Generic Name: azithromycin (a ZITH roe MYE sin)
Brand names: Azithromycin 3 Day Dose Pack, Azithromycin 5 Day Dose Pack, Zithromax, Zithromax TRI-PAK, Zithromax Z-Pak, Zmax, Zithromax IV
What is azithromycin?
Azithromycin is in a group of drugs called macrolide antibiotics. Azithromycin fights bacteria in the body.
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.
What is the most important information I should know about azithromycin?
You should not use this medication if you have ever had jaundice or liver problems caused by taking azithromycin. You should not use azithromycin if you are allergic to it or to similar drugs such as erythromycin (E-Mycin, Ery-Tab, E.E.S.), clarithromycin (Biaxin), telithromycin (Ketek), or troleandomycin (Tao).
There are many other medicines that can interact with azithromycin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.
Take this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Azithromycin will not treat a viral infection such as the common cold or flu.
Do not take antacids that contain aluminum or magnesium within 2 hours before or after you take azithromycin. This includes Rolaids, Maalox, Mylanta, Milk of Magnesia, Pepcid Complete, and others. These antacids can make azithromycin less effective when taken at the same time.
What should I discuss with my healthcare provider before taking azithromycin?
You should not use this medication if you have ever had jaundice or liver problems caused by taking azithromycin. You should not use azithromycin if you are allergic to it or to similar drugs such as erythromycin (E-Mycin, Ery-Tab, E.E.S.), clarithromycin (Biaxin), telithromycin (Ketek), or troleandomycin (Tao).
To make sure you can safely take azithromycin, tell your doctor if you have any of these other conditions:
liver disease;
kidney disease;
myasthenia gravis;
a heart rhythm disorder; or
a history of Long QT syndrome.
FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether azithromycin passes into breast milk or if it could harm a nursing baby. Do not take this medication without telling your doctor if you are breast-feeding a baby.
How should I take azithromycin?
Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. The dose and length of treatment with azithromycin may not be the same for every type of infection.
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. Throw away any mixed oral suspension that has not been used within 12 hours.
To make sure you get the entire dose, add a little more water to the same glass, swirl gently and drink right away.
Azithromycin may be taken with or without food. Take the medicine with food if it upsets your stomach. Shake the oral suspension (liquid) well just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one. Take this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Azithromycin will not treat a viral infection such as the common cold or flu. 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.
Overdose symptoms may include nausea, vomiting, diarrhea, and stomach discomfort.
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 Rolaids, Maalox, Mylanta, Milk of Magnesia, Pepcid Complete, 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 azithromycin 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 any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using azithromycin and call your doctor at once if you have a serious side effect such as:
diarrhea that is watery or bloody;
chest pain, uneven heartbeats;
nausea, stomach pain, low fever, 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.
Less serious side effects may include:
mild nausea, vomiting, diarrhea, constipation;
stomach pain or upset;
dizziness, tired feeling, or headache;
nervous feeling, sleep problems (insomnia);
vaginal itching or discharge;
mild itching or skin rash;
ringing in your ears, problems with hearing; or
decreased sense of taste or smell.
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.
Azithromycin Dosing Information
Usual Adult Dose for Otitis Media:
Immediate release: 500 mg orally on the first day followed by 250 mg orally once a day on days 2 through 5
Usual Adult Dose for Upper Respiratory Tract Infection:
Immediate release: 500 mg orally on the first day followed by 250 mg orally once a day on days 2 through 5
Usual Adult Dose for Bronchitis:
Immediate release: 500 mg orally on the first day followed by 250 mg orally once a day on days 2 through 5
Usual Adult Dose for Pneumonia:
Community acquired:
Oral:
Immediate release: 500 mg orally on the first day followed by 250 mg orally once a day on days 2 through 5 for mild infections
Extended release suspension: 2 g orally once for mild to moderate infections
IV: 500 mg IV once a day for at least 2 days followed by 500 mg (immediate release formulation) orally once a day to complete a 7- to 10-day course of therapy
The IV dose should be reconstituted and diluted according to the manufacturer's recommendations, and administered as an infusion over not less than 60 minutes.
