Azithromycin Uses

• Azithromycin indications
• Uses of Azithromycin in details
• Azithromycin description
• Azithromycin dosage
• Azithromycin interactions
• Azithromycin side effects
• Azithromycin contraindications

What is Azithromycin?

Azithromycin injection is used to treat bacterial infections in many different parts of the body. It is also used to prevent Mycobacterium avium complex (MAC) disease in patients infected with the human immunodeficiency virus (HIV).

Azithromycin belongs to the class of drugs known as macrolide antibiotics. It works by killing bacteria or preventing their growth. However, Azithromycin will not work for colds, flu, or other virus infections. Azithromycin injection may be used for other problems as determined by your doctor.

Azithromycin is available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, Azithromycin is used in certain patients with the following medical condition:

• Trachoma (treatment).

Azithromycin indications

To reduce the development of drug-resistant bacteria and maintain the effectiveness of Azithromycin Tablets and other antibacterial drugs, Azithromycin Tablets should be used only to treat infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

Azithromycin Tablets are a macrolide antibacterial drug indicated for the treatment of patients with mild to moderate infections caused by susceptible strains of the designated microorganisms in the specific conditions listed below.

Mycobacterial Infections

Prophylaxis of Disseminated Mycobacterium avium complex (MAC) Disease

Azithromycin Tablets, taken alone or in combination with rifabutin at its approved dose, are indicated for the prevention of disseminated MAC disease in persons with advanced HIV infection.

Treatment of Disseminated MAC Disease

Azithromycin Tablets, taken in combination with ethambutol, are indicated for the treatment of disseminated MAC infections in persons with advanced HIV infection.

How should I use Azithromycin?

Use Azithromycin drops as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• An extra patient leaflet is available with Azithromycin drops. Talk to your pharmacist if you have questions about this information.
• Azithromycin drops is for use in the eye only. Do not swallow it.
• Wash your hands immediately before you use Azithromycin drops.
• To use Azithromycin drops, turn the bottle upside down and shake once before each use. Remove the cap while the bottle is still upside down. Tilt your head back. Using your index finger, pull the lower eyelid away from the eye to form a pouch. Gently squeeze the bottle to drop the medicine into the pouch, then gently close your eyes. Immediately use your finger to apply pressure to the inside corner of the eye for 1 to 2 minutes. Do not blink. Remove excess medicine around your eye with a clean, dry tissue, being careful not to touch your eye. Wash your hands to remove any medicine that may be on them.
• If a drop does not come out of the bottle when using your dose, repeat these steps.
• To prevent germs from contaminating your medicine, do not touch the applicator tip to any surface, including the eye. Keep the container tightly closed.
• Do not wear contact lenses while you are using Azithromycin drops. Take care of your contact lenses as directed by the manufacturer. Check with your doctor before you use them.
• To clear up your infection completely, use Azithromycin drops for the full course of treatment. Keep using it even if you feel better in a few days.
• If you miss a dose of Azithromycin drops, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Azithromycin drops.

Uses of Azithromycin in details

Use: Labeled Indications

Oral, IV:

Chancroid: Treatment of genital ulcer disease (in men) due to Haemophilus ducreyi (chancroid)

Chronic obstructive pulmonary disease, acute exacerbation: Treatment of acute bacterial exacerbations of chronic obstructive pulmonary disease (COPD) due to Haemophilus influenzae, Moraxella catarrhalis, or Streptococcus pneumoniae

Mycobacterium avium complex: Prevention of Mycobacterium avium complex (MAC) in patients with advanced HIV infection; treatment of disseminated MAC (in combination with ethambutol) in patients with advanced HIV infection

Otitis media, acute: Treatment of acute otitis media due to H. influenzae, M. catarrhalis, or S. pneumoniae

Pneumonia, community-acquired: Treatment of community-acquired pneumonia (CAP) due to Chlamydophila pneumoniae, H. influenzae, Legionella pneumophila, M. catarrhalis, Mycoplasma pneumoniae, or S. pneumoniae

Skin and skin structure infection, uncomplicated: Treatment of uncomplicated skin and skin structure infections due to Staphylococcus aureus, Streptococcus pyogenes, or Streptococcus agalactiae

Streptococcal pharyngitis (group A): Treatment of pharyngitis/tonsillitis due to S. pyogenes as an alternative to first-line therapy

Urethritis/cervicitis: Treatment of urethritis and cervicitis due to Chlamydia trachomatis or Neisseria gonorrhoeae

Off Label Uses

Acne vulgaris

Data from controlled trials support the use of Azithromycin in the treatment of acne vulgaris in adults with moderate to severe acne.

