Azithromycin

Azithromycin, an FDA-approved antibiotic belonging to the macrolide class, contains Azithromycin Dihydrate. It effectively treats respiratory, skin, and ear infections, along with certain sexually transmitted diseases caused by bacteria. Available in tablet, capsule, and suspension forms, doses typically range from 250mg to 600mg, varying based on infection severity and patient condition. Medical instructions must be followed exactly, Whether orally administered, with or without food. You should seek medical attention if you suffer from severe side effects like vomiting, nausea, diarrhea, or headaches. Avoiding alcohol and potential drug interactions is crucial. Missed doses should be taken promptly, except near the next scheduled dose. Store at room temperature, away from moisture and light, and keep out of children’s reach. Consulting healthcare providers for personalized advice on Azithromycin usage is recommended.

Azithromycin is an antibiotic medication approved by the FDA for treating various bacterial infections. It belongs to the class of drugs known as macrolide antibiotics and contains the active ingredient Azithromycin Dihydrate. It is typically recommended to treat infections like respiratory tract infections, ear infections, skin infections, and particularly sexually transmitted diseases caused by bacteria.

Azithromycin is available in several forms, such as tablets, capsules, oral suspension, and extended-release suspension. It has different strengths, typically ranging from 250 to 600mg per dose. It is usually taken orally, with or without food, as directed by a healthcare professional.

Common side effects of Azithromycin are vomiting, nausea, diarrhea, abdominal pain, and headache. Patients are advised to report any severe or persistent side effects to their healthcare provider. It is crucial to follow all precautions provided with the medication, including avoiding alcohol and certain medications that may interact with Azithromycin.

Unless it is almost time for the next scheduled dose, a missed dose should be taken as soon as remembered. Overdoses should be treated immediately. Azithromycin capsules should be kept in a cool place, away from moisture and light, and out of reach of children. It is always recommended to discuss with your healthcare provider regarding Azithromycin.

It is commonly used for the following infections caused by certain bacteria.

• Infections of the lungs (bronchitis, pneumonia)
• Infections of the throat (pharyngitis, tonsillitis)
• A sinus infection
• Infections of the skin
• Children’s ear infections
• Infections transmitted through sexual contact
• Female reproductive organ infections like pelvic inflammatory disease (PID)
• HIV/AIDS-related infections

It comes in the following forms and strengths:

Form 1: Tablets

Strengths: 250 mg, 500 mg

Form 2: Capsules

Strengths: 250 mg, 500 mg

Form 3: Oral Suspension

Strengths: 100 mg or 200 mg per 5 mL.

Form 4: Extended-Release Suspension

Strength: A single dose of 2000 mg

Form 5: Injection

Strength: 10 mL vial with 500 mg of Azithromycin

Recommended Dosage for Different Patients

Dosage for Legionella Pneumonia

• Adults: The initial IV therapy is 500 mg once daily for at least 2 days, followed by 500 mg orally once daily for 7 to 10 days. A dose of 500 mg is administered orally on the first day, followed by 250 mg once per day on the second day through 5.
• Pediatric Patients: For children 6 months and older, take 10 mg/kg orally once on the first day, followed by 5 mg/kg once a day on days 2-5

Dosage for Mycoplasma Pneumonia

• For Adults: The initial IV therapy is 500 mg once daily for at least 2 days, then 500 mg orally once daily for 7 to 10 days. A dose of 500 mg is administered orally on the first day, followed by 250 mg once daily on the second day through 5.
• For Pediatric Patients: Those 6 months and older should receive 10 mg/kg orally once on the first day then take 5 mg per kg once daily for five days.

Dosage for Pneumonia

• For Adults: The initial IV therapy is 500 mg once daily for at least 2 days, then 500 mg once daily for 7 to 10 days. A dose of 500 mg is administered orally on the first day, then 250 mg once daily on the second day through 5.
• For Pediatric Patients: For children 6 months and older, take 10 mg/kg orally once on the first day, followed by 5 mg/kg once a day on days 2-5

Dosage for Tonsillitis/Pharyngitis

• For Adults: A single dose of 500 mg orally is recommended on the first day, then 250 mg once per day on days 2-5.
• For Pediatric Patients: For children 2 years of age and older, take 12 mg/kg once a day for five days.

