Azithromycin

Azithromycin is used to treat certain bacterial infections, such as bronchitis; pneumonia; sexually transmitted diseases (STD); and infections of the ears, lungs, sinuses, skin, throat, and reproductive organs. Azithromycin also is used to treat or prevent disseminated Mycobacterium avium complex (MAC) infection [a type of lung infection that often affects people with human immunodeficiency virus (HIV)]. Azithromycin is in a class of medications called macrolide antibiotics. It works by stopping the growth of bacteria.

Antibiotics such as azithromycin will not work for colds, flu, or other viral infections. Using antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.

🔔 How should this medicine be used?

Azithromycin comes as a tablet, an extended-release (long-acting) suspension (liquid), and a suspension (liquid) to take by mouth. The tablets and suspension (Zithromax) are usually taken with or without food once a day for 1-5 days. When used for the prevention of disseminated MAC infection, azithromycin tablets are usually taken with or without food once weekly. The extended-release suspension (Zmax) is usually taken on an empty stomach (at least 1 hour before or 2 hours after a meal) as a one-time dose. To help you remember to take azithromycin, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take azithromycin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Shake the liquid well before each use to mix the medication evenly. Use a dosing spoon, oral syringe, or measuring cup to measure the correct amount of medication. Rinse the measuring device with water after taking the full dose of medication.

If you receive azithromycin powder for suspension (Zithromax) in the single-dose, 1-gram packet, you must first mix it with water before you take the medication. Mix the contents of the 1-gram packet with 1/4 cup (60 mL) of water in a glass and consume the entire contents immediately. Add an additional 1/4 cup (60 mL) of water to the same glass, mix, and consume the entire contents to ensure that you receive the entire dose.

If you receive azithromycin extended-release suspension (Zmax) as a dry powder, you must first add water to the bottle before you take the medication. Open the bottle by pressing down on the cap and twisting. Measure 1/4 cup (60 mL) of water, and add to the bottle. Close the bottle tightly, and shake well to mix. Use the azithromycin extended-release suspension within 12 hours of receiving it from the pharmacy or after adding water to the powder.

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If you vomit within an hour after taking azithromycin, call your doctor right away. Your doctor will tell you if you need to take another dose. Do not take another dose unless your doctor tells you to do so.

You should begin to feel better during the first few days of treatment with azithromycin. If your symptoms do not improve, or get worse, call your doctor.

Take azithromycin until you finish the prescription, even if you feel better. Do not stop taking azithromycin unless you experience the severe side effects described in the SIDE EFFECTS section. If you stop taking azithromycin too soon or skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.

Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

🔔 Other uses for this medicine

Azithromycin is also used sometimes to treat H. pylori infection, travelers’ diarrhea, and other gastrointestinal infections; Legionnaires’ disease (a type of lung infection); pertussis (whooping cough; a serious infection that can cause severe coughing); Lyme disease (an infection that may develop after a person is bitten by a tick); and babesiosis (an infectious disease carried by ticks). It is also used to prevent heart infection in people having dental or other procedures, and to prevent STD in victims of sexual assault. Talk to your doctor about the possible risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

🔔 What special precautions should I follow?

Before taking azithromycin,

• tell your doctor and pharmacist if you are allergic to azithromycin, clarithromycin (Biaxin, in Prevpac), dirithromycin (not available in the U.S.), erythromycin (E.E.S., ERYC, Erythrocin), telithromycin (Ketek; not available in the U.S.), any other medications, or any of the ingredients in azithromycin tablets or suspension (liquid). Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants (‘blood thinners’) such as warfarin (Jantoven); colchicine (Colcrys, Gloperba, Mitigare); cyclosporine (Gengraf, Neoral, Sandimmune); digoxin (Lanoxin); dihydroergotamine (D.H.E. 45, Migranal, Trudhesa); ergotamine (Ergomar, in Migergot); medications for irregular heartbeat such as amiodarone (Nexterone, Pacerone), dofetilide (Tikosyn), procainamide, quinidine, and sotalol (Betapace, Sorine, Sotylize); nelfinavir (Viracept); and phenytoin (Dilantin, Phenytek). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• if you are taking antacids containing aluminum hydroxide or magnesium hydroxide (Maalox, Mylanta, Tums, others), you will need to allow some time to pass between when you take a dose of these antacids and when you take a dose of azithromycin tablets or liquid. Ask your doctor or pharmacist how many hours before or after you take azithromycin you may take these medications. The extended-release suspension may be taken at any time with antacids.
• tell your doctor if you have ever had jaundice (yellowing of the skin or eyes) or other liver problems while taking azithromycin. Your doctor will probably tell you not to take azithromycin.
• tell your doctor if you or anyone in your family has or has ever had a prolonged QT interval (a rare heart problem that may cause irregular heartbeat, fainting, or sudden death) or a fast, slow, or irregular heartbeat, and if you have low levels of magnesium or potassium in your blood; if you have a blood infection; heart failure or other heart problems; cystic fibrosis; myasthenia gravis (a condition of muscles and the nerves that control them); or if you have kidney or liver disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking azithromycin, call your doctor.