Zithromax Generic Name & Formulations
Legal Class
Rx
General Description
Azithromycin (as dihydrate) 250mg, 500mg, 600mg; tabs.
Pharmacological Class
Macrolide (azalide).
How Supplied
Tabs—30; Z-Pak (6×250mg tabs)—3; Tri-Pak (3×500mg tabs)—3; Oral susp, Single-dose packets—contact supplier
Manufacturer
Generic Availability
YES
Mechanism of Action
Azithromycin acts by binding to the 50S ribosomal subunit of susceptible microorganisms and, thus, interferes with microbial protein synthesis.
Zithromax Indications
Indications
Mild to moderate susceptible infections including acute bacterial exacerbations of COPD, acute bacterial sinusitis, acute otitis media, community-acquired pneumonia, pharyngitis/tonsillitis, uncomplicated skin and skin structure, urethritis, cervicitis, chancroid in men. Treatment and prophylaxis of Mycobacterium avium complex (MAC) infection.
Zithromax Dosage and Administration
Adult
Use packets only for doses equal to 1g. COPD: 500mg once daily for 3 days; or 500mg once for 1 day, then 250mg once daily for 4 days. Sinusitis: 500mg once daily for 3 days. Community-acquired pneumonia, pharyngitis/tonsillitis, skin and skin structure: 500mg once for 1 day, then 250mg once daily for 4 days. Nongonococcal urethritis, cervicitis, chancroid: 1g as a single dose. Urethritis, cervicitis due to N. gonorrhoeae: 2g as a single dose. MAC prevention (alone or combined with rifabutin): 1200mg once weekly. MAC treatment (combined with ethambutol): 600mg once daily.
Children
Use oral susp (not packets). Otitis media: <6mos: not established; ≥6mos: 30mg/kg as a single dose (max 1.5g); or 10mg/kg (max 500mg) once daily for 3 days; or 10mg/kg (max 500mg) once then 5mg/kg (max 250mg) per day for 4 days. Sinusitis: <6mos: not established; ≥6mos: 10mg/kg (max 500mg) once daily for 3 days. Community-acquired pneumonia: <6mos: not established; ≥6mos: 10mg/kg (max 500mg) once for 1 day, then 5mg/kg (max 250mg) once daily for 4 days. Pharyngitis/tonsillitis: <2yrs: not established; ≥2yrs: 12mg/kg (max 500mg) once daily for 5 days.
Administration
May take with or without food; increased tolerability has been seen when taken with food.
Nursing Considerations
May take with or without food; increased tolerability has been seen when taken with food.
Zithromax Contraindications
Contraindications
Ketolide allergy. History of cholestatic jaundice/hepatic dysfunction associated with prior use.
Zithromax Boxed Warnings
Not Applicable
Zithromax Warnings/Precautions
Warnings/Precautions
Pneumonia: oral treatment is for mild, community-acquired cases suitable for outpatient therapy only. Discontinue if signs/symptoms of hepatitis occur. Known QT prolongation, proarrhythmic conditions, clinically significant bradycardia: avoid. Potential risk of cardiovascular death. Allergic symptoms may recur after initial successful symptomatic treatment. Myasthenia gravis. Hepatic or renal impairment. Elderly. Pregnancy. Nursing mothers: monitor infants.
Zithromax Pharmacokinetics
Elimination
Biliary (primarily), renal.
Zithromax Interactions
Interactions
Avoid concomitant aluminum- or magnesium-containing antacids. Monitor with digoxin, colchicine, phenytoin, warfarin. Monitor for azithromycin toxicity (eg, liver dysfunction, ototoxicity) with nelfinavir. Concomitant Class 1A (eg, quinidine, procainamide), or Class III (eg, dofetilide, amiodarone, sotalol) antiarrhythmics, or others known to prolong the QT interval: avoid.
Zithromax Adverse Reactions
Adverse Reactions
Diarrhea, nausea, abdominal pain, vomiting, rash; hepatotoxicity, torsade de pointes (esp. elderly), C. difficile associated diarrhea; rare: allergic reactions (eg, angioedema, AGEP, Stevens-Johnson syndrome, toxic epidermal necrolysis, DRESS), lab abnormalities.
Zithromax Clinical Trials
See Literature
Zithromax Note
Not Applicable
Zithromax Patient Counseling
See Literature