Generic Zithromax

By Kathleen G. Burke, PhD, RN
Medically Reviewed by Amy Schnees, Pharm.D. BCPS, CSP
Last Update: August 20, 2024

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What is Zithromax?

Zithromax (azithromycin) is one of the most popular antibacterial drugs available on the market today. It is used to treat various bacterial infections, primarily those associated with the respiratory organs. The drug can be used to treat both adults and children.

Azithromycin is an organic substance from the group of macrolides, a subclass of azalides. It is very similar in pharmacological action to erythromycin, of which it is derived. However, azithromycin differs in many ways from its predecessor. First of all, it is not destroyed by the action of gastric juice – the substance is about 300 times more resistant to acids than erythromycin. In addition, it causes a much smaller number of side effects associated with the gastrointestinal tract than erythromycin. In general, macrolides have a much milder, sparing effect on the body and less toxicity compared with the widely-spread but already rather outdated penicillins. For this reason, the drug can be used to treat infants.

Another useful feature of the antibiotic is its long time of withdrawal from the body. Half of azithromycin is eliminated from the body in approximately 50 hours. This means that this substance is stored in the body for a long time, and often it can have its effect after 5-7 days after the end of the course, which is very important in the treatment of severe and prolonged infections with a high probability of relapse. Also, this property of the medication can reduce the frequency of its admission and the duration of treatment.

However, despite the fact that the medication is prone to be in the body for a long time, it is absorbed into the blood very quickly – the maximum concentration of azithromycin is observed 2.5 hours after administration.

Another important feature of the antibiotic is its ability to accumulate primarily in the tissues (not in the blood plasma) mainly in the focus of infection. The concentration of a substance at the site of infection is about 30% higher than in healthy tissues. This ability of the antibiotic to find a source of infection is also very useful and distinguishes it from many other means evenly distributed in all tissues and fluids. The substance is able to penetrate into phagocytes and macrophages and be transported with them into tissues infected with bacilli.

In addition, azithromycin acts not only outside the body cells but also inside them. And this means that it can also affect bacteria – intracellular parasites, such as mycoplasma and chlamydia.

The antibiotic has a broad spectrum of activity and is active against various types of bacteria – gram-negative, gram-positive, aerobic and anaerobic. Only very few bacilli are resistant to it – these are some strains of streptococcus and staphylococcus, salmonella and shigella.

Bacteria sensitive to the effects of the drug:

• streptococci;
• staphylococcus;
• legionella;
• chlamydia;
• mycoplasmas;
• toxoplasma;
• Clostridiums;
• Borelli;
• hemophilic sticks.

The drug is usually produced in film-coated tablets with a dosage of 100, 250, 500 mg of the active substance.

Indications

Zithromax is used to treat infectious diseases involving:

• upper airways (throat, nasopharynx, sinuses);
• lower airways (bronchi and trachea);
• lungs;
• urinary organs;
• skin

Respiratory diseases for which the drug may be prescribed:

• bronchitis;
• pneumonia (including atypical);
• pharyngitis;
• rhinitis;
• sinusitis;
• scarlet fever;
• otitis media;
• sinusitis

Urogenital diseases for which the drug can be used:

• urethritis;
• cervicitis;
• cystitis;
• adnexitis;
• prostatitis.

Also, this antibiotic can be used in the early stages of borreliosis (Lyme disease), various skin infections and soft tissue infections (erysipelas, impetigo, dermatosis, acne of moderate severity).

As part of combination therapy, the medication can be used to kill Helicobacter pylori, which causes various diseases of the stomach – gastritis and ulcer.

Dosage and mode of application

A tablet should be swallowed whole with water. Use in children older than 12 years is possible according to the dosing regimen.

The required dose is taken once a day 1 hour before meals or 2 hours after meals.

Infections of the lower or upper respiratory tract, infections of soft tissues, skin infections: 0.5 g/day in one dose for three days (dose per course – 1.5 g).

Erythema migrans (at the onset of Lyme disease): on the 1st day – 1 g at a time, 2-5 days – 0.5 g daily (dose on a 5-day course – 3 g).

