Zithromax (Azithromycin)

To treat a common infections antibiotic Zithromax is prescribed. Its main active component is azithromycin. It is used for treating diseases which are sexually transmitted and bacterial infections. It decreases ability of bacteria to produce protein, in such way provoking peptide activity. This medicine stops bacteria from causing infection in organism and continuing to live. Zithromax is available in form of tablet as well as in a liquid form. Zithromax is permitted for adults and children.

Zithromax belongs to the family of medicines known as macrolides. Its main principle of action is suspending bacteria's protein production and lowering peptide activity. Both these factors make for reduced bacteria vitality. However, Zithromax cannot deal with viral infections, for example common cold, flu, or stomach flu.

Azithromycin causes an inhibiting effect both on peptides and protein, which prevents bacteria's further life and reproduction within the body. Zithromax's original vendor is Pfizer. Different brand names can be seen at the market as well. One of those are: Zithromax TRI-PAK, Zmax, Zithromax Z-PAK.

The medicine is sold in various dosages such as: 100 mg/5 mL solution (100 mg of Zithromax per teaspoon), 200 mg/5 mL solution (200 mg of Zithromax per teaspoon), 250 mg, 500 mg, 600 mg tablets, 1 gram powder pack. Zmax comes exclusively in a form of liquid solution. Zmax dosage is 2 mg/60 mL (the full 60 dose is intended to be taken once).





Licensed Zithromax (azithromycin) application is primarily the treatment of various bacterial infections in people of different ages. It is given with a prescription. Among infections treatable are:

• Sexually transmitted diseases (STDs)
• Bacterial infections

Sexually transmitted diseases

Infections that spread among people by means of sexual intercourse belong to a class of sexually transmitted diseases (STDs). People who happened to get an STD as a rule experience aching discharge accompanied by several other symptoms caused by inflammation of the urethra or cervix. Following STDs are commonly treated with Zithromax:

• Chlamydia
• Gonorrhea
• Chancroid

Bacterial infections

The following diseases are known to be successfully treated with Zithromax:

• Bronchitis and other respiratory infections
• Infections of sinus (sinusitis)
• Ear infections (otitis media)
• Throat infections (pharyngitis/tonsillitis)
• Pneumonia
• Pelvic inflammatory disease (PID)
• Folliculitis, cellulitis, impetigo and a number of other skin infections

Zithromax may also be prescribed in cases of less common bacterial infections. However, Zithromax cannot deal with viral infections, for example common cold, flu, or stomach flu.

Treating children

Zithromax has been clinically tested and can be applied for treatment of children, who suffer from diseases treatable by this medicine in adults. Examples of treatable infections include:

• Pneumonia
• Ear infections (otitis media)
• Bronchitis and other respiratory infections
• Pharyngitis/tonsillitis (Infections of throat)
• Skin infections
• Pelvic inflammatory disease
• Sinus infections (sinusitis)

Off-label usage

In rare cases, your doctor may consider prescribing this medicine for treatment of some disease other than mentioned in this text. Such cases fall under "off-label" usage category. Examples of "off-label" usages are given below:

• Treating acne
• Heart infections prevention (bacterial endocarditis)
• Treatment of pertussis (whooping cough)
• Cat scratch disease treatment
• Treatment of the HIV-positive having Mycobacterium avium complex (MAC)

A patient should take this medicine once a day, so that the level of it will be equal in your organism. It can be used during nourishing or just with water. When you see, that it is difficult for your organism to digest this medicine, you should take it when you eat. It is not necessary to take medicine with food if you are on a long acting medicine, it can be taken two hours after or one hour before you eat.

Zithromax is better to be drunk with a cup of water each time you take it. Like all other medicine, if you want to receive effect, you should take it, as they say it in the instructions. When you see that you are recovering, don't stop following the instructions. This will ensure that the infection is completely treated.

