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Zithromax (Azithromycin)

DosageQuantityPriceCheck product
250 mg
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500 mg30 pills€ 123.00
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500 mg120 pills€ 277.00
500 mg180 pills€ 357.00

What is Azithromycin

Azithromycin is a bacteriostatic (and for some species, bactericidal) agent belonging to the azalides, a subclass of macrolides. Azithromycin prevents RNA-dependent protein synthesis by binding to the 50S ribosomal subunit.

Azithromycin Drug Recommendation

In infections with gram-positive cocci, penicillins are nonetheless the primary alternative, so long as no resistance or -lactamase inhibition happens. Macrolides are only considered if there is penicillin resistance or hypersensitivity, and also for pathogens for which penicillins are ineffective but macrolides are (for example, Legionella pneumophila, for which it is likely one of the first brokers of alternative). One of many benefits of Azithromycin over erythromycin is its extra beneficial pharmacokinetic profile, which signifies that it must be used as soon as possible. Furthermore, the brief therapy period of Azithromycin (3 or 5 days, and for some indications, at the same time as a single therapy) is a bonus in comparison with erythromycin and the other macrolides; furthermore, using Azithromycin is cheaper.

Acute rhinosinusitis nearly always heals itself. Painkillers (paracetamol), steaming, and the nasal administration of a saline solution or a decongestant can relieve the symptoms. Antibiotics should not be mandatory. Antibiotics need to be given if a bacterial infection is suspected and if the affected person is significantly in poor health, and antibiotics need to be thought of if the affected person’s resistance is impaired and if the fever persists or recurs for more than 5 days. For the selection of antibiotics when indicated, see the acute rhinosinusitis therapy plan.

In acute pharyngotonsillitis, ache reduction with paracetamol is the primary alternative. Antibiotics are not often indicated. When pharyngotonsillitis is very bad, when the immune system isn’t working well, or if the GGD says so, a narrow-spectrum penicillin like pheneticillin or phenoxymethylpenicillin might be used. In the case of penicillin hypersensitivity, azithromycin for 3 days is the first alternative. All macrolides are equally efficient in opposition to streptococci, but Azithromycin is the most well-liked due to its brief period of use and price. If there’s a peritonsillar infiltrate or if therapy with narrow-spectrum penicillins has inadequate impact, amoxicillin/clavulanic acid is chosen.

In the therapy of otitis media acuta, a wait-and-see coverage with enough ache reduction is most well-liked. If the impact on ache and/or fever is inadequate after three days, antimicrobial therapy with amoxicillin needs to be begun. In high-risk teams (see otitis media acuta therapy plan) and with extremely generalised symptoms, antimicrobial therapy needs to be begun instantly.

What Should You Discuss To Your Doctor Before Using This Medicine

  • Being pregnant
    • Azithromycin crosses the placenta (in animals).
    • Teratogenesis: Affordable expertise (with a number of doses) from retrospective research exhibits no improve within the threat of start defects. A latest examine exhibits barely elevated threat of spontaneous miscarriage.
    • Suggestion: Can be utilized if any of the popular medicine (e.g. penicillins, cephalosporins) can’t be used.

  • Lactation
    • Transition in breast milk: Sure, to a (very) small extent.
    • Pharmacological impact: Regardless of the lengthy half-life, clinically related ranges are unlikely to be constructed up within the toddler. No severe uncomfortable side effects have been noticed in infants. In principle, it’s doable that the toddler intestinal flora is affected. This will likely result in diarrhoea and doable colonisation with yeasts or moulds.

Contraindications: sensitivity to macrolides.

Azithromycin Drug Interactions

Cautious when combining with medicinal merchandise that extend the QT interval equivalent to class IA and III antiarrhythmic brokers

  • flecainide
  • antipsychotics
  • antidepressants
  • antipsychotics
  • clarithromycin
  • erythromycin
  • fluoroquinolones
  • imidazole
  • triazole antimycotics
  • ketoconazole
  • pentamidine
  • sure antimalarial brokers
  • non-sedating antihistamines
  • levomepromazine
  • methadone
  • 5HT₃-antagonists
  • prucalopride
  • vandetanib

Azithromycin probably will increase publicity for PGP substrates equivalent to digoxin and colchicine. During treatment with Azithromycin and afterward, a doctor must follow up with the patient and may check their digoxin levels. Azithromycin will increase the publicity of ciclosporin; if co-administered, test the ciclosporin level and modify the dose if necessary.

