500 mg PO once, then 250 mg once daily for 4 days 2 g extended release suspension PO once 500 mg IV as single dose for at least 2 days; follow with oral therapy with single dose of 500 mg to complete 7-10 days course of therapy Infection of pharynx, cervix, urethra, or rectum: Ceftriaxone 250 mg IM once plus azithromycin 1 g PO once (preferred) or alternatively doxycycline 100 mg PO q12hr for 7 days CDC STD guidelines: MMWR Recomm Rep. June 5, 20(RR3);1-137 Agitation Allergic reaction Anemia Anorexia Candidiasis Chest pain Conjunctivitis Constipation Dermatitis (fungal) Dizziness Eczema Edema Enteritis Facial edema Fatigue Gastritis Headache Hyperkinesia Hypotension Increased cough Insomnia Leukopenia Malaise Melena Mucositis Nervousness Oral candidiasis Pain Palpitations Pharyngitis Pleural effusion Pruritus Pseudomembranous colitis Rash Rhinitis Seizures Somnolence Urticaria Vertigo Anaphylaxis Angioedema Anorexia Bronchospasm Constipation Dermatologic reactions Dyspepsia Elevated liver enzymes Erythema multiforme Flatulence Oral candidiasis Pancreatitis Pseudomembranous colitis Pyloric stenosis, rare reports of tongue discoloration Stevens-Johnson syndrome Torsades de pointes Toxic epidermal necrolysis Vomiting/diarrhea, rarely resulting in dehydration Neutropenia Elevated bilirubin, AST, ALT, BUN, creatinine Alterations in potassium Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Use with caution in abnormal liver function, hepatitis, cholestatic jaundice, hepatic necrosis, and hepatic failure have been reported, some of which have resulted in death; discontinue azithromycin immediately if signs and symptoms of hepatitis occur Injection-site reactions can occur with IV route In treatment of gonorrhea or syphilis, perform susceptibility culture tests before initiating azithromycin therapy; may mask or delay symptoms of incubating gonorrhea or syphilis. Bacterial or fungal superinfection may result from prolonged use Prolonged QT interval: Cases of torsades de pointes have been reported during postmarketing surveillance; use with caution in patients with known QT prolongation, history of torsades de pointes, congenital long QT syndrome, bradyarrhythmias, or uncompensated heart failure; also use with caution if coadministering with drugs that prolong QT interval or proarrhythmic conditions (eg, hypokalemia, hypomagnesemia); elderly patients may be more susceptible to drug-associated effects on QT interval Pneumonia: PO azithromycin is safe and effective only for community-acquired pneumonia (CAP) due to C pneumoniae, H influenzae, M pneumoniae, or S pneumoniae Cases of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) reported; despite successful symptomatic treatment of allergic symptoms, when symptomatic therapy was discontinued, allergic symptoms recurred soon thereafter in some patients without further azithromycin exposure; if allergic reaction occurs, the drug should be discontinued and appropriate therapy instituted; physicians should be aware that allergic symptoms may reappear when symptomatic therapy discontinued Endocarditis prophylaxis: Indicated only for high-risk patients, per current AHA guidelines Use caution in renal impairment (Cr Cl Because of the low levels of azithromycin in breastmilk and use in infants in higher doses, it would not be expected to cause adverse effects in breastfed infants (Lact Med; https://nih.gov/newtoxnet/lactmed.htm) Binds to 50S ribosomal subunit of susceptible microorganisms and blocks dissociation of peptidyl t RNA from ribosomes, causing RNA-dependent protein synthesis to arrest; does not affect nucleic acid synthesis Concentrates in phagocytes and fibroblasts, as demonstrated by in vitro incubation techniques; in vivo studies suggest that concentration in phagocytes may contribute to drug distribution to inflamed tissues Y-site: Amikacin, aztreonam, cefotaxime, ceftazidime, ceftriaxone, cefuroxime, ciprofloxacin, clindamycin, droperidol, famotidine, fentanyl, furosemide, gentamicin, imipenem, cilastatin, ketorolac, levofloxacin, morphine, piperacillin-tazobactam, ondansetron(? ), potassium chloride, ticarcillin-clavulanate, tobramycin The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. [Posted 08/03/2018]AUDIENCE: Patient, Health Professional, Oncology ISSUE: The antibiotic azithromycin (Zithromax, Zmax) should not be given long-term to prevent a certain inflammatory lung condition in patients with cancers of the blood or lymph nodes who undergo a donor stem cell transplant. Results of a clinical trial found an increased rate of relapse in cancers affecting the blood and lymph nodes, including death, in these patients. We are reviewing additional data and will communicate our conclusions and recommendations when our review is complete. BACKGROUND: The serious lung condition for which long-term azithromycin was being studied called bronchiolitis obliterans syndrome is caused by inflammation and scarring in the airways of the lungs, resulting in severe shortness of breath and dry cough. Cancer patients who undergo stem cell transplants from donors are at risk for bronchiolitis obliterans syndrome. The manufacturer of brand name azithromycin is providing a Dear Healthcare Provider letter on this safety issue to health care professionals who care for patients undergoing donor stem cell transplants. Azithromycin is not approved for preventing bronchiolitis obliterans syndrome.
Dose advice How to use Zithromax. Before you take Zithromax. When you must not take it. Do not take Zithromax if you are allergic to Azithromycin;; Any other. Zithromax is a macrolide antibacterial drug indicated for the treatment of patients with mild to moderate infections caused by susceptible strains of the designated