Avoid taking out-of-use drugs or it will damage your health. After the expiration date, the effect of drug may be damaged. When you are confused what dosage you need to take, your pharmacist or doctor will tell you more when you go and talk to them. When you think about quitting the treatment you should first talk to your doctor about your intentions.

What doses one should take when he has bacterial infections

When a person has a common bacterial infection, it is usually recommended to take Zithromax during three or five days a 250 mg or 500 mg pill one time a day. The doctor could tell you to prolong your treatment if you have any strong infections or if they are delayed and chronic.

You can vary the dose when you treat your kids with this medicine one time a day from 5 to 20 milligrams per kilogram of the weight of your child's body. The treatment may last during three or five days.

Dosing for diseases that are transmitted during sex

If a patient has STD's he could be prescribed 1 or 2 grams that is equivalent to 1000 or 2000 milligrams of medicine. The dose should be taken only once.


It is forbidden to take Zithromax when you:

• Experienced any problems with your liver after you took this medicine some time ago.
• Have allergies to any components that consist in this drug, like erythromycin or clarithromycin or any other inactive ingredient that they use for manufacturing. Usually the list of these ingredients exists in the office of your pharmacist or doctor.

When you decided to take this medicine your doctor should know about the following conditions that you might have:

• problems with liver or its failure
• problems with heart
• problems with kidney or their failure
• feeding with breast
• want to get pregnant or you are already pregnant
• myasthenia gravis
• you are going to have an operation
• any medication give you allergies

If you are under treatment with some other medicine at the moment, you also need to mention that to your doctor. This may include contraceptives that are taken orally, medicine for blood thinning, vitamins, bio addictions, antacids or drugs that are sold over the counter and by prescription.

Some warnings and precautions

Zithromax is a medicine that is able to interact with drugs of different types.

This drug belongs to the pregnancy type of medicine Category B. To this type belong that medications that were never tried by pregnant women. During tests that were made on animals, it was shown that this medication doesn't give any negative effects of infant that were not born. You still need to inform your doctor if you want to get pregnant or if you are already bearing a baby.

The doctor could change the dose of medicine or may even cancel its using to those patients that have problems with kidney.

This may also be applied by doctor to those patients that have problems with liver.

It is known that Zithromax may go inside the milk that goes from your breast. That is why you should inform your doctor about the fact that you are breastfeeding.

Like many other antibiotics, this medicine, can also bring strong diarrhea or as they say pseudomembranous colitis. The doctor should know if you are experiencing severe pain in stomach, watery diarrhea, low fever or bloody stool.

You might experience the appearance of other infections when you take this type of medication. When you feel that your condition is different from what you have had, you should say it to your doctor.

There were some occasions when this medication caused the raise of yeast infections that may be vaginal and oral.

Also this drug may be a cause of myasthenia gravis appearance or could make the symptoms of this disease much worse.

Avoid taking medicine with expired date. After the expiration date lots of drugs have a tendency to change the effects that they used to have.


About thousand of people were tested on how this drug influences them. All of the side effects that occurred to patients were examined and noted during the studies. They also took a group of people with the same symptoms which didn't take the medicine and made the comparison. According to such tests, the doctors could tell the frequency of side effects, what their kind is, and what the difference is when this medicine is not applied in your treatment.

In the following we list the most common side effects after taking this medicine, according to the studies:

• approximately 5% of patients had nausea
• 7% of patients were vomiting
• Another 7 had diarrhea
• 3% had pain in stomach
• 2% had unexplained rash
• 1% of patients had continuous headaches

The possibility of these side effects' appearance depends on the dosage of medicine and on the way of taking it.