Based on the American Academy of Dermatology guidelines of care for the management of acne vulgaris, Azithromycin, in combination with topical therapy, may be considered as a treatment option for moderate and severe acne and forms of inflammatory acne that are resistant to topical treatments. However, its use should be limited to patients who cannot receive a tetracycline (ie, pregnant women). Concomitant topical therapy with benzoyl peroxide or a retinoid should be administered with systemic antibiotic therapy (eg, Azithromycin) and continued for maintenance after the antibiotic course is completed.

Babesiosis

Data from a prospective, nonblinded, randomized trial in patients with non-life-threatening babesiosis, support the use of Azithromycin (in combination with atovaquone) for the treatment of this condition.

Based on the CDC Yellow Book, the ACG guideline for the diagnosis, treatment, and prevention of acute diarrheal infections in adults, and the IDSA practice guidelines for the diagnosis and management of infectious diarrhea, Azithromycin is effective and recommended treatment for patients with travelers' diarrhea. Due to increased levels of resistance to fluoroquinolones, Azithromycin may be a recommended first-line treatment, especially in regions with a high prevalence of Campylobacter (eg, Southeast Asia, India) or in geographical areas with suspected fluoroquinolone-resistant pathogens or enterotoxigenic Escherichia coli.

Azithromycin description

Each film-coated tablet contains Azithromycin dihydrate equivalent to Azithromycin 500 mg.

Azithromycin is a nitrogen-containing macrolide or azalide with actions and uses similar to those of erythromycin. Azithromycin is derived from erythromycin. However, it differs chemically from erythromycin in that a methyl-substituted nitrogen atom is incorporated into the lactone ring.

Azithromycin dosage

Not for pediatric use.

For pediatric patients, please refer to the INDICATIONS AND USAGE and DOSAGE AND ADMINISTRATION sections of the prescribing information for Azithromycin for oral suspension 100 mg/5 mL and 200 mg/5 mL bottles.

Azithromycin Tablets may be taken without regard to food. However, increased tolerability has been observed when tablets are taken with food.

Mycobacterial Infections

Prevention of Disseminated MAC Infections

The recommended dose of Azithromycin Tablets for the prevention of disseminated Mycobacterium avium complex (MAC) disease is: 1200 mg taken once weekly. This dose of Azithromycin Tablets may be combined with the approved dosage regimen of rifabutin.

Treatment of Disseminated MAC Infections

Azithromycin Tablets should be taken at a daily dose of 600 mg, in combination with ethambutol at the recommended daily dose of 15 mg/kg. Other antimycobacterial drugs that have shown in vitro activity against MAC may be added to the regimen of Azithromycin plus ethambutol at the discretion of the physician or health care provider.

Azithromycin interactions

See also:
What other drugs will affect Azithromycin?

Antacids: In a pharmacokinetic study investigating the effects of simultaneous administration of antacid with Azithromycin, no effects on overall bioavailability was seen although peak serum concentrations were reduced by up to 30%. In patients receiving both Azithromycin and antacids, the drug should not be taken simultaneously.

Carbamazepine: In a pharmacokinetic interaction study in healthy volunteers, no significant effect was observed on the plasma levels of carbamazepine or its active metabolite in patients receiving concomitant Azithromycin.

Cimetidine: A single dose of cimetidine administered 2 hrs before Azithromycin had no effect on the pharmacokinetics of Azithromycin.

Cyclosporin: In the absence of conclusive data from pharmacokinetics or clinical studies investigating potential interaction between Azithromycin and cyclosporin, caution should be exercised before concurrent administration of these drugs. If co-administration of these drugs is necessary, cyclosporin levels should be monitored and the dose adjusted accordingly.

