Zithromax (azithromycin) is an antibiotic that fights bacteria. Zithromax is used to treat many different types of infections caused by bacteria, such as respiratory infections, skin infections, ear infections, and sexually transmitted diseases. This includes middle ear infections, strep throat, pneumonia, traveler's diarrhea, and certain other intestinal infections. It can also be used for a number of sexually transmitted infections, including chlamydia and gonorrhea infections.
Brand Names: Zithromax, Zmax
Drug Fact
Class : Macrolide antibiotic
Category: Prescription Only
Uses: treat many different types of infections caused by bacteria, such as respiratory infections, skin infections, ear infections, and sexually transmitted diseases
Consumed by: adults and children
Pregnancy category: B
Category B
Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women..
Dosage form: tablet, capsule, suspension, eye drop, and injection.
Side Effect :
- Diarrhea
- loose stools
- Blistering, crusting, irritation, itching, or reddening of the skin
- cracked, dry, or scaly skin
- fever
- swelling
Administration
Tab & Susp: May be taken with or without food. May be taken w/ meals to reduce GI discomfort.
Cap &Amp; Extended Release Microspheres: Should be taken on an empty stomach. Take 1 hr before or 2 hr after meals.
Reconstitution
Intravenous:
Powder for inj: Add 4.8 mL of sterile water for inj to the 500 mg vial. Further diluted to a concentration of 1 mg/mL (500 mL) to 2 mg/mL (250 mL) in normal saline, 5% dextrose in water or lactated ringer solution.
Contraindications
Hypersensitivity to macrolide antibiotics. History of hepatic dysfunction/cholestatic jaundice following previous antibiotic use.
Special Precautions
Patients with myasthenia gravis, electrolyte disturbance particularly hypokalaemia and hypomagnesaemia; bradycardia, cardiac arrhythmia, severe cardiac insufficiency, congenital or documented QT prolongation, history of torsades de pointes. Severe renal (GFR <10 mL/min) and hepatic impairment. Children. Pregnancy and lactation. Azithromycin should not be given long-term to prevent bronchiolitis obliterans syndrome in patients with cancers of the blood or lymph nodes who undergo a hematopoietic stem cell transplant.
Adverse Reactions
Significant: Myasthenia gravis.
Ear and labyrinth disorders: Deafness.
Eye disorders: Pruritus, burning, stinging of the eye or ocular discomfort, sticky eye sensation, foreign body sensation (ophthalmic).
Gastrointestinal disorders: Diarrhoea, vomiting, abdominal pain, nausea, flatulence, dyspepsia, dysgeusia.
General disorders and admin site conditions: Injection site pain, fatigue.
Investigations: Decreased lymphocyte count and blood bicarbonate; increased eosinophil count, basophils, monocytes and neutrophils.
Metabolism and nutrition disorders: Anorexia.
Musculoskeletal and connective tissue disorders: Arthralgia.
Nervous system disorders: Headache, dizziness, paraesthesia.
Skin and subcutaneous tissue disorders: Pruritus, rash.
Potentially Fatal: Rarely, serious hypersensitivity reactions (e.g. anaphylaxis, angioedema, Stevens-Johnson syndrome, toxic epidermal necrolysis, acute generalised exanthematous pustulosis drug reaction with eosinophilia and systemic symptoms), fulminant hepatitis leading to liver failure, prolonged cardiac repolarisation and QT interval, cardiac arrhythmia, torsades de pointes, Clostridium difficile associated diarrhea (CDAD).
Pregnancy Category (US FDA)
IV/Ophth/Parenteral/PO: B
Patient Counseling Information
Ophthalmic: Avoid using contact lenses during treatment. This drug may cause blurred vision, if affected, do not drive or operate machinery.
MonitoringParameters
Monitor liver function values and blood count with differential. Perform culture and susceptibility testing before initiating therapy.
Overdosage
Symptoms: Diarrhoea, reversible hearing loss, severe nausea and vomiting. Management: Initiate symptomatic and supportive measures as necessary.
Drug Interactions
Increased risk of prolonged QT interval with class IA (e.g. quinidine, procainamide) and class III (e.g. dofetilide, amiodarone, sotalol) antiarrhythmics; pimozide cisapride and terfenadine. Increased serum concentrations of digoxin, colchicine, and ciclosporin. May potentiate the effects of oral anticoagulants (e.g. warfarin).
Action
Description: Azithromycin is a macrolide antibiotic under the azalide group. It inhibits RNA-dependent protein synthesis by binding to the 50s ribosomal subunit, preventing the translocation of peptide chains.
Pharmacokinetics:
Absorption: Rapidly absorbed from the gastrointestinal tract. Bioavailability: Approx 37%. Time to peak plasma concentration: Approx 2-3 hours (oral, immediate release).
Distribution: Extensively distributed in the tissues (skin, lungs, tonsils, cervix) and sputum. Present in breastmilk. Volume of distribution: 31-33 L/kg. Plasma protein-binding: 7-51%.
Metabolism: Metabolised in the liver to inactive metabolites.
Excretion: Via bile (50%, as unchanged drug); urine (6-14%, as unchanged drug). Terminal elimination half-life: 68-72 hours (conventional preparations); 59 hours (extended release).
Chemical Structure
Storage
Tab/Immediate release suspension/Inj: Store below 30°C. Cap/Eye drop (1.5%): Store below 25°C. Protect from light. Eye drop (1%): Store between 2-8°C.
ATC Classification
S01AA26 - azithromycin ; Belongs to the class of antibiotics. Used in the treatment of eye infections.
J01FA10 - azithromycin ; Belongs to the class of macrolides. Used in the systemic treatment of infections.
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