Usual Adult Dose for Tonsillitis/Pharyngitis:
Immediate release: 500 mg orally on the first day followed by 250 mg orally once a day on days 2 through 5
Recommended as an alternative (second line therapy) in patients who cannot use first line therapy
Usual Adult Dose for Sinusitis:
Acute bacterial sinusitis:
Immediate release: 500 mg orally once a day for 3 days
Extended release suspension: 2 g orally once for mild to moderate infections
Usual Adult Dose for Skin or Soft Tissue Infection:
Uncomplicated:
Immediate release: 500 mg orally on the first day followed by 250 mg orally once a day on days 2 through 5
Usual Adult Dose for Gonococcal Infection -- Uncomplicated:
Immediate release: 2 g orally once
Usual Adult Dose for Chancroid:
Immediate release: 1 g orally once
Usual Adult Dose for Nongonococcal Urethritis:
Immediate release: 1 g orally once
Usual Adult Dose for Cervicitis:
Immediate release: 1 g orally once
Usual Adult Dose for Pelvic Inflammatory Disease:
500 mg IV once a day for at least 2 days followed by 250 mg (immediate release formulation) orally once a day to complete a 7-day course of therapy
The IV dose should be reconstituted and diluted according to the manufacturer's recommendations, and administered as an infusion over not less than 60 minutes.
Usual Adult Dose for Granuloma Inguinale:
Immediate release: 1 g orally once a week for at least 3 weeks and until all lesions have completely healed
This regimen is recommended by the Centers for Disease Control and Prevention as an alternative to doxycyline.
Usual Adult Dose for Legionella Pneumonia:
500 mg IV once a day for at least 2 days followed by 500 mg (immediate release formulation) orally once a day to complete a 7- to 10-day course of therapy
The IV dose should be reconstituted and diluted according to the manufacturer's recommendations, and administered as an infusion over not less than 60 minutes.
Usual Adult Dose for Mycoplasma Pneumonia:
Immediate release: 500 mg orally on the first day followed by 250 mg orally once a day on days 2 through 5
Severe infection: 500 mg IV once a day can be administered for at least 2 days followed by 500 mg (immediate release formulation) orally once a day to complete a 7- to 10-day course of therapy
The IV dose should be reconstituted and diluted according to the manufacturer's recommendations, and administered as an infusion over not less than 60 minutes.
Usual Adult Dose for Chronic Obstructive Pulmonary Disease -- Acute:
Acute bacterial exacerbations (mild to moderate):
Immediate release: 500 mg orally once daily for 3 days
or
500 mg orally on the first day followed by 250 mg orally once a day on days 2 through 5
Usual Adult Dose for Mycobacterium avium-intracellulare -- Prophylaxis:
Patients with advanced HIV infection:
Immediate release: 1200 mg orally once a week alone or with rifabutin
Usual Adult Dose for Mycobacterium avium-intracellulare -- Treatment:
Patients with advanced HIV infection:
Immediate release: 500 mg orally once a day plus ethambutol, with or without rifabutin
Usual Adult Dose for Bacterial Infection:
Pertussis:
Immediate release: 500 mg orally on the first day followed by 250 mg orally once a day on days 2 through 5
Usual Adult Dose for Lyme Disease -- Erythema Chronicum Migrans:
Immediate release: 500 mg orally once a day
Usual Adult Dose for Bacterial Endocarditis Prophylaxis:
Immediate release: 500 mg orally once 30 to 60 minutes prior to the procedure
Usual Adult Dose for Toxoplasmosis:
Immediate release: 1200 to 1500 mg orally once a day
Usual Adult Dose for Typhoid Fever:
Immediate release: 1000 mg orally on the first day followed by 500 mg orally once a day for 6 days
Alternatively, a dosage of 1000 mg orally once a day for 5 days may also be used.
