Azithromycin is a widely-used antibiotic medication primarily prescribed to combat bacterial infections. It is available in various forms, including oral tablets, suspensions, eye drops, and intravenous solutions. This article delves into the uses of azithromycin, its potential side effects, crucial warnings, and other essential information you need to know.
Azithromycin: Key Highlights
- Azithromycin is available as both generic and brand-name drugs. The most common brand name is Zithromax.
- It is administered orally as a tablet or liquid suspension. Other forms include eye drops and intravenous solutions given by healthcare professionals.
- Azithromycin effectively treats a range of infections caused by susceptible bacteria.
Important Warnings Associated with Azithromycin
Before taking azithromycin, it’s crucial to be aware of the following warnings:
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Abnormal Heart Rhythm (QT Prolongation) Warning: Azithromycin can disrupt the heart’s electrical activity, leading to a condition called QT prolongation. This can cause serious, even fatal, irregular heartbeats. The risk is higher for individuals with pre-existing heart rhythm issues, older adults, and those taking other medications that can also prolong the QT interval. Inform your doctor immediately if you experience palpitations, dizziness, or fainting while taking azithromycin.
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Antibiotic-Associated Diarrhea Warning: Like most antibiotics, azithromycin can cause diarrhea. This ranges from mild to severe Clostridium difficile-associated diarrhea (CDAD), a condition that can cause significant colon inflammation and may be fatal. If you develop severe diarrhea, especially with bloody stools or persistent diarrhea after stopping azithromycin, seek medical attention without delay.
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Liver Problems Warning: Although rare, azithromycin can lead to liver dysfunction. Pre-existing liver conditions may worsen. Your doctor may monitor your liver function through blood tests during azithromycin treatment. Symptoms of liver problems include abdominal pain, dark urine, jaundice (yellowing of the skin or eyes), and fatigue. Report any of these symptoms to your doctor promptly.
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Myasthenia Gravis Warning: Azithromycin can exacerbate muscle weakness in individuals with myasthenia gravis, an autoimmune neuromuscular disease. It can also induce myasthenic syndrome, a similar condition. If you have myasthenia gravis, discuss the risks and benefits of azithromycin with your doctor before starting treatment.
What is Azithromycin and How Does It Work?
Azithromycin is a prescription macrolide antibiotic. It is available in several forms:
- Oral Tablet
- Oral Suspension (liquid)
- Eye Drops
- Intravenous (IV) solution
The oral tablet form is available generically and under the brand name Zithromax. Generic versions are typically more affordable than brand-name drugs.
Why is Azithromycin Prescribed?
Azithromycin is prescribed to treat various bacterial infections, including:
- Respiratory Tract Infections: Bronchitis, pneumonia, sinusitis, and pharyngitis/tonsillitis.
- Skin and Soft Tissue Infections: Cellulitis, impetigo, and certain wound infections.
- Sexually Transmitted Infections (STIs): Chlamydia, gonorrhea, and genital ulcer disease (chancroid).
- Ear Infections: Acute otitis media (middle ear infection).
- Mycobacterium Avium Complex (MAC) Infections: Often in combination with other antibiotics, particularly in individuals with weakened immune systems.
It’s important to note that azithromycin is ineffective against viral infections such as the common cold or flu.
Mechanism of Action
Azithromycin works by inhibiting bacterial protein synthesis. It binds to the 50S ribosomal subunit of bacteria, preventing them from producing essential proteins for growth and replication. This action effectively stops bacterial multiplication and helps clear the infection.
Understanding Azithromycin Side Effects
While azithromycin is generally well-tolerated, it can cause side effects.
Common Side Effects
Common side effects of azithromycin oral tablets may include:
- Diarrhea
- Nausea
- Abdominal pain
- Vomiting
- Headache
These side effects are usually mild and temporary, often resolving within a few days or weeks. If they become severe or persistent, consult your doctor or pharmacist.