Digoxin: Some of the macrolide antibiotics have been reported to impair the metabolism of digoxin (in the gut) in some patients. Therefore, in patients receiving concomitant Azithromycin and digoxin, the possibility of raised digoxin levels should be bourne in mind, and digoxin levels monitored.

Ergot Derivatives: Because of the theoretical possibility of ergotism, Azithromycin and ergot derivatives should not be co-administered.

Methylprednisolone: In a pharmacokinetic interaction study in healthy volunteers, Azithromycin had no significant effect on the pharmacokinetics of methylprednisolone.

Terfenadine: Pharmacokinetic studies have reported no evidence of an interaction between Azithromycin and terfenadine. There have been rare cases reported where the possibility of such an interaction could not be entirely excluded; however, there was no specific evidence that such an interaction had occured.

Theophylline: There is no evidence of any pharmacokinetic interaction when Azithromycin and theophylline are co-administered in healthy volunteers.

Coumarin-Type

Oral Anticoagulants:

In a pharmacodynamic interaction study, Azithromycin did not alter the anticoagulant effect of a single dose warfarin 15 mg administered to healthy volunteers. There have been reports received in the post-marketing period of potentiated anticoagulant subsequent to co-administration of Azithromycin and coumarin-type oral anticoagulants. Although a causal relationship has not been established, consideration should be given to the frequency of monitoring prothrombin time when Azithromycin is used in patients receiving coumarin-type oral anticoagulants.

Zidovudine: Single 1000 mg doses, and multiple 1200 mg or 600 mg doses of Azithromycin did not affect the plasma pharmacokinetics or urinary excretion of zidovudine or its glucuronide metabolite. However, administration of Azithromycin increased the concentrations of phosphorylated zidovudine, the clinically active metabolite, in peripheral blood mononuclear cells. The clinical significance of this finding is unclear, but it may be of benefit to patients.

Didanosine: Co-administration of daily doses of Azithromycin 1200 mg with didanosine in 6 subjects did not appear to affect the pharmacokinetics of didanosine as compared with placebo.

Rifabutin: Co-administration of Azithromycin and rifabutin did not affect the serum concentrations of either drug. Neutropenia was observed in subjects receiving concomitant treatment of Azithromycin and rifabutin. Although neutropenia has been associated with the use of rifabutin, a causal relationship to combination with Azithromycin has not been established.

Azithromycin side effects

See also:
What are the possible side effects of Azithromycin?

Applies to Azithromycin ophthalmic: ophthalmic solution

In addition to its needed effects, some unwanted effects may be caused by Azithromycin ophthalmic. In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking Azithromycin ophthalmic:

Less common:

• Burning, redness, stinging, or other eye irritation

Rare

• Blistering, burning, crusting, dryness, or flaking of the skin
• blurred vision
• cough
• decreased vision
• discharge from the eye
• fever
• headache
• hives or welts
• itching, scaling, severe redness, soreness, or swelling of the skin
• pain or tenderness around the eyes and cheekbones
• painful irritation of the clear front part of the eye
• shortness of breath or troubled breathing
• skin rash
• stuffy or runny nose
• swelling of the face
• swelling or puffiness of the eyes
• tightness of the chest or wheezing

Minor Side Effects

Some of the side effects that can occur with Azithromycin ophthalmic may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Rare

• Change in taste
• dry eyes
• loss of taste

Azithromycin contraindications

See also:
What is the most important information I should know about Azithromycin?

Hypersensitivity

Azithromycin Tablets are contraindicated in patients with known hypersensitivity to Azithromycin, erythromycin, any macrolide, or ketolide drug.

Hepatic Dysfunction

Azithromycin Tablets are contraindicated in patients with a history of cholestatic jaundice/hepatic dysfunction associated with prior use of Azithromycin.

