
Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: azithromycin
BRAND NAME: Zithromax, Zmax
DRUG CLASS AND
MECHANISM: Azithromycin is a semi-synthetic macrolide antibiotic chemically
related to erythromycin and clarithromycin (Biaxin). It is effective against a
wide variety of bacteria such as Hemophilus influenzae, Streptococcus
pneumoniae, Mycoplasma pneumoniae, Staphylococcus aureus, mycobacterium avium,
and many others. Azithromycin, like all macrolide antibiotics, prevents bacteria
from growing by interfering with their ability to make proteins. Due to the
differences in the way proteins are made in bacteria and humans, the macrolide
antibiotics do not interfere with production of proteins in humans. It is an
unusual antibiotic in that it stays in the body for quite a while (has a long
half-life), allowing for once a day dosing and for shorter treatment courses for
most infections. The FDA approved azithromycin in November 1991.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 250, 500, and 600 mg. Suspension: 100 mg/ teaspoon,
200 mg/teaspoon, 167 mg/teaspoon or 1 g/packet. Powder for Injection: 500 mg.
STORAGE: Tablets should be stored at room temperature between 15-30°C
(59-86°F). Suspension and solution for injection should be kept between 5-30°C
(41-86°F).
PRESCRIBED FOR: Azithromycin is effective against susceptible bacteria
causing otitis media (infection of the middle ear), tonsillitis, laryngitis,
bronchitis, pneumonia, and
sinusitis. It also is effective against
several sexually transmitted infectious diseases such as nongonococcal
urethritis and cervicitis.
DOSING: Azithromycin (except Zmax) can be taken with or without food, but
food reduces stomach upset. Zmax should be taken on an empty stomach 1 hour
before or 2 hours after a meal since food reduces its absorption. The adult
azithromycin dose is 500-2000 mg in multiple or single doses. For most
infections, azithromycin is taken once daily for a relatively short course of
treatment (usually five days). The first dose is often a "double dose," twice as
much as the remainder of the doses given. For acute bacterial sinusitis,
azithromycin way be taken once daily for three days. Zmax usually is given as a
single 2 gm dose.
DRUG INTERACTIONS: Azithromycin (except Zmax) should not be taken at the same
time as aluminum- or magnesium- based antacids, such as
Mylanta or
Maalox
because antacids will bind the azithromycin and prevent it from being absorbed
from the intestine.
PREGNANCY: There are no adequate studies of azithromycin in
pregnant women.
Azithromycin should only be used during pregnancy if it is clearly necessary.
NURSING MOTHERS: It is not known if azithromycin is secreted in
breast milk.
SIDE EFFECTS: Azithromycin is generally well tolerated. The most common side
effects are diarrhea or loose stools,
nausea, abdominal pain, and
vomiting which
may occur in fewer than one in twenty persons who receive azithromycin. Rare
side effects include abnormal liver tests, allergic reactions, and nervousness.
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Back to Medications IndexLast Editorial Review: 3/4/2008