What is a Z-Pak and how does it work. What are the common uses of azithromycin. How is the antibiotic dosed for different infections. What are the potential side effects and risks of taking azithromycin. Who should avoid using this medication.

Understanding Azithromycin: A Powerful Antibiotic in the Z-Pak

Azithromycin, commonly known as Zithromax or Z-Pak, is a versatile antibiotic that has been a cornerstone in treating various bacterial infections since its FDA approval in 1991. This macrolide antibiotic works by inhibiting bacterial protein synthesis, effectively stopping the growth and reproduction of harmful microorganisms.

The Z-Pak’s popularity stems from its convenient dosing schedule and broad spectrum of activity. Typically prescribed as a five-day course, it offers patients a straightforward treatment option for numerous infections.

How does azithromycin differ from other antibiotics?

Azithromycin stands out due to its unique pharmacokinetics. Unlike many antibiotics that are rapidly eliminated from the body, azithromycin is taken up by white blood cells and concentrated in infected tissues. This characteristic allows for a shorter treatment duration and once-daily dosing in most cases.

• Bacteriostatic action: Prevents bacterial growth rather than directly killing bacteria
• Extended half-life: Remains active in the body longer than many other antibiotics
• Tissue concentration: Accumulates in infection sites for targeted action

Common Uses of Azithromycin 500mg Dose Pack

The azithromycin 500mg dose pack is prescribed for a wide range of bacterial infections affecting various parts of the body. Its versatility makes it a go-to choice for many healthcare providers.

Which infections can be treated with azithromycin?

Azithromycin is effective against numerous bacterial pathogens, making it suitable for treating:

• Respiratory tract infections (bronchitis, pneumonia)
• Skin and soft tissue infections
• Ear infections (otitis media)
• Sinusitis
• Pharyngitis/tonsillitis
• Certain sexually transmitted infections

It’s important to note that azithromycin is not effective against viral infections, including the common cold or flu.

Dosage and Administration of the Azithromycin 500mg Dose Pack

The azithromycin 500mg dose pack is designed to provide a complete course of treatment for many common infections. However, the specific dosing regimen may vary depending on the type and severity of the infection being treated.

What is the typical dosing schedule for a Z-Pak?

The standard Z-Pak dosing schedule is as follows:

1. Day 1: 500mg (two 250mg tablets)
2. Days 2-5: 250mg once daily

This regimen provides a total dose of 1.5 grams over five days. However, for certain infections, alternative dosing schedules may be prescribed.

Are there other dosage forms available?

Azithromycin is available in several formulations to accommodate different patient needs and infection types:

• Tablets: 250mg, 500mg, 600mg
• Oral suspension: 100mg/5mL, 200mg/5mL, 1000mg/5mL
• Intravenous formulation: 500mg/10mL vial

Mechanism of Action: How Azithromycin Fights Bacterial Infections

Understanding how azithromycin works in the body can help patients appreciate the importance of completing the full course of treatment, even if symptoms improve before the medication is finished.

How does azithromycin stop bacterial growth?

Azithromycin belongs to the macrolide class of antibiotics, which work by:

• Binding to the 50S subunit of the bacterial ribosome
• Inhibiting protein synthesis in susceptible bacteria
• Preventing bacterial cell growth and reproduction

This bacteriostatic action allows the body’s immune system to more effectively clear the infection. Unlike bactericidal antibiotics that directly kill bacteria, azithromycin’s approach can sometimes result in a slower resolution of symptoms but may reduce the risk of rapid bacterial cell lysis and associated toxin release.

Side Effects and Potential Risks of Azithromycin

While azithromycin is generally well-tolerated, it’s crucial for patients to be aware of potential side effects and risks associated with its use.

What are the most common side effects of azithromycin?

Common side effects of azithromycin may include:

• Gastrointestinal disturbances (nausea, diarrhea, abdominal pain)
• Headache
• Dizziness
• Fatigue
• Skin rash or itching

These effects are typically mild and resolve on their own. However, if they persist or worsen, medical attention should be sought.

Are there any serious risks associated with azithromycin use?

While rare, some serious adverse effects have been reported with azithromycin use:

• Cardiovascular risks: Increased risk of fatal heart rhythm problems in some patients
• Liver toxicity: Rare cases of severe liver injury have been reported
• Clostridium difficile-associated diarrhea: A potentially severe intestinal infection
• Allergic reactions: Including anaphylaxis in sensitive individuals

In 2018, the FDA issued a warning about an increased risk of cancer relapse and death in some patients using long-term azithromycin. This underscores the importance of using the medication only as prescribed and for the shortest duration necessary.