Usual Pediatric Dose for Pneumonia:
Community acquired:
6 months or older:
Immediate release: 10 mg/kg (maximum: 500 mg/dose) orally as a single dose on the first day followed by 5 mg/kg (maximum: 250 mg/dose) orally once a day on days 2 thru 5
or
30 mg/kg orally once
or
10 mg/kg orally once a day for 3 days
Extended release suspension:
Less than 34 kg: 60 mg/kg orally once for mild to moderate infections
34 kg or more: 2 g orally once for mild to moderate infections
Usual Pediatric Dose for Sinusitis:
Acute bacterial sinusitis:
6 months or older:
Immediate release: 10 mg/kg orally once a day for 3 days
16 years or older:
Immediate release: 500 mg orally once a day for 3 days
Extended release suspension: 2 g orally once for mild to moderate infections
Usual Pediatric Dose for Otitis Media:
Acute:
6 months or older:
Immediate release: 30 mg/kg (maximum: 1500 mg/dose) orally once
or
10 mg/kg (maximum: 500 mg/dose) orally once a day for 3 days
or
10 mg/kg (maximum: 500 mg/dose) orally as a single dose on the first day followed by 5 mg/kg (maximum: 250 mg/dose) orally once a day on days 2 thru 5
Usual Pediatric Dose for Tonsillitis/Pharyngitis:
2 years or older:
Immediate release: 12 mg/kg (maximum: 500 mg/dose) orally once a day for 5 days
Recommended as an alternative (second line therapy) in patients who cannot use first line therapy
Usual Pediatric Dose for Skin or Soft Tissue Infection:
Uncomplicated:
16 years or older:
Immediate release: 500 mg orally on the first day followed by 250 mg orally once a day on days 2 through 5
Usual Pediatric Dose for Bacterial Infection:
Pertussis:
Immediate release:
Neonates: 10 mg/kg orally once a day for 5 days.
Less than 6 months: 10 mg/kg orally once a day for 5 days.
6 months or older: 10 mg/kg (maximum: 500 mg/dose) orally as a single dose on the first day followed by 5 mg/kg (maximum: 250 mg/dose) orally once a day on days 2 thru 5.
Usual Pediatric Dose for Upper Respiratory Tract Infection:
Immediate release:
6 months or older: 10 mg/kg (maximum: 500 mg/dose) orally as a single dose on the first day followed by 5 mg/kg (maximum: 250 mg/dose) orally once a day on days 2 thru 5
Usual Pediatric Dose for Mycobacterium avium-intracellulare -- Prophylaxis:
Unlabeled use:
Primary prevention:
Children: 20 mg/kg (maximum: 1200 mg/dose) once a week (preferred) or 5 mg/kg (maximum: 250 mg/dose) orally once a day.
Secondary prevention:
Children: 5 mg/kg (maximum: 250 mg/dose) orally once a day plus ethambutol, with or without rifabutin.
Usual Pediatric Dose for Mycobacterium avium-intracellulare -- Treatment:
Unlabeled use:
Children: 10-12 mg/kg/day (maximum dose: 500 mg/day) orally once daily.
Usual Pediatric Dose for Typhoid Fever:
6 months or older:
Immediate release: 10 mg/kg orally once a day for 7 days
Usual Pediatric Dose for Chancroid:
Immediate release: 20 mg/kg (maximum: 1 g/dose) orally once
Usual Pediatric Dose for Nongonococcal Urethritis:
Uncomplicated:
Immediate release:
Less than 8 years and less than 45 kg: 20 mg/kg (maximum: 1 g/dose) orally once.
8 years or older and 45 kg or more: 1 g orally once.
Usual Pediatric Dose for Cervicitis:
Uncomplicated:
Immediate release:
Less than 8 years and less than 45 kg: 20 mg/kg (maximum: 1 g/dose) orally once.
8 years or older and 45 kg or more: 1 g orally once.