Acne vulgaris: 0.5 g/day in 1 dose for three days, then 0.5 g/day once a week for nine weeks. The first weekly pill must be taken seven days after taking the first daily pill (that is, 8 days from the start of treatment), the next 8 weekly pills are taken at intervals of 7 days.

Chlamydial infections of the urinary tract (uncomplicated cervicitis, urethritis): 1 g once a day.

Patients with kidney failure: with moderate impairment (creatinine release rate> 40 ml/minute), the dose adjustment is not required.

If you miss a single dose of medication, take it as soon as possible, the next dose is taken with an interval of 24 hours.

The physician should take into account that in the treatment with Azithromycin, as with any antibiotic therapy, superinfection may be added (against the background of an unfinished infectious process, the imposition of a new infection), including fungal infection.

A tablet must be taken at least one hour before or two hours after taking drugs that reduce the acidity of the gastric juice (antacids).

The patient should take into account that during treatment it is necessary to refrain from engaging in hazardous types of work that require a high concentration of attention, quick reactions, as well as driving vehicles.

Contraindications

Do not use this antibiotic if you have any of the conditions listed below:

• severe hepatic and/or renal failure;
• children up to 12 years old;
• breastfeeding;
• concomitant use with ergotamine and dihydroergotamine;
• hypersensitivity to macrolide antibiotics.

The drug is used with caution: moderate liver and kidney problems, arrhythmias or susceptibility to arrhythmias and prolongation of the QT interval, concomitant use with terfenadine, warfarin, digoxin.

Side effects

• Infectious diseases: candidiasis (including oral mucosa and genital mucosa), pneumonia, pharyngitis, gastroenteritis, respiratory diseases, rhinitis, pseudomembranous colitis;
• Blood and lymphatic system: leukopenia, neutropenia, eosinophilia, thrombocytopenia, hemolytic anemia;
• Metabolism: anorexia;
• Allergic reactions: angioedema, hypersensitivity reaction, anaphylactic reaction;
• Nervous system: headache, dizziness, a violation of taste, paresthesia, drowsiness, insomnia, nervousness, agitation, hypesthesia, anxiety, aggression, fainting, convulsions, psychomotor hyperactivity, loss of smell, perversion of smell, loss of taste, myasthenia, delusions, hallucinations;
• Organ of vision: visual impairment;
• Organ of hearing and labyrinth disorders: hearing loss, vertigo, hearing impairment until deafness and/or tinnitus;
• Cardiovascular system: a feeling of heartbeat, flushing of the face, decrease in blood pressure, prolongation of QT interval on ECG, “pirouette” type arrhythmia, ventricular tachycardia;
• Respiratory system: shortness of breath, epistaxis;
• Digestive system: diarrhea, nausea, vomiting, abdominal pain, flatulence, dyspepsia, constipation, gastritis, dysphagia, abdominal distension, dryness of the oral mucosa, belching, ulcers of the oral mucosa, increased salivary gland secretion, change the color of the tongue, pancreatitis;
• Liver and biliary tract: hepatitis, liver dysfunction, cholestatic jaundice, liver failure (in rare cases with a fatal outcome mainly due to severe liver dysfunction), liver necrosis, fulminant hepatitis;
• Skin and subcutaneous tissues: skin rash, itching, urticaria, dermatitis, dry skin, sweating, photosensitivity reaction, Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme;
• Musculoskeletal system: osteoarthritis, myalgia, back pain, neck pain, arthralgia;
• Kidneys and urinary tract: dysuria, pain in the kidneys, interstitial nephritis, acute renal failure;
• Genital organs and the mammary gland: metrorrhagia, dysfunction of the testicles;
• Local reactions: pain and inflammation at the injection site;
• Other: asthenia, malaise, feeling tired, swelling of the face, chest pain, fever, peripheral edema;
• Laboratory data: a decrease in the number of lymphocytes, an increase in the number of eosinophils, an increase in the number of basophils, an increase in the number of monocytes, an increase in the number of neutrophils, a decrease in plasma bicarbonate concentration, an increase in AST/ALT activity, an increase in plasma bilirubin concentration, an increase in plasma urea concentration, an increase in plasma creatinine concentration, a change in plasma potassium content, an increase in alkaline phosphorus plasma activity, an increase in plasma chlorine, an increase in the concentration of glucose in the blood, an increase in the number of platelets, an increase in hematocrit, an increase in the concentration of bicarbonate in the blood plasma, a change of the sodium content in the blood plasma.