Dosage for Sinusitis

• For Adults: The typically recommended dose is 500 mg orally once daily for 3 days.
• For Pediatric Patients: When the child is 6 months or older, 10 mg/kg must be taken three times daily

Dosage for Skin and Structure Infection (Cat Scratch Disease)

• For Adults: On day 1, 500 mg should be taken orally as a single dose, followed by 250 mg once a day on days 2-5.
• For Pediatric Patients: On day 1, 10 mg/kg should be taken orally, followed by 5 mg/kg every day for four more days if the weight is less than 45 kg.

Dosage for Bartonellosis

• For Adults: The first dose is 500 mg taken orally as a single dose, followed by 250 mg once daily from days 2 to 5.
• Pediatric Patients: On day 1, 10 mg/kg should be taken orally, followed by 5 mg/kg every day for four more days if the weight is less than 45 kg.

Dosage for Gonococcal Infection – Uncomplicated

• For Adults: A single dose of 2 g should be taken orally.
• Pediatric Patients: A single dose of 2 g should be given to adolescents

Dosage for Nongonococcal Urethritis

• For Adults: A single dose of 1 g should be taken orally.

Dosage for Chlamydia Infection

• For Adults: A single dose of 1 g should be taken orally.
• Pediatric Patients: The recommended dose for adolescents is 1 g taken orally once daily.

Dosage for Cervicitis

• For Adults: A single dose of 1 g should be taken orally.

Dosage for Chancroid

• For Adults: A single dose of 1 g should be taken orally.

Dosage for Pelvic Inflammatory Disease

• For Adults: An initial IV therapy of 500 mg is administered once daily for one or two days, followed by 250 mg orally once daily for seven days.
• Pediatric Patients: A 7-day course requires 500 mg IV once a day for 1 or 2 days, followed by 250 mg oral once a day for 16 years or older

Dosage for Bronchitis

• For Adults: The dosage is 500 mg once daily for three days or 250 mg once daily for three days after the first dose.

Dosage for Mycobacterium Avium-intracellulare – Prophylaxis

• For Adults: Take 1200 mg once a week orally.
• Pediatric Patients: As a first line of defense, you should take 20 mg/kg orally once a week. However, you can also take 5 mg/kg orally once daily as an alternative.

Dosage for Mycobacterium Avium-intracellulare – Treatment

• For Adults: One dose of 600 mg is taken orally every day.
• Pediatric Patients: For at least a year, take 10-12 mg/kg orally once daily.

Dosage for Mycobacterium Kansasii

• For Adults: One dose of 600 mg is taken orally every day.

Dosage for Granuloma Inguinale

• For Adults: Once a week, take 1 g orally or take 500 mg orally once daily for at least 3 weeks.

Dosage for Pertussis Prophylaxis

• For Adults: You can take 250 mg or 500 mg orally once for one day, then 250 mg once daily for four days.
• Pediatric Patients: An oral prophylactic dose of 10 mg/kg is administered as a loading dose, followed by a daily dosage of 5 mg/kg for 4 days after exposure.

Dosage for Pertussis

• For Adults: You can take 250 mg or 500 mg orally once for one day, then 250 mg once daily for four days.
• Pediatric Patients: One dose of 5 mg per kg of pertussis vaccine should be taken orally once daily.

Dosage for Lyme Disease – Erythema Chronicum Migrans

• For Adults: Once a day for 7 days, take 500 mg orally.
• Pediatric Patients: A daily dose of 10 mg/kg for 7 days should be taken orally.

Dosage for Babesiosis

• For Adults: It is recommended to take 500 mg orally on day 1 and 250 mg every 24 hours for seven to ten days for ambulatory patients.
• Pediatric Patients: One dose of 5 mg per kg of pertussis vaccine should be taken orally once daily.

Dosage for Bacterial Endocarditis Prophylaxis

• For Adults: An oral dose of 500 mg 30 to 60 minutes before surgery is recommended.
• Pediatric Patients: 15 mg per kg orally as a single dose 30-60 minutes before the treatment.