Contraindications and Precautions: When to Avoid Azithromycin

Not everyone is a suitable candidate for azithromycin treatment. Certain medical conditions and medications may increase the risk of adverse effects or reduce the efficacy of the antibiotic.

Who should not take azithromycin?

Azithromycin is contraindicated in the following situations:

• Known hypersensitivity to azithromycin, erythromycin, or any macrolide or ketolide antibiotic
• History of jaundice or liver dysfunction with previous azithromycin use
• Patients with certain heart conditions, particularly those with prolonged QT interval

Caution is advised in patients with liver disease, myasthenia gravis, and in those taking medications that can affect heart rhythm.

Drug Interactions: Medications to Watch Out For

Azithromycin can interact with various medications, potentially altering their effectiveness or increasing the risk of side effects. It’s crucial for patients to disclose all medications, including over-the-counter drugs and supplements, to their healthcare provider before starting azithromycin.

Which drugs may interact with azithromycin?

Notable drug interactions include:

• Antacids containing aluminum or magnesium: May reduce azithromycin absorption
• Warfarin: Azithromycin may enhance the anticoagulant effect
• Nelfinavir: May increase azithromycin levels in the body
• QT-prolonging medications: Increased risk of cardiac arrhythmias

Patients should always consult their healthcare provider or pharmacist about potential drug interactions.

Special Considerations for Azithromycin Use in Specific Populations

The safety and efficacy of azithromycin may vary in certain patient groups, requiring special consideration and potentially adjusted dosing.

Is azithromycin safe during pregnancy and breastfeeding?

Azithromycin is classified as FDA Pregnancy Category B, indicating no clear evidence of risk in humans. However, it should be used during pregnancy only if clearly needed. Small amounts of azithromycin do pass into breast milk, so caution is advised for nursing mothers.

How should azithromycin be used in pediatric patients?

Azithromycin is approved for use in children, with dosing based on weight and the type of infection. The oral suspension form is often preferred for younger children who may have difficulty swallowing tablets.

Are there special considerations for elderly patients?

Elderly patients may be more susceptible to certain side effects, particularly QT interval prolongation. Dose adjustment is not typically required based on age alone, but renal and hepatic function should be considered.

In conclusion, the azithromycin 500mg dose pack offers a convenient and effective treatment option for many bacterial infections. However, like all medications, it carries potential risks and should be used judiciously under medical supervision. Patients should be informed about proper use, potential side effects, and when to seek medical attention. By understanding these aspects of azithromycin therapy, patients can maximize the benefits of treatment while minimizing risks.

Zithromax (Z-Pak) | Uses, Dosage & Azithromycin Interactions

Zithromax (azithromycin), also known as Z-Pak, is an antibiotic approved for treatment of respiratory, skin and other bacterial infections. Studies link the drug to side effects, including an increased risk of fatal heart problems. In August 2018, the U.S. Food and Drug Administration warned of an increased risk of cancer relapse and death in some patients who take the drug long-term.

What Is a Z-Pak?

Zithromax (azithromycin), also known as Z-Pak, is an antibiotic used to treat bacterial infections by inhibiting the growth of bacteria in the body. A Z-Pak is typically taken over a five-day course to treat infections such as bronchitis, pneumonia, and infections of the ears, lungs and other organs. First approved by the FDA in 1991 to treat certain respiratory and skin infections, its use has since expanded to include a wide variety of bacterial infections. These include sexually transmitted diseases, bacterial inflammation and middle-ear infections in children.

COVID-19 Alert

Medical providers are experimenting with azithromycin plus hydroxychloroquine to treat COVID-19.


Learn More

Zithromax has been highly profitable for its manufacturer, Pfizer. At the height of sales in 2002, it brought in over $1 billion for Pfizer. Although the wide availability of generics reduced the company’s revenue, sales still totaled $435 million in 2012.

This antibiotic is popular because it treats infections in adults and children. But, the drug is not without side effects — including fatal heart-related risks.

Zithromax also led to some legal trouble for Pfizer. The company was forced to pay millions to several states to settle allegations that it used misleading tactics to market the drug to children.

How Zithromax Works

Zithromax belongs to a class of antibiotics called macrolides, which are bacteriostatic — meaning they treat infections by preventing bacteria from multiplying and producing the proteins that are essential for their growth. Eventually, the remaining bacteria die or are killed by the immune system, not by the drug itself. This is in contrast to bactericidal antibiotics, which kill bacteria. Bactericidal drugs include fluoroquinolones and penicillin.

