Azithromycin ( Zithromax ) tablets

Azithromycin is the generic name for a prescription drug available as Zithromax, Zmax, and Z-Pak.
The drug is an antibiotic used to treat a variety of bacterial infections, such as cat-scratch disease, ear infections, infections of the skin or surrounding tissue, and throat or tonsil infections.
Azithromycin is also used to treat lung and other respiratory infections, such as bronchitis, sinusitis, community acquired pneumonia, some cases of chronic obstructive pulmonary disease (COPD), and whooping cough (pertussis).
Doctors may also prescribe azithromycin for genital infections and sexually transmitted diseases, such as gonorrhea, infections of the urethra or cervix, genital ulcers, and severe pelvic inflammatory disease.
Azithromycin belongs to group of drugs known as macrolide antibiotics. They work by preventing bacteria from making their own proteins.
As with other antibiotics, to prevent the spread of drug-resistant infections, the Food and Drug Administration (FDA) strongly advises doctors to prescribe the drug only when there is proof, or a strong suspicion, that the infection is caused by bacteria against which azithromycin is effective.
The FDA first approved azithromycin under the brand name Zithromax in 1991. Pfizer Pharmaceuticals manufactures the drug.

Azithromycin Warnings

Azithromycin can cause abnormal changes in the electrical activity of the heart, which may lead to deadly irregular heart rhythm, according to a special warning by the FDA in 2012.
If you have a heart-rhythm condition, such as a slow or irregular heartbeat, or take drugs to treat these conditions, you should talk to your doctor about it before taking azithromycin.
Your doctor also should make sure you have normal blood levels of potassium and magnesium before prescribing azithromycin.
In addition, you should not take azithromycin if you:

• Are allergic to azithromycin or any of its inactive ingredients
• Have a form of jaundice known as cholestatic jaundice, in which bile backs up into the liver and causes a yellowing of the skin, eyes, or nails
• Are taking pimozide (Orap)

Before taking azithromycin, talk to your doctor if you:

• Have an irregular or slow heartbeat
• Have liver problems, including hepatitis
• Very severe kidney problems
• Have myasthenia gravis

Before taking azithromycin for gonorrhea or syphilis, you should be tested to find out whether the bacteria causing the infection will actually respond to azithromycin.
People who take azithromycin for long periods of time are more prone to developing very serious bacterial or fungal infections that may be much more difficult to treat.

Pregnancy and Azithromycin

Azithromycin is generally safe to take while pregnant.
Regardless, you should tell your doctor if you are pregnant or plan to become pregnant before taking this medication.
Whether azithromycin is found in breast milk remains unknown. Talk to you doctor if you are breastfeeding or plan to breastfeed before taking azithromycin.

Azithromycin Side Effects

Common Side Effects of Azithromycin

Many people experience fewer side effects when taking azithromycin compared with other antibiotics in the macrolide class, such as erythromycin (Erythrocin).
However, you may still experience side effects, especially if your doctor prescribed a high dose of azithromycin to be taken just one time. Tell your doctor if you experience any of the following:

• Nausea
• Vomiting
• Diarrhea
• Gas
• Loose stools
• Stomach discomfort

Some people may also experience cramps and yeast or vaginal infection.

Serious Side Effects

Get emergency medical help right away if you experience any of the following:

• Chest pain
• Seizures
• Swelling of the feet or ankles
• Inflammation of the colon (symptoms may include abdominal pain, severe diarrhea, fatigue)
• Fluid build-up between the lungs and the chest wall (symptoms may include chest pain or heaviness, or difficulty breathing difficulties)
• Low count of white blood cells (this is usually discovered in blood tests, but if you have symptoms, they may include weakness, tiredness, shortness of breath, or infections that do not go away)

Azithromycin Interactions

It is always important to share with your doctor and pharmacist all of the medications you are taking.
This includes not only all of your prescription medicine, but also products that may not seem like medication, such as over-the-counter drugs, vitamins and other dietary supplements (nutritional shakes, protein powders, etc.), and herbals along with any legal or illegal recreational drugs.
You should not take Azithromycin if you are taking

• Pimozide (Orap)
• BCG live (Theracrys)
• Dronedarone (Multaq)

Talk to your doctor about the possibility of prescribing a different antibiotic than azithromycin if you are taking any of the following drugs:

• Blood thinners like enoxaparin (Lovenox), fondaparinux (Arixta), heparin, warfarin (Coumadin or Jantoven)
• Medications used to prevent blood clots, for instance during or after surgery or in life-threatening situations: antithrombin III (Thrombin), bivalirudin (Angiomax), dalteparin (Fragmin)
• Amiodarone (Cordarone, Pacerone, or Nextarone)
• Digoxin (Lanoxin)
• Live typhoid vaccine (Vivotif)
• Quinidine

Azithromycin and Alcohol

Alcohol may increase or worsen certain side effects caused by azithromycin, such as dizziness and upset stomach.

Azithromycin and Grapefruit Juice

Grapefruit and azithromycin are both broken down the same way by the liver, so interactions are possible, although they are thought to be uncommon.
To be safe, avoid all grapefruit products while taking this drug.

Azithromycin Dosage

Azithromycin is taken as a pill or liquid. It's also given as intravenous (IV) injection in hospitals. Packets of powder are mixed with water to create the liquid solution.
Azithromycin may be taken with or without food.
Doctors sometimes prescribe azithromycin for shorter periods than they do for other antibiotics, such as in a one-day "mega-dose," or for three or five days, using the Z-Pak, which starts at a higher dose than longer regimens.
The dosage and length of time for azithromycin treatment vary according to the type of infection:

• Infections of the skin and skin tissues: One dose of 500 milligrams (mg), then 250 mg per day for four days
• Infection of the throat and tonsils: One dose of 500 mg; then 250 mg per day for four days
• Community Acquired Pneumonia (CAP): One dose of 500 mg, then 250 mg per day for four days
• Genital Ulcer Disease: 1 gram (g), one time
• Sinus infections caused by bacteria: 500 mg a day for three days or 2 g as a one-time dose

Azithromycin Overdose

If you suspect an overdose, you should contact a poison-control center or emergency room immediately.
You can get in touch with a poison control center at (800) 222-1222.

Missed Dose of Azithromycin

If you miss a dose of Azithromycin, try to take it as soon as you remember, unless it is almost time for the next dose.
Then skip the missed dose and take your next dose at the regular time.
Do not take two doses of the medication at the same time.