Dosage for Campylobacter Gastroenteritis

• For Adults: For five days, take 500 mg orally once daily.
• Pediatric Patients: In adolescents, 500 mg orally once daily for five days is recommended

Dosage for Shigellosis

• For Adults: For five days, take 500 mg orally once daily.
• Pediatric Patients: In adolescents, take 500 mg once a day for five days.

Dosage for Bacterial Infection

• For Adults: A daily dose of 250 mg should be taken orally.

Dosage for Syphilis – Early

• Adults: A single dose of 2 g should be taken orally.
• Pediatric Patients: For adolescents, take 2 g orally once daily

[Note: Azithromycin dosage will be determined by your healthcare professional based on your health status and studies about the drug. Over time, they will adjust your Azithromycin dosage as needed.]

• Adhere closely to the prescribed regimen of Azithromycin as directed by your healthcare provider.
• Take Azithromycin with or without food.
• Ingest azithromycin tablets or capsules whole with a full glass of water.
• Maintain a consistent daily dosing schedule.
• Ensure the entire prescribed course is completed, even without symptom amelioration.

[Note: The amount of Azithromycin you need will be decided by your healthcare professional based on your condition and studies about the drug. Over time, they will adjust your Azithromycin dosage as needed.]

Azithromycin works by stopping the bacterial growth. It belongs to the class of drugs called macrolide antibiotics. Azithromycin binds to the bacterial ribosome, which is the site of protein synthesis and interferes with the essential protein production that is crucial for bacteria to survive and replicate. By disrupting this process, Azithromycin effectively stops the growth and spread of bacteria, helping to treat various bacterial infections like skin infections, respiratory tract infections, and sexually transmitted diseases.

Common side effects of Azithromycin may include:

• Nausea
• Vomiting
• Diarrhea
• Abdominal pain
• Headache
• Dizziness
• Fatigue
• Rash or itching
• Changes in taste

Mild side effects of Azithromycin may include:

• Upset stomach
• Mild diarrhea
• Drowsiness
• Minor allergic reactions like itching or rash

Adverse side effects of Azithromycin may include:

• Severe allergic reactions (rare but serious)
• Liver problems
• Irregular heartbeat or palpitations
• Severe diarrhea (potentially indicating Clostridium difficile infection)
• Difficulty breathing or wheezing
• Severe skin allergies (Stevens-Johnson syndrome or toxic epidermal necrolysis)

[Note: There may be other side effects caused by Azithromycin that are not listed here. Side effects should always be discussed with your healthcare provider.]

• Allergic Reactions: Serious allergic reactions to Azithromycin are rare but can occur. Contact a healthcare professional if you observe redness, itching, or swelling.
• Antibiotic Resistance: Overuse or unnecessary use of Azithromycin can result in antibiotic resistance. Use only as prescribed by your healthcare provider. Avoid taking it for viral infections such as the common cold or flu.
• Liver Problems: Azithromycin may cause liver problems, especially in people with pre-existing liver disease. Inform your doctor if you have a history of liver issues.
• Clostridium Difficile Infection: Azithromycin use may increase the risk of developing Clostridium difficile-associated diarrhea due to disruption of normal gut flora. Contact your healthcare professional if you encounter long-lasting or severe diarrhea during or after azithromycin treatment.
• QT Prolongation: Azithromycin can prolong the QT interval in the heart’s electrical cycle, potentially leading to a serious irregular heartbeat (arrhythmia). This risk is higher in individuals with certain heart conditions or those taking other medications that prolong the QT interval. Inform your doctor of any heart conditions or medications you are taking before starting Azithromycin.
• Myasthenia Gravis: Azithromycin may exacerbate symptoms of myasthenia gravis (a neuromuscular disease described by muscle weakness). Use caution and consult your doctor if you have this condition.
• Pediatric Considerations: Azithromycin is generally considered safe for children, but the adjustments of dose may be necessary based on age and weight. Follow your pediatrician’s instructions carefully when administering Azithromycin to children.
• Pregnancy and Breastfeeding: You should tell your doctor before taking Azithromycin if pregnant or breastfeeding.