Zithromax does not break down in the body as quickly as other antibiotics. Instead of floating freely in the blood, the drug molecules are picked up by white blood cells that fight bacteria. The white blood cells take the medicine to the front lines of their struggle with germs, where it becomes concentrated in the tissues surrounding the infection. That concentration helps it remain in the body longer, which means patients need fewer doses to beat their infections.

Zithromax and Z-Pak Dosage

Zithromax is most familiar to the public as the “Z-Pak,” a convenient five-day pill regimen with a dose of 500 mg (2 tablets of 250 mg) the first day and 250 mg for the remaining four days. But, as of 2022, Zithromax comes in several dosages and forms, including oral tablets and liquids for oral use, injections and intravenous drips.

Dosage forms and strengths

Tablets

250 mg, 500 mg, 600 mg

Oral suspension (liquid)

100 mg/5 mL, 200 mg/5 mL, 1,000 mg/5 mL

Injection and IV

10 mL vial of 500 mg

A doctor determines the dose depending on the infection being treated. For example, for pneumonia, pharyngitis or skin infections the recommended dose is the standard 500 mg for the first day and 250 mg for the remaining 4 days.

For more a complicated disease such as acute sinusitis, doctors prescribe 500 mg a day for three days. In the case of sexually transmitted diseases, the dose is 1 gram, or 1,000 mg, in a single dose.

Who Shouldn’t Take Zithromax?

According to the medication insert, certain people should not take Zithromax. Patients with allergies to azithromycin, erythromycin, or any macrolide or ketolide should not take Zithromax. People with liver problems or who had jaundice with prior use of Zithromax should not take it again.

Sexually Transmitted Infections

Antibiotics used at high doses for short periods of time may mask or delay the symptoms of incubating gonorrhea or syphilis (meaning the disease is already present and developing in the body but symptoms have not yet appeared). Therefore, Zithromax, at the recommended dose, should not be relied upon to treat gonorrhea or syphilis, two types of sexually transmitted diseases (STDs) caused by bacterial infections.

All patients who are diagnosed with or suspected of having sexually transmitted urethritis (urethral inflammation) or cervicitis (irritation or infection of the cervix) should also be tested for gonorrhea and syphilis prior to starting treatment with Zithromax. If infection is confirmed, treatment for those diseases should be initiated with a more appropriate antibacterial drug.

Pregnancy

In animal studies on mice and rats, researchers did not find evidence of birth defects at 3.2 times the human daily dose of 600 mg. But, because there are no actual studies on pregnant humans, pregnant mothers should only use Zithromax while pregnant if necessary. Since it can pass into breast milk, health care providers should use caution in administering Zithromax to breastfeeding mothers, according to the medication label.

Seniors

In clinical trials, 9 percent of patients were at least 65 years of age, and 3 percent were at least 75 years of age. Researchers did not find any differences in effectiveness or safety between young patients and seniors.

Side Effects

In most cases, patients don’t experience side effects from Z-Paks. In clinical trials, adverse reactions occurred in about 12 percent of patients, and less than 10 percent of the reactions were severe.

The most common side effects were gastrointestinal and included diarrhea, stomach pain and nausea. Generally, side effects were more severe with a higher dose.

Serious side effects are rare but can be life-threatening. These include severe allergic reactions, liver injury and diarrhea associated with antibiotic-resistant bacteria.

In March 2013, the FDA warned azithromycin, including brand names Zithromax, Zmax, Azithrocin and Azin, “can cause abnormal changes in the electrical activity of the heart that may lead to a potentially fatal irregular heart rhythm.”

More recently, in August 2018, the FDA warned long-term use of Zithromax can cause cancer relapse and death in people who have had blood or lymph node cancer and have received donor stem cell transplants.

Zithromax Drug Interactions

In clinical trials, Zithromax had the potential to interact with two different types of drugs. Taking Zithromax with alcohol could also intensify side effects.

Drugs that react to Zithromax include:

Nelfinavir

is a drug doctors prescribe to treat HIV infections. This drug can increase the amount of Zithromax in the blood. The medication insert does not recommend the use of these two drugs together. Health care providers should check for liver abnormalities and hearing impairment.

Warfarin

is a blood thinner. Taking Warfarin with Zithromax increased the blood thinning effect. Doctors should monitor patients taking both drugs.