Usual Pediatric Dose for Gonococcal Infection -- Uncomplicated:
16 years or older:
Immediate release: 2 g orally once
Usual Pediatric Dose for Chronic Obstructive Pulmonary Disease -- Acute:
Acute bacterial exacerbations (mild to moderate):
16 years or older:
Immediate release: 500 mg orally once a day for 3 days
or
500 mg orally on the first day followed by 250 mg orally once a day on days 2 through 5
Usual Pediatric Dose for Babesiosis:
Immediate release: 12 mg/kg (maximum: 600 mg/dose) orally once a day for 7 to 10 days plus oral atovaquone
Usual Pediatric Dose for Bacterial Endocarditis Prophylaxis:
Immediate release: 15 mg/kg (maximum: 500 mg) orally once 30 to 60 minutes prior to procedure
Usual Pediatric Dose for Cystic Fibrosis:
Chronic Pseudomonas aeruginosa infection:
Children 6 years or older and adolescents:
25 to less than 40 kg: 250 mg orally on Mondays, Wednesdays, Fridays
40 kg or more: 500 mg orally on Mondays, Wednesdays, Fridays
If side effects are intolerable, the dose should be decreased to twice a week, or if necessary, once a week.
What other drugs will affect azithromycin?
Many drugs can interact with azithromycin. Below is just a partial list. Tell your doctor if you are using:
digoxin (Lanoxin, Lanoxicaps);
carbamazepine (Carbatrol, Tegretol);
cyclosporine (Neoral, Sandimmune);
phenytoin (Dilantin);
pimozide (Orap);
theophylline (Theo-Dur, Theolair, Theochron);
triazolam (Halcion);
warfarin (Coumadin, Jantoven);
another antibiotic, especially clarithromycin (Biaxin) or erythromycin (E-Mycin, E.E.S, Ery-Tab);
a calcium channel blocker such as diltiazem (Cartia, Cardizem), felodipine (Plendil), nifedipine (Nifedical, Procardia), verapamil (Calan, Covera, Isoptin, Verelan), and others;
cholesterol-lowering medicines such as lovastatin (Mevacor), atorvastatin (Lipitor), or simvastatin (Zocor);
ergot medicine such as methysergide (Sansert), ergotamine (Ergostat, Medihaler, Cafergot, Ercaf, Wigraine), dihydroergotamine mesylate (D.H.E., Migranal Nasal Spray);
HIV medicines such as nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Invirase); or
alprazolam (Xanax), diazepam (Valium), midazolam (Versed), or triazolam (Halcion).
This list is not complete and there are many other drugs that can interact with azithromycin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.
More azithromycin resources
- Azithromycin Use in Pregnancy & Breastfeeding
- Drug Images
- Azithromycin Drug Interactions
- Azithromycin Support Group
- 105 Reviews for Azithromycin - Add your own review/rating
- azithromycin Advanced Consumer (Micromedex) - Includes Dosage Information
- Azithromycin Professional Patient Advice (Wolters Kluwer)
- Azithromycin MedFacts Consumer Leaflet (Wolters Kluwer)
- Azithromycin Monograph (AHFS DI)
- Zithromax Prescribing Information (FDA)
- Zithromax Consumer Overview
- Zmax Prescribing Information (FDA)
- Zmax Extended-Release Oral Suspension MedFacts Consumer Leaflet (Wolters Kluwer)
Compare azithromycin with other medications
- Babesiosis
- Bacterial Endocarditis Prevention
- Bacterial Infection
- Bartonellosis
- Bronchitis
- Cervicitis
- Chancroid
- COPD, Acute
- Cystic Fibrosis
- Gonococcal Infection, Uncomplicated
- Granuloma Inguinale
- Legionella Pneumonia
- Lyme Disease, Erythema Chronicum Migrans
- Mycobacterium avium-intracellulare, Prophylaxis
- Mycobacterium avium-intracellulare, Treatment
- Mycoplasma Pneumonia
- Nongonococcal Urethritis
- Otitis Media
- Pelvic Inflammatory Disease
- Pharyngitis
- Pneumonia
- Sinusitis
- Skin Infection
- Tonsillitis/Pharyngitis
- Toxoplasmosis
- Typhoid Fever
- Upper Respiratory Tract Infection
Where can I get more information?
- Your pharmacist can provide more information about azithromycin.
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