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azithromycin - Zithromax

General Information Azithromycin (Zithromax) is an antibiotic that is used to treat and prevent certain infections.
Specifics Azithromycin is a well-respected and very effective antibiotic.  It has a long track record of effectiveness and safety.

Azithromycin works by inhibiting the production of protein in bacteria.  Azithromycin is used for a variety of purposes including but not limited to the following:

1.  To treat serious infections due to bacteria such as pneumonia
2.  To treat a serious infection called DMAC ("disseminated Mycobacterium avium complex") which is found in the blood, bone marrow, liver, and/or other organs.
3.  To prevent DMAC.  This is probably its most frequent use.
4.  To treat sexually transmitted diseases especially chlamydia

Azithromycin is such an excellent and safe drug there may be tendency for it to be overused.  If it is overused in individuals or overall in the community, bacterial infections may become resistant to its effects.  Therefore, it is important to take this drug only when advised by someone that knows what they are doing.

Dosing Azithromycin may be given intravenously or by pill or liquid at a variety of doses to treat infections: the usual range is 250 mg once or twice a day depending on the type of infection.  Much higher doses may be given safely if necessary.

If taken to prevent DMAC, the usual dose is two 600 mg capsules once a week.

This refers to your willingness, ability, and actual performance in taking your medications.

For further information and tips on adherence, go to the Adherence section of this site.

It is very important to take every dose that is prescribed unless instructed by your healthcare provider.

Do not adjust the dose or frequency of azithromycin without speaking to your healthcare provider first.

If you miss doses, the infection that is being treated may not get better or sometimes the infection can even get much worse by the germ developing resistance to azithromycin or you may get DMAC if you are taking azithromycin for prevention.

It is strongly recommended that you consider using weekly pill boxes and arrange all of your doses a week in advance.  Buy a small pill box so that you can carry a dose or two of your medicines with you in case you are away from home.

Possible Side Effects
The package insert for most drugs including azithromycin is often overwhelming and scary with perhaps an overemphasis on side effects.  We have summarized the important and more common problems here.

Most people take azithromycin without any or very many side effects.  

Many folks will have a "spurt" or two of diarrhea after taking the preventative dose once a week.

Many side effects get better with time.

Other possible side effects include hearing loss, stomach upset, persistent diarrhea, nausea, liver problems, fever, or allergic rashes.

Allergic rashes can be very minor to very serious (rarely,) but all rashes should be reported.  If you have rash that steadily gets worse or you have a rash and fever, you need to inform your healthcare provider immediately.

This refers to the way that azithromycin affects other medications in your system and how other medications might affect azithromycin in your system.
There are several drugs that should not be used with azithromycin at all:  terfenidine, astemizole, cisapride.

There are several other drugs which should be used with the knowledge of their possible interactions with azithromycin:

antacids (take azithromycin at least an hour before the antacid)
oral contraceptives (birth control pills)
anticoagulant treatment with warfarin (Coumadin)

Make sure that your healthcare provider is aware of all the medications you are taking so that important and possibly dangerous interactions are not overlooked.

Report to you healthcare provider or go to an Emergency Room if you have severe side effects, increasing side effects, shortness of breath, fever, jaundice (eyes and skin turn yellow,) nausea and vomiting (so that you cannot hold down your food and liquids) or rash.
You can download this handout in PDF format by clicking HERE.