Active ingredient matches for Azithromycin:

Azithromycin

Unit description / dosage (Manufacturer)	Price, USD
Tablet, Film-Coated; Oral; Azithromycin Monohydrate 250 mg
Injectable; Injection; Azithromycin 500 mg
Capsule; Oral; Azithromycin Dihydrate 250 mg
Tablet; Oral; Azithromycin 500 mg
Capsule; Oral; Azithromycin 250 mg
Injectable; Injection; Azithromycin Hydrogencitrate 2.5 g
Injectable; Injection; Azithromycin Hydrogencitrate 500 mg
Tablet; Oral; Azithromycin 250 mg
Tablet; Oral; Azithromycin 600 mg
Tablet, Film-Coated; Oral; Azithromycin Monohydrate 500 mg
Suspension; Oral; Azithromycin 100 mg / 5 ml
Suspension; Oral; Azithromycin 200 mg / 5 ml
Tablet, Film-Coated; Oral; Azithromycin 250 mg
Tablet, Film-Coated; Oral; Azithromycin 500 mg
Zithromax 3 1 gm Packets Box	$ 118.26
Azithromycin 2.5 gm bulk vial	$ 75.60
Zmax adult-ped 2 g/60 ml susp	$ 70.39
Zithromax Tri-Pak 3 500 mg tablet Disp Pack	$ 69.67
Zithromax Z-Pak 6 250 mg tablet Disp Pack	$ 68.62
Zmax 2 g/60 ml susp sr	$ 67.04
Zmax pediatric 2 g/60 ml susp	$ 67.04
Zithromax 200 mg/5ml Suspension 30ml Bottle	$ 52.00
Zithromax 100 mg/5ml Suspension 15ml Bottle	$ 51.60
Zithromax 200 mg/5ml Suspension 15ml Bottle	$ 50.46
Zithromax 200 mg/5ml Suspension 22.5ml Bottle	$ 50.46
Azithromycin 3 500 mg tablet Disp Pack	$ 48.52
Azithromycin 6 250 mg tablet Disp Pack	$ 48.52
Azasite 1% eye drops	$ 42.85
Zithromax i.v. 500 mg vial	$ 34.39
Azithromycin 200 mg/5ml Suspension 15ml Bottle	$ 34.25
Zithromax 600 mg tablet	$ 27.22
Zithromax 500 mg tablet	$ 22.68
Zithromax tri-pak 500 mg tablet	$ 22.24
Azithromycin 600 mg tablet	$ 19.04
Azithromycin 500 mg tablet	$ 15.87
Trimox 125 mg/5ml Suspension 100ml Bottle	$ 11.99
Trimox 125 mg/5ml Suspension 150ml Bottle	$ 11.99
Trimox 250 mg/5ml Suspension 80ml Bottle	$ 11.99
Zithromax 250 mg z-pak tablet	$ 11.12
Azithromycin i.v. 500 mg vial	$ 11.09
Azithromycin powder	$ 10.89
Zithromax 250 mg tablet	$ 9.41
Azithromycin 250 mg tablet	$ 6.33
Apo-Azithromycin 250 mg Tablet	$ 3.11
Co Azithromycin 250 mg Tablet	$ 3.11
Mylan-Azithromycin 250 mg Tablet	$ 3.11
Novo-Azithromycin 250 mg Tablet	$ 3.11
Phl-Azithromycin 250 mg Tablet	$ 3.11
Pms-Azithromycin 250 mg Tablet	$ 3.11
Ratio-Azithromycin 250 mg Tablet	$ 3.11
Sandoz Azithromycin 250 mg Tablet	$ 3.11
Zithromax 40 mg/ml Suspension	$ 1.70
Zithromax 20 mg/ml Suspension	$ 1.20
Novo-Azithromycin 40 mg/ml Suspension	$ 0.95
Pms-Azithromycin 40 mg/ml Suspension	$ 0.95
Sandoz Azithromycin 40 mg/ml Suspension	$ 0.95
Novo-Azithromycin 20 mg/ml Suspension	$ 0.67
Pms-Azithromycin 20 mg/ml Suspension	$ 0.67
Sandoz Azithromycin 20 mg/ml Suspension	$ 0.67
Tablets, Film-Coated; Oral; Azithromycin Monohydrate 250 mg
Capsules; Oral; Azithromycin Dihydrate 250 mg
Tablets; Oral; Azithromycin 500 mg
Capsules; Oral; Azithromycin 250 mg
Injectable; Injection; Azithromycin Hydrogen Citrate 2.5 g
Injectable; Injection; Azithromycin Hydrogen Citrate 500 mg
Tablets; Oral; Azithromycin 250 mg
Tablets; Oral; Azithromycin 600 mg
Tablets, Film-Coated; Oral; Azithromycin Monohydrate 500 mg
