azithromycin, Zithromax, Zithromax Tri-Pak, Zithromax Z-Pak, Zmax

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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PREPARATIONS: Tablets: 250, 500, and 600 mg. Suspension: 100 mg/5 ml (teaspoon), 200 mg/5 ml (teaspoon). Powder for suspension (extended release): 2 g. Powder for oral suspension: 1 g. Powder for Injection: 500 mg. Z-PAK (Blister pack containing six 250 mg tablets); TRI-PAK (Blister pack containing three 500 mg tablets).

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 AND BREASTFEEDING SAFETY: There are no adequate studies of azithromycin in pregnant women. Azithromycin should only be used during pregnancy if it is clearly necessary.

It is not known if azithromycin is secreted in breast milk.

STORAGE: Tablets should be stored at room temperature between 15 C to 30 C (59 F to 86 F). Suspension and solution for injection should be kept between 5 C to 30C (41 F to 86 F).

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 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. Because of 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.

Medically reviewed by Eni Williams, PharmD

Reference: FDA Prescribing Information

Medically Reviewed by a Doctor on 3/29/2016

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