Azithromycin is the generic name for a prescription drug available as

Zithromax, Zmax, and Z-Pak.

The drug is an antibiotic used to treat a variety of bacterial infections, such
as cat-scratch disease, ear infections, infections of the skin or surrounding
tissue, and throat or tonsil infections.
Azithromycin is also used to treat lung and other respiratory infections, such
as bronchitis, sinusitis, community acquired pneumonia, some cases
of chronic obstructive pulmonary disease (COPD), and whooping cough
(pertussis).
Doctors may also prescribe azithromycin for genital infections and sexually
transmitted diseases, such as gonorrhea, infections of the urethra or cervix,
genital ulcers, and severe pelvic inflammatory disease.
Azithromycin belongs to group of drugs known as macrolide antibiotics. They
work by preventing bacteria from making their own proteins.
As with other antibiotics, to prevent the spread of drug-resistant infections,
the Food and Drug Administration (FDA) strongly advises doctors to
prescribe the drug only when there is proof, or a strong suspicion, that the
infection is caused by bacteria against which azithromycin is effective.
The FDA first approved azithromycin under the brand name Zithromax in
1991. Pfizer Pharmaceuticals manufactures the drug.

Azithromycin Warnings
Azithromycin can cause abnormal changes in the electrical activity of the
heart, which may lead to deadly irregular heart rhythm, according to a
special warning by the FDA in 2012.
If you have a heart-rhythm condition, such as a slow or irregular heartbeat,
or take drugs to treat these conditions, you should talk to your doctor about
it before taking azithromycin.
Your doctor also should make sure you have normal blood levels of
potassium and magnesium before prescribing azithromycin.
In addition, you should not take azithromycin if you:

 Are allergic to azithromycin or any of its

inactive ingredients
 Have a form of jaundice known as
cholestatic jaundice, in which bile backs
up into the liver and causes a yellowing
of the skin, eyes, or nails
 Are taking pimozide (Orap)
Before taking azithromycin, talk to your doctor if you:

 Have an irregular or slow heartbeat

 Have liver problems, including hepatitis
 Very severe kidney problems
 Have myasthenia gravis
Before taking azithromycin for gonorrhea or syphilis, you should be tested to
find out whether the bacteria causing the infection will actually respond to
azithromycin.
People who take azithromycin for long periods of time are more prone to
developing very serious bacterial or fungal infections that may be much
more difficult to treat.

Pregnancy and Azithromycin

Azithromycin is generally safe to take while pregnant.
Regardless, you should tell your doctor if you are pregnant or plan to
become pregnant before taking this medication.
Whether azithromycin is found in breast milk remains unknown. Talk to you
doctor if you are breastfeeding or plan to breastfeed before taking
azithromycin.

Azithromycin Side Effects

Common Side Effects of Azithromycin
Many people experience fewer side effects when taking azithromycin
compared with other antibiotics in the macrolide class, such
as erythromycin (Erythrocin).
However, you may still experience side effects, especially if your doctor
prescribed a high dose of azithromycin to be taken just one time. Tell your
doctor if you experience any of the following:

 Nausea
 Vomiting
 Diarrhea
 Gas
 Loose stools
 Stomach discomfort
Some people may also experience cramps and yeast or vaginal infection.

Serious Side Effects

Get emergency medical help right away if you experience any of the
following:

 Chest pain
 Seizures
 Swelling of the feet or ankles
 Inflammation of the colon (symptoms
may include abdominal pain, severe
diarrhea, fatigue)
 Fluid build-up between the lungs and
the chest wall (symptoms may include
chest pain or heaviness, or difficulty
breathing difficulties)
 Low count of white blood cells (this is
usually discovered in blood tests, but if
you have symptoms, they may include
weakness, tiredness, shortness of
breath, or infections that do not go
away)
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Azithromycin Interactions
It is always important to share with your doctor and pharmacist all of the
medications you are taking.
This includes not only all of your prescription medicine, but also products
that may not seem like medication, such as over-the-counter
drugs, vitamins and other dietary supplements (nutritional
shakes, protein powders, etc.), and herbals along with any legal or illegal
recreational drugs.
You should not take Azithromycin if you are taking

 Pimozide (Orap)
 BCG live (Theracrys)
 Dronedarone (Multaq)
Talk to your doctor about the possibility of prescribing a different antibiotic
than azithromycin if you are taking any of the following drugs:

 Blood thinners like enoxaparin

(Lovenox), fondaparinux (Arixta),
heparin, warfarin (Coumadin or
Jantoven)
 Medications used to prevent blood clots,
for instance during or after surgery or in
life-threatening situations: antithrombin
III (Thrombin), bivalirudin (Angiomax),
dalteparin (Fragmin)
 Amiodarone (Cordarone, Pacerone, or
Nextarone)
 Digoxin (Lanoxin)
 Live typhoid vaccine (Vivotif)
 Quinidine

Azithromycin and Alcohol

Alcohol may increase or worsen certain side effects caused by azithromycin,
such as dizziness and upset stomach.

Azithromycin and Grapefruit Juice

Grapefruit and azithromycin are both broken down the same way by the
liver, so interactions are possible, although they are thought to be
uncommon.
To be safe, avoid all grapefruit products while taking this drug.
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Azithromycin Dosage
Azithromycin is taken as a pill or liquid. It's also given as intravenous (IV)
injection in hospitals. Packets of powder are mixed with water to create the
liquid solution.
Azithromycin may be taken with or without food.
Doctors sometimes prescribe azithromycin for shorter periods than they do
for other antibiotics, such as in a one-day "mega-dose," or for three or five
days, using the Z-Pak, which starts at a higher dose than longer regimens.
The dosage and length of time for azithromycin treatment vary according to
the type of infection:

 Infections of the skin and skin tissues:

One dose of 500 milligrams (mg), then
250 mg per day for four days
 Infection of the throat and tonsils: One
dose of 500 mg; then 250 mg per day
for four days
 Community Acquired Pneumonia (CAP):
One dose of 500 mg, then 250 mg per
day for four days
 Genital Ulcer Disease: 1 gram (g), one
time
 Sinus infections caused by bacteria: 500
mg a day for three days or 2 g as a one-
time dose

Azithromycin Overdose
If you suspect an overdose, you should contact a poison-control center or
emergency room immediately.
You can get in touch with a poison control center at (800) 222-1222.

Missed Dose of Azithromycin

If you miss a dose of Azithromycin, try to take it as soon as you remember,
unless it is almost time for the next dose.
Then skip the missed dose and take your next dose at the regular time.
Do not take two doses of the medication at the same time.