What is azithromycin?
Azithromycin is an antibiotic that fights bacteria.
Azithromycin is used to treat many different types of infections caused by bacteria, such as respiratory infections, skin infections, ear infections, and sexually transmitted diseases.
Azithromycin may also be used for purposes not listed in this medication guide.
You should not use azithromycin if you have ever had jaundice or liver problems when you have previously taken this medicine.
Before taking this medicine
You should not use azithromycin if you are allergic to it, or if:
- you have ever had jaundice or liver problems caused by taking azithromycin; or
- you are allergic to similar drugs such as clarithromycin, erythromycin, or telithromycin.
To make sure azithromycin is safe for you, tell your doctor if you have:
- liver disease;
- kidney disease;
- myasthenia gravis;
- a heart rhythm disorder; or
- a history of Long QT syndrome.
This medicine is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
It is not known whether azithromycin passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
Do not give this medicine to a child younger than 6 months old.
How should I take azithromycin?
Take azithromycin exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. The dose and length of treatment may not be the same for every type of infection.
You may take most forms of azithromycin with or without food.
Take Zmax extended release liquid (oral suspension) on an empty stomach, at least 1 hour before or 2 hours after a meal.
To use the oral suspension single dose packet: Open the packet and pour the medicine into 2 ounces of water. Stir this mixture and drink all of it right away. Do not save for later use. To make sure you get the entire dose, add a little more water to the same glass, swirl gently and drink right away.
Throw away any mixed Zmax oral suspension that has not been used within 12 hours.
Shake the oral suspension (liquid) well just before you measure a dose. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.
Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Azithromycin will not treat a viral infection such as the flu or a common cold.
Store at room temperature away from moisture and heat. Throw away any unused liquid medicine after 10 days.
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking azithromycin?
Do not take antacids that contain aluminum or magnesium within 2 hours before or after you take azithromycin. This includes Acid Gone, Aldroxicon, Alternagel, Di-Gel, Gaviscon, Gelusil, Genaton, Maalox, Maldroxal, Milk of Magnesia, Mintox, Mylagen, Mylanta, Pepcid Complete, Rolaids, Rulox, and others. These antacids can make azithromycin less effective when taken at the same time.
Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking this medicine and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.
Avoid exposure to sunlight or tanning beds. Azithromycin can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.
Azithromycin side effects
Get emergency medical help if you have signs of an allergic reaction to azithromycin: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
In rare cases, azithromycin may cause a severe skin reaction that can be fatal if it spreads to other parts of the body. Seek medical treatment if you have a new or worsening skin rash with fever, swollen glands, flu symptoms, or severe tingling or numbness.
Call your doctor at once if you have:
severe stomach pain, diarrhea that is watery or bloody;
headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;
liver problems – nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or
severe skin reaction – fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.
Older adults may be more likely to have side effects on heart rhythm, including a life-threatening fast heart rate.
Common azithromycin side effects may include:
- nausea, vomiting, stomach pain; or
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect azithromycin?
Tell your doctor about all your current medicines and any you start or stop using, especially:
- nelfinavir; or
- a blood thinner – warfarin, Coumadin, Jantoven.
This list is not complete. Other drugs may interact with azithromycin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
Major Side Effects
You should check with your doctor immediately if any of these side effects occur when taking azithromycin:
- loose stools
- Less common:
- Blistering, crusting, irritation, itching, or reddening of the skin
- cracked, dry, or scaly skin
- Abdominal or stomach pain
- blistering, peeling, or loosening of the skin
- bloody or cloudy urine
- bloody, black, or tarry stools
- body aches or pain
- burning while urinating
- chest pain
- cough increased
- cough producing mucus
- dark urine
- difficult or labored breathing
- difficult or painful urination
- dryness or soreness of the throat
- fast, irregular, pounding, or racing heartbeat or pulse
- general feeling of discomfort or illness
- general feeling of tiredness or weakness
- irregular or slow heart rate
- joint or muscle pain
- large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
- light-colored stools
- loss of appetite
- muscle aches and pains
- nausea or vomiting
- noisy breathing
- passing of gas
- red skin lesions, often with a purple center
- red, irritated eyes
- redness or swelling in the ear
- runny nose
- shortness of breath
- sores, ulcers, or white spots on the lips or in the mouth
- stomach pain, continuing
- stomach pain, fullness, or discomfort
- stuffy nose
- swelling of the face, ankles, hands, feet, or lower legs
- tender, swollen glands in the neck
- tightness in the chest
- trouble with sleeping
- trouble with swallowing
- unpleasant breath odor
- unusual bleeding or bruising
- unusual tiredness or weakness
- upper right abdominal or stomach pain
- voice changes
- vomiting of blood
- yellow eyes or skin
Incidence not known:
- Abdominal or stomach cramps or tenderness
- bleeding gums
- blood in the urine or stools
- blurred vision
- change in hearing
- clay-colored stools
- continuing ringing or buzzing or other unexplained noise in the ears
- decreased urine output
- diarrhea, watery and severe, which may also be bloody
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- greatly decreased frequency of urination or amount of urine
- increased thirst
- loss of hearing
- lower back or side pain
- muscle twitching
- pains in the stomach, side, or abdomen, possibly radiating to the back
- pale skin
- pinpoint red spots on the skin
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- rapid weight gain
- unusual weight loss
Minor Side Effects
Some of the side effects that can occur with azithromycin 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:
- Acid or sour stomach
- aggressive or angry
- bad, unusual, or unpleasant (after) taste
- burning feeling in the chest or stomach
- burning, crawling, itching, numbness, prickling, “pins and needles”, or tingling feelings
- change in taste
- changes in the color of the tongue
- dry mouth
- excess air or gas in the stomach or intestines
- feeling of constant movement of self or surroundings
- full feeling
- increase in body movements
- itching of the vagina or genital area
- lack or loss of strength
- mental depression
- pain during sexual intercourse
- quick to react or overreact emotionally
- rapidly changing moods
- rash with flat lesions or small raised lesions on the skin
- redness of the skin
- sensation of spinning
- shortness of breath
- sleepiness or unusual drowsiness
- sore mouth or tongue
- stomach upset
- thick, white vaginal discharge with no odor or with a mild odor
- unable to sleep
- white patches in the mouth, tongue, or throat
- Incidence not known:
- Difficulty with moving
- fear or nervousness
- increased sensitivity of the skin to sunlight
- muscle pain or stiffness
- pain in the joints
- redness or other discoloration of the skin
- severe sunburn
- trouble sitting still
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