Macrolides

are a class of antibiotic, and Zithromax belongs to this class. Researchers observed interactions between other macrolides and two drugs: digoxin and phenytoin. Patients who use Zithromax with digoxin and phenytoin should be carefully monitored for drug interactions.

Zithromax Effectiveness in Clinical Trials

In clinical trials, Zithromax was effective at fighting bacterial infection, including some antibiotic-resistant strains.

Studies conducted before approval of the drug measured its minimum inhibitory concentration (MIC) in relation to a host of bacteria. MIC is the lowest concentration of an antibiotic that will inhibit the growth of bacteria and thereby kill them. A lower MIC means a more effective antibiotic.

In a 1991 study in the European Journal of Clinical Microbiology and Infectious Diseases, researchers found Zithromax had a markedly low MIC against some bacteria compared with three other types of antibiotics, meaning it was highly effective — for example, resolving 92 percent of gonorrhea infections treated.

Zithromax Litigation

In 2003, Pfizer agreed to pay $6 million to settle deceptive Zithromax marketing allegations from 19 states. Oregon’s attorney general at the time, Hardy Myers, led the investigation. According to court documents, Pfizer misrepresented the effectiveness of Zithromax in its ads and failed to disclose the risks of antibiotic overuse.

Pfizer Settlement

Pfizer admitted no wrongdoing and said the FDA approved its advertising and promotional materials. It claimed it was settling to avoid unnecessary costs.

The drugmaker created a mascot for Zithromax, a zebra named Max, to use in its marketing. Pfizer sent plastic zebras that hang on stethoscopes and medical journals wrapped in zebra stripes to pediatricians. It also donated a zebra named Max to the San Francisco Zoo and invited children to a naming celebration.

The 2013 FDA heart rhythm warning prompted some lawyers to investigate and file Zithromax lawsuits. According to plaintiffs, Zithromax caused abnormal heart rhythms. But there have been no settlements or trial dates set.

Zithromax Facts

Please seek the advice of a medical professional before making health care decisions.

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How and when to take azithromycin

Dosage and strength

Azithromycin tablets come as either 250mg or 500mg strengths. The capsules are 250mg. The liquid comes as 200mg in 5ml.

The usual dose is 500mg a day for 3 to 10 days depending on the infection being treated.

For some infections, you’ll be given a one-off higher dose of 1g or 2g.

The dose may be lower for children or if you have liver or kidney problems.

Azithromycin is sometimes prescribed long-term to prevent chest infections if you keep getting them. In this case you will usually need to take it 3 times a week, often on a Monday, Wednesday and Friday.

Important

Carry on taking this medicine until the course is completed, even if you feel better. If you stop your treatment early, your infection could come back.

How to take it

You’ll usually take azithromycin once a day. Try to take your medicine at the same time each day.

Swallow tablets and capsules whole with a drink of water. If you are taking azithromycin capsules, take them at least 1 hour before food or 2 hours after eating. If you have tablets or liquid, you can take them with or without food.

The liquid can have a bitter aftertaste, so it can be a good idea to offer children a drink of fruit juice afterwards.

Do not take medicines for indigestion 2 hours before or after you take this medicine.

Azithromycin liquid is available for children and people who find it difficult to swallow tablets.

If you, or your child, are taking azithromycin as a liquid, your pharmacist will usually make it up for you. The medicine will come with a syringe or spoon to help you measure the right amount. If you do not have one, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount.

If you forget to take it

If you forget to take a dose, take it as soon as you remember, unless it’s nearly time for your next one. In this case, just leave out the missed dose and take your next dose at the usual time.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for other ways to help you remember to take your medicine.

If you take too much

Taking an extra dose of azithromycin is unlikely to harm you or your child. It may, however, increase the chance of temporary side effects, such as feeling or being sick or diarrhoea.

Talk to your pharmacist or doctor if you’re worried, or if you or your child take more than 1 extra dose.

Page last reviewed: 20 January 2022

Next review due: 20 January 2025

Azithromycin tablets | Borimed

* In other regions, the graphic design of the packaging may differ depending on the country of registration.

Registration countries:

• Belarus;
• Azerbaijan;
• Armenia;
• Georgia;
• Kazakhstan;
• Kyrgyzstan;
• Russian Federation;
• Tajikistan;
• Uzbekistan;
• Iraq;
• Libya;

INN:

Azithromycin

Dosage form:

Tablets

Dosage:

500 mg

Packaging:

3 tablets

Pharmacotherapeutic group, ATX:

J01. Antibacterial agents for systemic use

ATX code:

J01FA10

Trade name:

Azithromycin

Release form:

Tablets

Description:

film-coated tablets 500 mg, blue, round, with a biconvex surface, scored.