Pregnancy and breastfeeding

The active substance penetrates the placental barrier. Use during pregnancy is possible only in cases where the intended benefit to the mother outweighs the potential risk to the fetus.

If it’s necessary to use Azithromycin during lactation, breastfeeding should be stopped.

Interactions

The antibiotic can interact with the medications listed below, so their simultaneous use is not recommended:

• R-glycoprotein substrates, such as digoxin;
• warfarin;
• isoenzymes of the cytochrome P450 system;
• derivatives of ergot alkaloids;
• atorvastatin;
• terfenadine;
• disopyramide;
• lovastatin;
• rifabutin;
• cyclosporine

Safety precautions

Caution should be used in patients with mild and moderately impaired liver function due to the possibility of the development of fulminant hepatitis and severe liver failure. If there are symptoms of abnormal liver function, such as rapidly increasing asthenia, jaundice, dark urine, bleeding tendency, hepatic encephalopathy, the therapy should be discontinued.

In light and moderate renal dysfunction, antibiotics should be used with caution. Control of kidney function is required.

Prolonged use of azithromycin may cause pseudomembranous colitis caused by Clostridium difficile in the form of mild diarrhea and severe colitis.

Patients taking macrolides have an increased risk of developing cardiac arrhythmias, including arrhythmia type “pirouette”.

Antacids and alcohol also reduce the concentration of the drug in the blood. Therefore, while taking antacids and azithromycin, it is necessary to observe an interval of 2 hours between taking these medications. Simultaneous use of Zithromax and alcohol is not recommended.

When using the drug in children, one should strictly observe the compliance of the dosage form with the age of the patient.

After discontinuation of antibiotic therapy, hypersensitivity reactions in some patients may persist for a long time and may require specific therapy under the supervision of a physician.

Overdose symptoms include temporary hearing loss, nausea, vomiting, diarrhea. Treatment should be symptomatic.

If you have undesirable effects related to the nervous system and the organ of vision, you should take care when performing actions that require increased concentration and attention.

How to buy Zithromax?

Today, many online pharmacies offer to buy antibiotics online. This is convenient since you do not even need to leave your home. Besides, online pharmacies set lower prices for medications, so you can save a lot. The best decision is to buy antibiotics on a prescription or at least on the recommendation of a doctor. We recommend that you visit a doctor before ordering any pills online. The doctor will prescribe the necessary drug, the exact dosage and tell you about the methods of use. If you need to buy drugs without a prescription, it is important to know the composition of the pills that you need, the indications for their use and contraindications. You need to buy medicine correctly. It is important to know that many drugs interact with antibiotics and can cause dangerous side effects. If you buy the wrong medication (this is especially dangerous if you need antibiotics), the drug will be useless or, even worse, will worsen the condition. Make sure you know the name of the pills and how they are used. Such accuracy will avoid many problems and complications. Also, ask a doctor which form of the drug you need to take – if you need capsules or syrup, you should not purchase tablets or solutions.

If you approach treatment with full responsibility, buying Zithromax in an online pharmacy will be a good way to save money and time.

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About the Author

Kathleen G. Burke, PhD, RN, CENP, FAAN, is an influential nurse leader and educator, currently serving as the Assistant Dean for Clinical Nurse Learning and Innovation at Penn Nursing and the Corporate Director of Nursing Professional Development and Innovation at the University of Pennsylvania Health System. She is also the Editor-in-Chief of the Journal for Nurses in Professional Development and a board member of the CCNE. Dr. Burke’s extensive experience and commitment to advancing nursing education and practice have significantly shaped the nursing profession both nationally and internationally.

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Disclaimer: The information provided on this site is solely for educational purposes and is not a replacement for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional before altering your medical treatment or medications. Relying on this content instead of seeking professional advice is not recommended.