• Take Azithromycin exactly as recommended by your healthcare professional. Only increase or decrease the dosage after consulting them.
• Finish all the medication, even if you start to feel better before the course is completed. Skipping doses or stopping early could lead to incomplete treatment and antibiotic resistance.
• Inform your doctor about all the medications you are taking, especially if you’re on blood thinners or medications for heart rhythm disorders. Azithromycin may interact with these medications and cause complications.
• If you notice redness, inflammation, or difficulty, it could be because of an allergic reaction. Seek immediate medical attention if you experience any of these symptoms.
• Drink plenty of fluids to help prevent gastrointestinal side effects like vomiting, nausea, and diarrhea.
• Look for unusual symptoms while taking Azithromycin, and promptly report them to your healthcare provider.
• If you are pregnant or breastfeeding, consult the disadvantages and benefits of Azithromycin with your doctor before taking it.
• Limit or avoid alcohol consumption while on Azithromycin as it may increase the risk of side effects and liver problems.
• If being treated for a sexually transmitted infection, refrain from sexual activity or use barrier methods (e.g., condoms) to prevent transmission to your partner(s).
• Store Azithromycin securely and out of the reach of children, as accidental ingestion can be harmful.

It is contraindicated in:

• Those with cholestatic jaundice or hepatic dysfunction related to prior azithromycin use.
• Individuals with known hypersensitivity to Azithromycin, erythromycin, or any other macrolide or ketolide drug.
• If you have a history of long QTc on ECG, abnormal heartbeats, slow heartbeat, low potassium or magnesium levels, or heart failure.

• Do not miss a dose. Take it as soon as you remember.
• You may skip the missed dose if it is almost time for your next dose.
• If you miss a dose, do not double up.

[Note: If you have missed an Azithromycin dose and are still determining when to take the next one, consult your doctor or pharmacist immediately.]

Symptoms of overdose are severe vomiting, nausea, diarrhea, or signs of allergic reaction. Do not attempt to treat an overdose without medical supervision.

[Note: If you suspect that you consumed more than the recommended dose of Azithromycin, get medical help promptly or contact the Poison Help line at 1-800-222-1222.]

• Store azithromycin in its original container with the lid tightly closed.
• Keep it at room temperature, away from moisture and heat sources.
• Ensure it’s inaccessible to children and pets.
• Don’t use expired medication or if the packaging is damaged.
• Dispose of any unused medication following local regulations.

[Note: Consult your healthcare professional about the proper disposal of unused Azithromycin and any questions you may have regarding its storage.]

Here are some possible interactions mentioned below:

• Advair Diskus (fluticasone / salmeterol)
• Aspirin (Low Strength)
• Augmentin (amoxicillin/clavulanate)
• Benadryl (diphenhydramine)
• Claritin (loratadine)
• CoQ10 (ubiquinone)
• Cymbalta (duloxetine)
• Eliquis (apixaban)
• Fish Oil (omega-3 polyunsaturated fatty acids)
• Flonase (fluticasone nasal)
• Hydroxychloroquine
• Lyrica (pregabalin)
• Metoprolol Succinate ER (metoprolol)
• MiraLAX (polyethylene glycol 3350)
• Mucinex (guaifenesin)
• Nexium (esomeprazole)
• Norco (acetaminophen/hydrocodone)
• Paracetamol (acetaminophen)
• ProAir HFA (albuterol)
• Singulair (montelukast)
• Symbicort (budesonide / formoterol)
• Synthroid (levothyroxine)
• Tylenol (acetaminophen)
• Ventolin HFA (albuterol)
• Vitamin B12 (cyanocobalamin)
• Vitamin C (ascorbic acid)
• Vitamin D3 (cholecalciferol)
• Xanax (alprazolam)
• Zofran (ondansetron)
• Zoloft (sertraline)
• Zyrtec (cetirizine)

[Note: This isn’t a complete list and other drugs may interact with Azithromycin. Tell your doctor about any medications you are taking, whether they are prescription or over-the-counter.]

• Amoxicillin (amoxicillin)
• Augmentin (amoxicillin with clavulanate)
• Cefaclor (cefaclor)
• Doxycycline (doxycycline)
• Levofloxacin (levofloxacin)
• Ceftriaxone (ceftriaxone)
• Clarithromycin (clarithromycin)
• Erythromycin (erythromycin)

[Note: Your doctor will choose the best Azithromycin alternative for you. Before using any of these alternative medications, consult your healthcare provider. Side effects may occur if you take them by yourself.]

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