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Azithromycin (Zithromax, Zpak, Zmax)



Azithromycin is an antibiotic that works by binding to the 50S unit of the bacteria’s ribosomes, which inhibits the bacteria’s ability to make essential proteins. It is effective in killing gram negative bacteria and can kill some gram positive bacteria as well. It is useful in treating common respiratory and skin infections.



How to Use


Take this medication by mouth with a glass of water. This medication can be taken with or without food. If it upsets your stomach, take it with food or milk. Be sure to take it regularly, exactly as directed.


It is important that you finish the entire course of this medicine, do not stop taking it because you are feeling better or take more than directed.


If you miss a dose, take it as soon as you can. If it is already almost time for your next dose, take only that next dose. Do not double up on any dose.



Important Information


Contact your doctor if you have sever diarrhea that last for more than 2 days


Contact your doctor if your symptoms are not improving.


This medication can make you more sensitive to the sun. Try to keep out of the sun, and do not use tanning booths, and use sunscreen if you have to be exposed to the sun for a long period of time.



Side effects that should be immediately reported to your healthcare provider


Confusion, hallucinations, dark colored urine, loss of hearing, chest pain or changes in heartbeat, pain or difficulty passing urine, white patches in the mouth, yellowing of skin or eyes, Allergic reactions(hives, itching, rashes, swelling of the face or mouth), trouble breathing, any red, blistering or peelings skin.


Other Side Effects


Diarrhea, dizziness, fatigue, headache, nausea or vomiting, tooth discoloration, vaginal irritation.



Be sure that your prescribing doctor is aware if you have any of the the following conditions before taking this medication


Liver disease, kidney disease, heart conditions, history of allergic reactions, pregnancy or breastfeeding.


Adult Dose


Community Acquired Pneumonia


500 mg by mouth for one day, followed by 250 mg by mouth daily on days 2-5.


Bacterial Sinusitis


Tablets: 500 mg by mouth daily for 3 days.


Extended Release Oral Suspension: 2 grams by mouth as a single dose given 1 hour before or two hours after a meal.



Streptococcal Pharyngitis and Tonsilitis


Tablets or Immediate Release Suspension: 500 mg by mouth on the first day, then 250 mg by mouth once daily on days 2-5.



Chronic Bacterial Bronchitis in Patients With COPD


500 mg by mouth daily for 3 days OR 500 mg by mouth daily for one day, followed by 250 mg by mouth once daily for 4 days.


Extended Release Oral Suspension: 2 grams by mouth given either 1 hour before a meal or 2 hours after a meal.





1. Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis 2007;44(Suppl 2):S27-72.


2. ZIithromax® oral tablets, suspension, azithromycin oral tablets, suspension[package insert]. New York, NY: Pfizer Labs; 2007.


3. Zithromax (azithromycin 250 mg and 500 mg tablets and azithromycin oral suspension) [package insert]. New York, NY: Pfizer Inc.; 2016.


4. Zervos M, Breen J, Jorgensen D, et al. Novel, single-dose microsphere formulation of azithromycin versus levofloxacin for the treatment of acute exacerbations of chronic bronchitis. Infect Dis Clin Prac 2005;13:115-121.


5. ZMAX(R) extended release oral suspension, azithromycin extended release oral suspension[package insert]. New York, NY: Pfizer Inc; 2008.

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