Antacids scale back the high serum concentration of Azithromycin by roughly 24%; take Azithromycin no less than 1 hour earlier than or 2 hours after antacids. Nevertheless, the general bioavailability doesn’t change. Probably, azithromycin enhances the impact of vitamin Okay antagonists.

The poisonous limit of ergotamine and derivatives was previously reached by using some macrolides (resulting in ergotism); avoid the combination of azithromycin and ergotamine.

Azithromycin Dosage

In youngsters, use the suspension; this may be dosed per 0.5 ml (e.g. in a baby weighing approx. 14 kg, dosage for 3 days: 3.5 ml 1/day).

  1. Therapy of infections
    • Adults and kids > 45 kg: 500 mg 1×/day for 3 days or 500 mg 1×/day on the primary day adopted by 250 mg 1×/day on days 2-5.
    • Kids ≤ 45 kg: Suspension: 10 mg/kg physique weight 1×/day for 3 days or 10 mg/kg physique weight 1×/day on the primary day, adopted by 5 mg/kg physique weight 1×/day on days 2 to five. Few knowledge can be found on the use in youngsters < 1 12 months of age.

  2. Streptococcal pharyngitis in youngsters
    • Kids: Suspension: 10-20 mg/kg physique weight 1×/day, for 3 days; most 500 mg/day. Few knowledge can be found on the use in youngsters < 1 12 months of age.

  3. Group-acquired pneumonia (CAP)
    • Adults: 500 mg 1×/day. Remedy period: 3 days.

  4. Sexually transmitted ailments brought on by Chlamydia trachomatis
    • Adults: 1 g in a single donation.

  5. Offlabel: Gonorrhoea
    • Adults: 2 g in a single present (4 tablets of 500 mg), and solely in case of absolute contraindication to ceftriaxone and the absence of a resistance sample of the pressure.

  6. Lyme illness prophylaxis after a tick chew
    • Adults (particularly pregnant ladies) and kids ≥ 8 years previous:  If a tick has been on the pores and skin for greater than 24 hours and was eliminated lower than 72 hours in the past, a single dose of antibiotics or watchful ready might be chosen. If not contraindicated, doxycycline is given to non-pregnant individuals ≥ 8 years of age.
      • Posology of Azithromycin: adults 500 mg as soon as, youngsters 10 mg/kg physique weight (max. 500 mg) as soon as inside 72 hours after tick elimination.
    • Kids < 8 years previous: If a tick has been on the pores and skin for greater than 24 hours and was eliminated lower than 72 hours in the past, a single dose of antibiotics or watchful ready might be chosen.
      • Dosage of Azithromycin: as soon as 10 mg/kg physique weight, inside 72 hours of tick elimination.

  7. Erythema migrans
    • Adults and kids ≥ 8 years: In case of contraindications to doxycycline and hypersensitivity to amoxicillin, Azithromycin might be given.
      • Posology of Azithromycin: adults 500 mg 1×/day, youngsters 10 mg/kg physique weight (max. 500 mg) 1×/day.
      • Remedy period: 5 days.
    • Kids < 8 years previous: In case of contraindications to doxycycline and hypersensitivity to amoxicillin, Azithromycin might be given.
      • Posology of Azithromycin: 10 mg/kg physique weight (max. 500 mg) 1×/day.
      • Remedy period: 5 days.

  8. MAC an infection prophylaxis in HIV-infected sufferers
    • Adults: 1200 mg 1×/week.

Severely impaired renal function: exposure to Azithromycin may improve by approximately 33%; adjust dose if necessary.

Administration: The suspension and tablets could also be taken with meals. Shake the suspension earlier than usual. If you drink fruit juice right after taking the suspension, you can avoid a bitter aftertaste.