Serious Side Effects
Seek immediate medical attention if you experience any of the following serious side effects:
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Liver Problems:
- Loss of appetite
- Upper abdominal pain
- Dark urine
- Jaundice (yellowing of the skin or whites of the eyes)
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QT Prolongation:
- Palpitations (feeling fluttering in your chest)
- Gasping during sleep
- Fainting
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Allergic Reactions:
- Difficulty breathing
- Swelling of the face, lips, tongue, or throat
- Severe skin reactions (Stevens-Johnson syndrome, AGEP, toxic epidermal necrolysis) with symptoms like red, blistering skin or skin peeling.
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Clostridium difficile (C. diff) Diarrhea:
- Abdominal pain
- Nausea
- Reduced appetite
- Severe diarrhea
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Infantile Hypertrophic Pyloric Stenosis (IHPS) in newborns:
- Vomiting after feeding
- Irritability with feeding
- Lack of weight gain
If you suspect an allergic reaction, call your doctor or local poison control center immediately. For life-threatening symptoms, call 911 or go to the nearest emergency room. Do not take azithromycin again if you have ever had an allergic reaction to it.
Disclaimer: This information is intended to be informative and does not encompass all possible side effects. Always discuss potential side effects with your healthcare provider.
Drug Interactions with Azithromycin
Azithromycin can interact with other medications, vitamins, and herbal supplements, potentially altering how each drug works and increasing the risk of side effects. Inform your doctor about all medications you are currently taking before starting azithromycin.
Interactions Increasing Side Effect Risks
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Nelfinavir: Combining azithromycin with nelfinavir (an antiviral drug) may increase the risk of liver and hearing problems. Your doctor will monitor you closely for these side effects if these medications are used together.
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Warfarin: Taking azithromycin with warfarin (a blood thinner) may increase the risk of bleeding. Close monitoring by your doctor is necessary if these drugs are co-administered.
Disclaimer: This is not an exhaustive list of interactions. Consult your healthcare provider for comprehensive information about potential drug interactions with azithromycin.
Azithromycin Warnings and Precautions
Allergy Warning
Azithromycin can trigger severe allergic reactions. Symptoms include trouble breathing, throat or tongue swelling, hives, and severe skin reactions. Seek immediate medical help if you experience any of these symptoms. Never take azithromycin again if you have had an allergic reaction to it in the past.
Warnings for Specific Populations
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Myasthenia Gravis: Azithromycin may worsen symptoms of myasthenia gravis. Discuss this condition with your doctor before taking azithromycin.
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Heart Problems: Individuals with pre-existing heart rhythm abnormalities, including QT prolongation, or decompensated heart failure are at increased risk of life-threatening arrhythmias when taking azithromycin. Discuss your heart health with your doctor to determine if azithromycin is safe for you.
Special Warnings
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Pregnancy: While studies in pregnant women are limited, available data and animal studies do not suggest an increased risk of pregnancy loss, birth defects, or other adverse outcomes. Azithromycin should be used during pregnancy only when clearly necessary. Discuss the risks and benefits with your doctor if you are pregnant or planning to become pregnant.
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Breastfeeding: Azithromycin passes into breast milk and may cause side effects like diarrhea, vomiting, and rash in breastfed infants. Consult your doctor about the safety of breastfeeding while taking azithromycin.
Azithromycin Dosage and Administration
The appropriate dosage and duration of azithromycin treatment depend on several factors, including:
- Age
- Condition being treated
- Severity of the infection
- Other medical conditions
- Individual response to the medication
Dosage Forms and Strengths
Generic: Azithromycin
- Oral Tablet Strengths: 250 mg, 500 mg, 600 mg
Brand: Zithromax
- Oral Tablet Strengths: 250 mg, 500 mg
Typical Dosages for Common Infections
- Bronchitis: 500 mg once daily for 3 days, or 500 mg on day 1 followed by 250 mg daily for days 2-5.
- Sinusitis: 500 mg once daily for 3 days for adults; 10 mg/kg of body weight once daily for 3 days for children (6 months to 17 years). Not recommended for children under 6 months.
- Skin and Skin Structure Infections: 500 mg on day 1, followed by 250 mg once daily for days 2-5.
- Urethritis and Cervicitis: 1 gram single dose (non-gonococcal); 2 gram single dose (gonococcal).
- Genital Ulcer Disease: 1 gram single dose.
