irritation, itching, or reddening of the skin
  • Cracked, dry, or scaly skin
  • Fever
  • Swelling
  • Abdominal or stomach pain
  • Blistering, peeling or loosening of the skin
  • Bloody or cloudy urine
  • Bloody, black, or tarry stools
  • Body aches or pain
  • Burning while urinating
  • Chest pain
  • Chills
  • Congestion
  • Cough increased
  • A cough producing mucus
  • Dark urine
  • Difficult or labored breathing
  • Difficult or painful urination
  • Dizziness
  • Drowsiness
  • Dryness or soreness of the throat
  • Earache
  • Fainting
  • Fast, irregular, pounding or racing heartbeat or pulse
  • General feeling of discomfort or illness
  • General feeling of tiredness or weakness
  • Headache
  • Indigestion
  • Irregular or slow heart rate
  • Itching
  • Joint or muscle pain
  • Large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • Light-colored stools
  • Loss of appetite
  • Muscle aches and pains
  • Nausea or vomiting
  • Noisy breathing
  • Passing of gas
  • Rash
  • Red skin lesions, often with a purple center
  • Red, irritated eyes
  • Redness or swelling in the ear
  • Runny nose
  • Shivering
  • Shortness of breath
  • Sneezing
  • Sores, ulcers, or white spots on the lips or in the mouth
  • Stomach pain, continuing
  • Stomach pain, fullness, or discomfort
  • Stuffy nose
  • Sweating
  • Swelling of the face, ankles, hands, feet, or lower legs
  • Tender, swollen glands in the neck
  • Tightness in the chest
  • Trouble with sleeping
  • Trouble with swallowing
  • Unpleasant breath odor
  • Unusual bleeding or bruising
  • Unusual tiredness or weakness
  • Upper right abdominal or stomach pain
  • Voice changes
  • Vomiting of blood
  • Wheezing
  • Yellow eyes or skin
  • Abdominal or stomach cramps or tenderness
  • Bleeding gums
  • Bloating
  • Blood in the urine or stools
  • Blurred vision
  • Change in hearing
  • Clay-colored stools
  • Coma
  • Confusion
  • Constipation
  • Continuing ringing or buzzing or other unexplained noise in the ears
  • Decreased urine output
  • Depression
  • Diarrhea, watery and severe, which may also be bloody
  • Dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • Fainting
  • Greatly decreased frequency of urination or amount of urine
  • Hives
  • Hostility
  • Increased thirst
  • Irritability
  • Lethargy
  • Loss of hearing
  • Lower back or side pain
  • Muscle twitching
  • Pains in the stomach, side, or abdomen, possibly radiating to the back
  • Pale skin
  • Pinpoint red spots on the skin
  • Puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • Rapid weight gain
  • Seizures
  • Stupor
  • Unusual weight loss

Less serious side effects:

  • Acid or sour stomach
  • Aggressive or angry
  • Bad, unusual, or unpleasant (after) taste
  • Belching
  • Burning feeling in the chest or stomach
  • Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • Change in taste
  • Changes in the color of the tongue
  • Crying
  • Depersonalization
  • Dry mouth
  • Dysphoria
  • Euphoria
  • Excess air or gas in the stomach or intestines
  • Feeling of constant movement of self or surroundings
  • Full feeling
  • Heartburn
  • Hyperventilation
  • Increase in body movements
  • Itching of the vagina or genital area
  • Lack or loss of strength
  • Mental depression
  • Nervousness
  • Pain during sexual intercourse
  • Paranoia
  • Quick to react or overreact emotionally
  • Rapidly changing moods
  • Rash with flat lesions or small raised lesions on the skin
  • Redness of the skin
  • Restlessness
  • Sensation of spinning
  • Shaking
  • Shortness of breath
  • Sleepiness or unusual drowsiness
  • Sleeplessness
  • Sore mouth or tongue
  • Stomach upset
  • Thick, white vaginal discharge with no odor or with a mild odor
  • Unable to sleep
  • White patches in the mouth, tongue, or throat
  • Difficulty with moving
  • Fear or nervousness
  • Increased sensitivity of the skin to sunlight
  • Muscle pain or stiffness
  • Pain in the joints
  • Redness or other discoloration of the skin
  • Severe sunburn
  • Trouble sitting still

Not all side effects are listed above. If you notice any other effects, check with your healthcare professional.

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