Strong side effects

There are side effects after taking this drug that could be very dangerous. You should immediately quit taking the medication and run to your doctor. They may be the following:

• Wet diarrhea
• Unusual swell of all parts of the body
• Problems with swallowing and breathing
• Hissing respiration
• Bloody feces
• Yellow eyes and skin
• Abnormal swelling
• Rash
• Itchiness
• Skin peels
• Non-regular beat of heart

Side effects that are rare

There are side effects that happen rarely to patients, at about 1% of those that take Zithromax. It is not clear for what reason they occur, because they are very uncommon. They may be the following:

• Problems with kidney
• Liver sensitivity
• Allergies
• Dyspepsia and burn in heart
• Tinnitus
• Vagina sensitivity
• Coprostasis
• Low pressure of blood
• A low level of blood disks
• Dangerous gastric infections
• Thrush of vulva
• Infection in mouth
• Deaquation
• Sensitiveness to sun
• Burning and sounds in ears
• Giddiness

The main ingredient in this medicine is azithromycin. It is a antibiotic of macrolide that is semi-synthetic. From the chemical side, it comes from clarithromycin and erythromycin. Streptococcus pneumoniae, mycobacterium avium, Staphylococcus aureus, Hemophilus influenzae, Mycoplasma pneumoniae and many other bacteria can be treated effectively by this medication. The advantage of this solution is that it allows a short treatment and low doses because it may stay in your body for a pretty long time.

It also has an original ability to prevent the increasing of these bacterias by preventing them to create more proteins. It is the usual ability of all macrolide antibiotics. The whole action appears when a ribosomal subunit of 50S of microorganisms that are susceptible is bound to it and by this action it interferes with synthesizing of microbial protein. As a matter of fact it doesn't affect the synthesis of nucleic acid. There is a difference between how the proteins are made in humans and bacteria, thanks to this fact, this type of antibiotics does not prevent the production of proteins in human body.


Starting from 1970 a pharmaceutical company, from Zagreb, Croatia had a created a team that made researches with Dr. Slobodan Dokic as a head of this team. They made their researches in the field of macrolide antibiotics. Gabrijela Kobrehel, Gorjana Radobolja-Lazarevski and Zrinka Tamburasev made a synthesis of a new antibiotic in 1981. They named it azithromycin. It was a first macrolide antibiotic that belonged to azalides group. They received the dihydrate of azithromycin from a molecule of erythromycin. This solution showed predominant qualities.

In 1981 it received its patent and some time later, scientists from a famous pharmaceutical company Pfizer, found it when they went though the documents of patent. The licensing agreement between Pfizer and Pliva was signed in 1986. It gave an exclusive right to one of the companies on distribution of this medicine on the market of America and Western Europe under a name of Zithromax in 1991 by Pfizer. In 1988 Pliva started distributing it in Eastern and Central Europe with a name Sumamed.

Azithromycin made a revolution in the field of treatment with antibiotics thanks to its superior properties in therapy. It had also become one of the most prosperous medicine in the whole world. Beginning from the first tests, it showed its possibility to be exceedingly effectual having low percentage of side effects in the gastrointestinal area, improved and expanded activity against bacteria, especially its anti gram-negative pathogens activity and its high consistence in tissues if you make a parallel with antibiotics that are similar to this.


There are some companies that are producing a generic version of azithromycin. They are Pliva, Teva Pharmaceuticals, and Sandoz.

There are Azithromycin liquid or oral suspension and Azithromycin pills that are marketed as a generic azithromycin. It is divided into the doses according to the strength. For example:

• 250mg pills of Azithromycin
• 500mg pills of Azithromycin
• 600mg pills of Azithromycin
• A 200mg oral suspesnsion per 5mL. A teaspoon of 5mL of this liquid contains 200mg of azithromycin
• A 100mg oral suspesnsion per 5mL. A teaspoon of 5mL of this liquid contains 100mg of azithromycin

There is a whole list of other drugs that can react on the action of azithromycin. In the following we give a list of these medicines:

• Halcion or Triazolam
• Mylanta, Rolaids, Maalox, Riopan, Amphojel, Gelusis and other antacids that contain magnesium and aluminum
• Viracept or Nelfinavir
• Prograf, Tacrolimus or Protopic
• Alkaloids of ergot
• Jantoven, Coumadin or Warfarin
• Lanoxin, Digitek, Lanoxicaps or Digoxin
• Neoral, Restasis, Sandimmune, Cyclosporine or Gengraf
• Theo-24, Theochron, Theophylline, TheoCap, Uniphyl or Elixophyllin
• Quinine
• Phenytoin, Phenytek or Dilantin
• Epitol, Tegretol-XR, Tegretol, Equetro, Quinine Carbamazepine or Carbatrol

Below we describe in details why these medications may create a negative influence when azithromycin is combined with them.