Composition:

each tablet contains: active ingredient: azithromycin -500 mg; excipients: calcium hydrophosphate dihydrate, hypromellose, corn starch, starch 1500, partially pregelatinized corn starch, sodium lauryl sulfate, magnesium stearate, microcrystalline cellulose, Opadry II (including polyvinyl alcohol, talc, macrogol 3350, soy lecithin ), titanium dioxide E 171, iron oxide yellow E 172, aluminum varnish based on indigo carmine E 132).

Indications for use

• Upper respiratory infections (acute and chronic tonsillopharyngitis, acute and chronic recurrent sinusitis, acute otitis media).
• Infections of the lower respiratory tract (acute bacterial bronchitis, exacerbation of chronic bronchitis, community-acquired bacterial pneumonia).
• Infections of the skin and soft tissues: uncomplicated forms of acne vulgaris, migrating chronic erythema (the initial stage of Lyme disease), erysipelas, impetigo, pyoderma.
• Sexually transmitted diseases (urethritis, cervicitis).
• Diseases of the stomach and duodenum associated with Helicobacter pylori.

Contraindications

Hypersensitivity to macrolide antibiotics.
Because of the theoretical possibility of ergotism, azithromycin should not be co-administered with ergotamine derivatives.

Dosage and administration

Inside, once a day, 1 hour before a meal or 2 hours after it, with water.
For infections of the upper and lower respiratory tract, skin and soft tissues (excluding chronic erythema migrans): 500 mg once a day for 3 days; the total dose is 1500 mg.

In uncomplicated forms of acne vulgaris: The course dose is 6 g. The first 3 days are prescribed 1 tablet 500 mg 1 time per day, in the next 9 weeks – 1 tablet 500 mg 1 time per week, and in the second week the tablet is taken every other day. 7 days after the previous dose. For chronic erythema migrans: 1 g (2 tablets of 500 mg at the same time) on the first day and 500 mg daily once a day from the second to the fifth day.
For sexually transmitted infections:

Uncomplicated urethritis/cervicitis – 1 g once.

Diseases of the stomach and duodenum associated with Helicobacter pylori: 1 g (2 tablets of 500 mg) daily, in combination with anti-secretory drugs and other drugs, as directed by a physician.

Azithromycin 500 mg tablets may be given to children weighing over 45 kg.
The score on the tablet is not intended to be divided into two equal doses.

Renal insufficiency

Patients with creatinine clearance > 40 ml/min do not require dose adjustment. No studies have been conducted in patients with creatine clearance <40 ml/min. Such patients should use azithromycin with caution.
Hepatic impairment

Use with caution in patients with severe hepatic impairment.

Packaging and conditions for dispensing from pharmacies

3 or 10 tablets in a blister pack. Released by prescription.

Download instructions

Search for a drug by dosage in pharmacies of Belarus

Availability in pharmacies

Similar medicines:

AZITHROMYCIN AVEXIMA | JSC Aveksima

Azithromycin is a broad-spectrum bacteriostatic antibiotic from the group of azalide macrolides. It has a wide spectrum of antimicrobial activity. The mechanism of action of azithromycin is associated with the suppression of protein synthesis of microbial cells. By binding to the 50S-sybunit of the ribosome, it inhibits the peptide translocase at the translation stage and inhibits protein synthesis, slowing down the growth and reproduction of bacteria. In high concentrations, it has a bactericidal effect.

It has activity against a number of gram-positive, gram-negative, anaerobic, intracellular and other microorganisms. Microorganisms may initially be resistant to the action of an antibiotic or may acquire resistance to it.

Azithromycin Susceptibility Scale (Minimum Inhibitory Concentration [MIC], mg/mL)

Mostly sensitive organisms

1. Gram-positive aerobes

Staphylococcus aureus methicillin sensitive

Streptococcus pneumoniae penicillin-susceptible

Streptococcus pyogenes

2 . Gram-negative aerobes

Haemophilus influenzae

Haemophilus parainfluenzae

Legionella pneumophila

Moraxella catarrhalis

Pasteurella multocida

Neisseria gonorrhoeae

3. Anaerobes

Clostridium perfringens

Fusobacterium spp.

Prevotella spp.

Porphyriomonas spp.