Azithromycin Indications

Infections brought on by micro-organisms delicate to Azithromycin:

  • of the higher respiratory tract (sinusitis, pharyngitis, tonsillitis) and acute otitis media
  • of the decrease respiratory tract (acute bronchitis, gentle to reasonable pneumonia acquired outdoors the hospital
  • of pores and skin and mushy tissues equivalent to:
    • cellulite
    • ecthyma ulcer
    • erysipelas, erysipeloid
    • erythrasma
    • folliculitis
    • furunkel
    • impetigo, impetigo of different dermatoses
    • erythema migrans and the Borrelia lymphoma
    • wound an infection excluding contaminated burns.
  • uncomplicated Chlamydia trachomatis an infection of urethra and cervix;
  • Lyme illness prophylaxis after a tick chew
  • prophylaxis in opposition to Mycobacterium avium intracellulare complicated (MAC) an infection, in HIV-infected sufferers at a complicated stage (CD4 depend ≤ 100/mm³).

Azithromycin shouldn’t be used for severe infections that need high blood concentrations quickly, such as severe pneumonia.

Azithromycin Precautions

QT prolongation: use warning in instances of established or elevated threat of QT prolongation equivalent to clinically related bradycardia (< 50 min),

  • hypokalaemia
  • hypocalcaemia
  • hypomagnesaemia
  • cardiac arrhythmia
  • extreme coronary heart failure
  • co-medication with medicinal merchandise that extend the QT interval
  • congenital
  • acquired QT prolongation

Particular care needs to be taken with the aged, as proarrhythmic circumstances might happen to them. In the case of extreme renal impairment (creatinine clearance  10 ml/min), elevated publicity (33%) happens.

Hepatic ailments: hepatitis, cholestatic icterus, hepatic necrosis, and hepatic failure have been reported, deadly in some instances; discontinue use instantly if indicators of hepatitis happen. With current liver illness, a quickly developing asthenia related to icterus, dark urine, bleeding tendency, or hepatic encephalopathy might happen. Use Azithromycin with caution in current important liver illnesses and test liver function assessments instantly if indicators and signs of liver dysfunction happen.

Cross-resistance: cross-resistance exists between macrolides and lincomycins.

Azithromycin shouldn’t be indicated for the therapy of contaminated burns. When diarrhoea is extreme and chronic, take into account the diagnosis of antibiotic-associated or pseudomembranous colitis. As with other macrolides, there have been rare reports of people having extreme allergic reactions. If this happens, stop using the drug.

Persistent vomiting and irritation during feeding have been reported in neonates (up to 42 days); advise father, mother, and caregivers to contact the doctor if this occurs.

Azithromycin Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur, they may require medical attention. Check with your doctor immediately if any of the following side effects occur:

  • nausea
  • stomach ache
  • flatulence
  • diarrhoea
  • vomiting
  • dyspepsia
  • anorexia
  • Pores and skin rash, itching
  • Joint ache
  • Fatigue
  • Dizziness, headache, paraesthesia, style dysfunction
  • Visible disturbance
  • Deafness
  • Decreased lymphocyte depend, elevated eosinophil depen
  • Decreased bicarbonate of blood

Some side effects may occur that usually do not require medical attention. These side effects may go away during treatment as your body adjusts to the medicine. 


Information concerning psychotic disorders, included within the review of Azithromycin, is used for the informative features exclusively and should not be thought of as an alternative to licenced healthcare or referral of the well-being treatment distributor.

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    Azithromycin Generic is used to treat certain bacterial infections in many different parts of the body. However, this medication is not effective against syphilis infections and will only mask or delay the symptoms of the disease. Syphilis infections cannot be cured by this medication.

  2. What to do if you miss a dose?

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  3. What if u take too much Azithromycin Generic?

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  4. How to store Azithromycin Generic?

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  5. What Should I Avoid While Taking Azithromycin Generic?

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  6. What are the side effects of Azithromycin Generic?

    There is a possibility that taking this medication will lead to adverse effects such as diarrhoea or loose stools, nausea, abdominal pain, vomiting, irregular heartbeats, and a loss of appetite.

  7. What are the Contraindication?

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