Tablets, Film-Coated; Oral; Azithromycin 250 mg
Tablets, Film-Coated; Oral; Azithromycin 500 mg
Azithromycin tablet, film coated 600 mg/1 (REMEDYREPACK INC. (US))
Azithromycin tablet 600 mg (Sanis Health Inc (Canada))
Azithromycin tablet 250 mg (4513347 Canada Inc. (Canada))
Azithromycin tablet, film coated 250 mg/1 (Department Of State Health Services, Pharmacy Branch (US))
Azithromycin tablet, film coated 500 mg/1 (REMEDYREPACK INC. (US))
Azithromycin tablet 500 mg/1 (REMEDYREPACK INC. (US))
Azithromycin injection 500 mg/10mL (Apotex Corp. (US))
List of Azithromycin substitutes (brand and generic names):
Azithrommycin-1A Pharma (Poland)
Azithromycin +pharma (Austria)
Azithromycin +pharma 500 mg (Austria)
Azithromycin - 1 A Pharma (Germany)
Azithromycin 10% (Japan)
AZITHROMYCIN 100MG DT TABLET
AZITHROMYCIN 100MG DT TABLET 1 strip / 10 tablets each (Jan Aushadhi)	$ 0.26
AZITHROMYCIN 100MG/ 5ML SYRUP
AZITHROMYCIN 100MG/ 5ML SYRUP 1 bottle / 15 ML syrup each (Jan Aushadhi)	$ 0.19
Azithromycin 1A Farma (Denmark)
Azithromycin 1A Pharma 250 mg (Hungary)
Azithromycin 1A Pharma 500 mg (Austria, Hungary)
Azithromycin 200mg/5ml (United Kingdom)
Azithromycin 250
Azithromycin 250 mg
Azithromycin 250mg (United Kingdom)
AZITHROMYCIN 250MG TABLET
AZITHROMYCIN 250MG TABLET 1 strip / 10 tablets each (Jan Aushadhi)	$ 0.84
Azithromycin 3 Day Dose Pack
Azithromycin 5 Day Dose Pack
Azithromycin 500 Mg
Azithromycin 500mg (United Kingdom)
AZITHROMYCIN 500MG TABLET
AZITHROMYCIN 500MG TABLET 1 strip / 10 tablets each (Jan Aushadhi)	$ 1.63
Azithromycin AbZ (Germany)
Azithromycin Actavis (Switzerland)
Azithromycin Actavis film-coated tab 250 mg 15's (Actavis)
Azithromycin Actavis film-coated tab 250 mg 6's (Actavis)
Azithromycin Actavis film-coated tab 500 mg 15's (Actavis)
Azithromycin Actavis film-coated tab 500 mg 3's (Actavis)
Azithromycin Actavis 500 mg (Austria)
Azithromycin Adico (Switzerland)
Azithromycin AL (Germany)
Azithromycin Almus (Germany)
Azithromycin Alphapharm (Australia)
Azithromycin Apotex (United States)
Azithromycin Arcana (Austria)
Azithromycin Arcana 200 mg/5 ml (Austria)
Azithromycin Arcana 500 mg (Austria)
Azithromycin Aristo (Germany)
Azithromycin Aristopharma (Georgia)
Azithromycin Astro (Austria)
Azithromycin Aurochem (Georgia)
Azithromycin Aurovitas (Poland)
Azithromycin AWD (Germany)
Azithromycin Bidiphar (Vietnam)
Azithromycin Bidiphar 250 mg x 1 Blister x 6 Tablet
Azithromycin Central Procurement (Malta)
See 7333 substitutes for Azithromycin

References

1. DailyMed. "AZITHROMYCIN: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
2. PubChem. "azithromycin". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
3. DrugBank. "azithromycin". http://www.drugbank.ca/drugs/DB00207 (accessed September 17, 2018).

Reviews

The results of a survey conducted on ndrugs.com for Azithromycin are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Azithromycin. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.

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Information checked by Dr. Sachin Kumar, MD Pharmacology