Azithromycin

💊 What is Azithromycin used for?

• •Acute bacterial exacerbations (flare-ups) of chronic bronchitis in adults
• •Acute bacterial sinusitis (sinus infection) in adults
• •Community-acquired pneumonia in adults and in children 6 months of age and older
• •Pharyngitis/tonsillitis (infected throat or tonsils) in adults and in children 2 years of age and older, used as an alternative to first-line therapy in people who cannot use first-line therapy
• •Uncomplicated skin and skin structure infections in adults
• •Urethritis and cervicitis (infections of the urethra or cervix) in adults
• •Genital ulcer disease (chancroid) in men
• •Acute otitis media (ear infections) in children 6 months of age and older

How it works

How it is usually taken

• •The label says azithromycin tablets can be taken with or without food.
• •The label says to take the medicine exactly as your healthcare provider tells you.
• •The label says not to skip doses or stop taking it early, even if you start to feel better, until you finish the prescribed treatment. The only exceptions it gives are a serious allergic reaction or a healthcare provider telling you to stop.
• •The label says that the length of treatment and the amount taken depend on the infection and on the patient, and that these are set by the prescriber. Follow the instructions from your prescriber or pharmacist.

Comes as

• •250 mg tablets (white to off-white, capsule-shaped, film-coated)
• •500 mg tablets (white to off-white, oval-shaped, film-coated)

⚠️ Azithromycin side effects

🛑 Who should not take Azithromycin, and who should be careful

The label says not to take it if

• 🚨The label says not to take azithromycin if you have had a severe allergic reaction to azithromycin, erythromycin, or any other macrolide or ketolide antibiotic.
• 🚨The label says not to take azithromycin if you have a history of cholestatic jaundice or liver dysfunction that happened with past use of azithromycin.

Tell your doctor before taking it if

• •Tell your provider if you have pneumonia, cystic fibrosis, or a bacterial infection in the blood (bacteremia).
• •Tell your provider if you have liver or kidney problems.
• •Tell your provider if you have an irregular heartbeat or QT prolongation.
• •Tell your provider if you have myasthenia gravis.
• •Tell your provider if you are pregnant or plan to become pregnant, or if you are breastfeeding or plan to breastfeed.
• •Tell your provider about all medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
• •The label notes that azithromycin should not be used in patients with pneumonia who are judged inappropriate for oral therapy because of moderate to severe illness or risk factors.
• •The label also notes that a study-based association with short-term acute cardiovascular death was seen in adults compared with some other antibacterial drugs. The label says prescribers should weigh this potential risk against the benefits.

🔀 Azithromycin with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Nelfinavir: the label says close monitoring for side effects such as liver enzyme changes and hearing problems is warranted. A dose adjustment is not recommended.
• •Warfarin (a blood thinner): the label says azithromycin may increase the effect of warfarin, and prothrombin times should be carefully monitored.
• •Digoxin, colchicine, and phenytoin: the label says interactions have not been reported in clinical trials, but careful monitoring is advised.
• •Aluminum- and magnesium-containing antacids: the label says patients should not take these at the same time as azithromycin.

Alcohol and food

The label says azithromycin can be taken with or without food. The label does not mention alcohol.

🤰 Azithromycin in pregnancy and breastfeeding

Pregnancy

The label says published data and experience over several decades have not identified drug-associated risks for major birth defects, miscarriage, or adverse outcomes with azithromycin use in pregnant women. The label also says it is not known whether azithromycin will harm an unborn baby, so pregnant patients should discuss this with their provider.

Breastfeeding

The label says azithromycin has been reported to pass into breast milk. Talk with your healthcare provider about the best way to feed your baby while you take it. Contact your provider right away if a young child under 6 weeks old vomits or becomes irritable when fed.

🗓️ Storage, missed doses and taking too much

Storage

The label says to store the tablets at 20 to 25 degrees C (68 to 77 degrees F), which is controlled room temperature.

If a dose is missed

The label does not give specific instructions for a missed dose. It says that skipping doses may decrease how well the treatment works and may increase the chance that bacteria become resistant. Ask your prescriber or pharmacist what to do.

If too much is taken

The label says that higher-than-recommended doses caused reactions similar to normal doses, mainly nausea, diarrhea, and vomiting. It says general symptom treatment and supportive measures are used as needed.

🗒️ Questions to ask about Azithromycin

• How long will I need to take azithromycin for my infection?
• Should I take it with food or on an empty stomach for my situation?
• What should I do if I miss a dose?
• Are any of my other medicines, including antacids or blood thinners, a concern with this medicine?
• Could this medicine affect my heart rhythm, given my health history?
• What signs of an allergic reaction or diarrhea should I watch for after I finish the medicine?
• Is it safe for me to breastfeed or to be pregnant while taking this medicine?

❓ Azithromycin: frequently asked questions