- Acute Middle Ear Infection: Children (6 months to 17 years): 30 mg/kg single dose, or 10 mg/kg daily for 3 days, or 10 mg/kg on day 1 followed by 5 mg/kg daily for days 2-5. Not recommended for children under 6 months.
- Community-Acquired Pneumonia: Adults: 500 mg on day 1, followed by 250 mg once daily for days 2-5. Children (6 months to 17 years): 10 mg/kg on day 1, followed by 5 mg/kg daily for days 2-5. Not recommended for children under 6 months.
- Mycobacterium Avium Complex (MAC) Disease: Treatment: 600 mg once daily (with ethambutol). Prevention: 1,200 mg once weekly.
- Pharyngitis or Tonsillitis: Adults: 500 mg on day 1, followed by 250 mg once daily for days 2-5. Children (2 to 17 years): 12 mg/kg once daily for 5 days. Not recommended for children under 2 years.
Disclaimer: Dosage information is for general guidance only and may not be applicable to all individuals. Always follow your doctor’s specific instructions.
How to Take Azithromycin Correctly
Azithromycin is typically prescribed for short-term treatment. It is crucial to take it exactly as directed by your doctor.
- If you stop taking azithromycin prematurely or skip doses: The infection may not clear completely and could worsen or recur. Bacteria may also develop resistance to antibiotics.
- Missed Dose: Take the missed dose as soon as you remember. If it is close to your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to catch up.
- Overdose: Taking too much azithromycin can lead to dangerous drug levels in your body, potentially causing liver damage or irregular heart rhythms. If you suspect an overdose, seek immediate medical attention.
Azithromycin Overdose
Symptoms of azithromycin overdose may include nausea, vomiting, diarrhea, and potential liver damage or heart rhythm disturbances. In case of suspected overdose, contact your doctor or local poison control center immediately, or go to the nearest emergency room.
Important Considerations When Taking Azithromycin
General Information
- Take azithromycin with or without food. However, taking it with food may help reduce stomach upset.
- Complete the full course of treatment even if you feel better before the medication is finished, unless your doctor tells you to stop.
Storage
- Store azithromycin tablets at room temperature between 68°F and 77°F (20°C and 25°C).
- Avoid storing it in damp or moist areas like bathrooms.
Refills and Travel
- Prescriptions for azithromycin are typically refillable.
- When traveling, keep the medication in its original container with the pharmacy label. Carry it in your carry-on bag and avoid storing it in extreme temperatures.
Azithromycin Drug Class
Azithromycin belongs to the macrolide class of antibiotics. Macrolide antibiotics work against bacterial infections by inhibiting bacterial protein synthesis. Other macrolide antibiotics include clarithromycin and erythromycin.
Alternatives to Azithromycin
Several other antibiotics are available to treat bacterial infections. Depending on the type of infection and individual factors, alternatives to azithromycin may include:
- Amoxicillin
- Doxycycline
- Clarithromycin
- Erythromycin
- Ciprofloxacin
Discuss alternative treatment options with your doctor to determine the most suitable medication for your specific condition.
Q&A: Azithromycin vs. Amoxicillin
Q: What are the key differences between azithromycin and amoxicillin?
A: Both azithromycin and amoxicillin are antibiotics that fight bacterial infections, but they belong to different drug classes and have some distinct characteristics.
- Drug Class: Azithromycin is a macrolide antibiotic, while amoxicillin is a beta-lactam antibiotic, related to penicillin.
- Spectrum of Activity: Both treat many common infections, including bronchitis, sinusitis, pneumonia, ear infections, and skin infections. However, azithromycin is also used for certain STIs and MAC infections, while amoxicillin is effective against urinary tract infections and H. pylori infections.
- Dosage Frequency and Duration: Azithromycin is often taken once daily for a shorter duration (1-5 days), whereas amoxicillin is usually taken two or three times daily for a longer period (10-14 days).
Consult your healthcare provider to determine which antibiotic is most appropriate for your specific infection.
Disclaimer: This information is for educational purposes and does not constitute medical advice. Always consult with a qualified healthcare professional for diagnosis and treatment.
Medical News Today Medical Team has reviewed this article for medical accuracy.
This article is based on information available up to April 23, 2020, and may not reflect the most recent medical advances. Always consult with your doctor for the latest information and personalized medical advice.
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