Halcion or Triazolam
The level of triazolam could be increased in your body if you are using it with azithromycin. Your organism can regenerate it in a different way as it supposed to be. Ask your doctor to adjust the dose of your medication and maintain the progress that you have. It was not proved that this kind of interaction will appear during treatment exactly with azithromycin, but similar antibiotics had shown such effects.

Mylanta, Rolaids, Maalox, Riopan, Amphojel, Gelusis and other antacids that contain magnesium and aluminum
Antacids that contain magnesium or aluminum may prevent the total absorption of this medicine by your body comparing if you are not taking azithromycin with this type of antacids. Just maintain taking this medicine two hours later or couple of hours before you take antacids.

Viracept or Nelfinavir
Taking this medication with nelfinavir could cause its metabolization in other way as it should be. For example, it could raise the quantity of azithromycin in the organism. It is not necessary to adjust the dose. You can let your doctor to maintain the growth.

Prograf, Tacrolimus or Protopic
The use of tacrolimus and azithromycin at one time will make a different reaction on your body as it is intended. The amount of medicine in the organism could rise up high. Ask your doctor to choose what dose you need and monitor your recovery.

Alkaloids of ergot
If this type of medication is taken with medications of ergot, there is a danger to get a toxicity of it. Ask your doctor to choose what dose you need and monitor your recovery. It was not proved that this kind of interaction will appear during treatment exactly with azithromycin, but similar antibiotics had shown such effects.

Jantoven, Coumadin or Warfarin
When you take azithromycin with this medicine, the organism could react to it in a different way. There is a danger of bleeding. The doctor will maintain and adjust the state of your thrombinogen and INR. This will happen by making tests to define the quality of clotting of your blood.

Lanoxin, Digitek, Lanoxicaps or Digoxin
If this type of medication is taken with digoxin, your organism could metabolize it in a different way causing its toxicity. We advise you to talk and ask for advice from your doctor before you start taking it.

Neoral, Restasis, Sandimmune, Cyclosporine or Gengraf
The use of cyclosporine and azithromicin together will make a different reaction to your organism. It could make another metabolization and rise up the amount of drug in your body. Ask your doctor to choose what dose you need and monitor the process of your recovery.

Theo-24, Theochron, Theophylline, TheoCap, Uniphyl or Elixophyllin
When a patient takes theophylline and azithromycin together, his body could react in a different way on the metabolization as it is intended. It could probably rise up the amount of medicine in body. Ask your doctor to choose what dose you need and monitor the process of your recovery.

Quinine
It is advised to avoid taking azithromicin with quinine. It could bring harmful amounts of quinine to your blood.

Phenytoin, Phenytek or Dilantin
When a patient takes phenytoin and azithromycin together, his body could react in a different way on the metabolization as it is intended. It could probably rise up the amount of medicine in body. Ask your doctor to choose what dose you need and monitor the process of your recovery. It was not proved that this kind of interaction will appear during treatment exactly with azithromycin, but similar antibiotics had shown such effects.

Epitol, Tegretol-XR, Tegretol, Equetro, Quinine Carbamazepine or Carbatrol
The use of carbamazepine and azithromicin together will make a different reaction to your organism. It could make a distinct metabolisation and rise up the amount of drug in your body. Ask your doctor to choose what dose you need and monitor the process of your recovery. It was not proved that this kind of interaction will appear during treatment exactly with azithromycin, but similar antibiotics had shown such effects.