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Zithromax

Zithromax is a broad-spectrum bacteriostatic antibiotic from the group of azrolide macrolides. It has a wide range of antimicrobial effects. The mechanism of action is associated with the suppression of protein synthesis of microbial cells. By binding to the 5OS subunit of the ribosome, it inhibits the peptide translocase and inhibits protein synthesiы. It slows the growth and reproduction of bacteria. In high concentrations, it obtains a bactericidal effect.

It is effective against a number of gram-positive bacteria, gram-negative bacteria, anaerobes, intracellular and other microorganisms.

Microorganisms may initially be resistant to the action of an antibiotic or may obtain it during the application.

Indications for use

Infectious and inflammatory diseases caused by microorganisms sensitive to azithromycin:

  • infections of the upper respiratory tract and ENT organs (sinusitis, tonsillitis, pharyngitis, otitis media);
  • lower respiratory tract infections (acute bronchitis, exacerbation of chronic bronchitis, pneumonia, including those caused by atypical pathogens);
  • infections of the skin and soft tissues (erysipelas, impetigo, secondarily infected dermatoses);
  • urinary tract infections caused by Chlamydia trachomatis (urethritis, cervicitis);
  • the initial stage of Lyme disease (borreliosis), erythema migrans.

Dosage and mode of application

  • Oral application, 1 hour before or 2 hours after eating 1 time per day.
  • Adults and children over 12 years old with body weight over 45 kg for infections of the upper and lower respiratory tract, ENT organs, skin and soft tissues – 0.5 g (2 capsules) 1 time per day for 3 days (course dose – 1.5 g).
  • For infections of the genitourinary tract caused by Chlamydia trachomatis (urethritis, cervicitis) – once 1 g (4 capsules).
  • In Lyme disease (the initial stage of borreliosis), erythema migrans – 1 g (4 capsules) on the first day and 0.5 g (2 capsules) daily from 2 to 5 days (course dose – 3 g).
  • In case of impaired renal function: when used in patients with the impaired renal function of mild severity (CC more than 40 ml/min), dose adjustment is not required.
  • In case of impaired liver function: when used in patients with the impaired liver function of mild to moderate severity, dose adjustment is not required.
  • Elderly patients: dose adjustment not required. Since older people may already have current proarrhythmic conditions, be cautious when using this drug due to the high risk of developing cardiac arrhythmias, including pirouette type arrhythmias.

Contraindications

  • Severe hepatic and/or renal failure;
  • Children under 12 years old with a body weight of less than 45 kg (for this dosage form);
  • Breastfeeding;
  • Concomitant use with ergotamine and dihydroergotamine;
  • Hypersensitivity to antibiotics of the macrolide group.

Precautions: moderate hepatic and renal impairment; arrhythmias or a predisposition to arrhythmias and lengthening of the QT interval; the combined use of terfenadine, warfarin, digoxin.

Side effects

  • Infectious diseases: infrequently – candidiasis (including the mucous membrane of the oral cavity and genitals), pneumonia, pharyngitis, gastroenteritis, respiratory diseases, rhinitis; unknown frequency – pseudomembranous colitis.
  • Blood and lymphatic system: infrequently – leukopenia, neutropenia, eosinophilia; very rarely – thrombocytopenia, hemolytic anemia.
  • Metabolism: infrequently – anorexia.
  • Allergic reactions: infrequently – angioedema, hypersensitivity reaction; unknown frequency – anaphylactic reaction.
  • Nervous system: often – headache; infrequently – dizziness, violation of taste, paresthesia, drowsiness, insomnia, nervousness; rarely – agitation; unknown frequency – hypesthesia, anxiety, aggression, fainting, convulsions, psychomotor hyperactivity, loss of smell, perversion of smell, loss of taste, myasthenia gravis, delirium, hallucinations.
  • Organs of vision: infrequently – impaired vision.
  • Hearing organ and labyrinth disorders: infrequently – hearing impairment, vertigo; unknown frequency – hearing impairment up to deafness and/or tinnitus.
  • Cardiovascular system: infrequently – a feeling of palpitations, flushing of the face; unknown frequency – decreased blood pressure, increased QT interval on the ECG, pirouette type arrhythmia, ventricular tachycardia.
  • Respiratory system: infrequently – shortness of breath, nosebleeds.
  • Digestive system: very often – diarrhea; often – nausea, vomiting, abdominal pain; infrequently – flatulence, dyspepsia, constipation, gastritis, dysphagia, bloating, dryness of the oral mucosa, belching, ulcers of the oral mucosa, increased secretion of the salivary glands; very rarely – discoloration of the tongue, pancreatitis.
  • Liver and biliary tract: infrequently – hepatitis; rarely – impaired liver function, cholestatic jaundice; unknown frequency – liver failure (in rare cases with a fatal outcome mainly due to severe impairment of liver function), liver necrosis, fulminant hepatitis.
  • Skin and subcutaneous tissues: infrequently – skin rash, itching, urticaria, dermatitis, dry skin, sweating; rarely – photosensitivity reaction; unknown frequency – Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme.
  • Musculoskeletal system: infrequently – osteoarthritis, myalgia, back pain, pain in the neck; unknown frequency – arthralgia.
  • Kidneys and urinary tract: infrequently – dysuria, pain in the kidneys; unknown frequency – interstitial nephritis, acute renal failure.
  • Genitals and mammary gland: infrequently – metrorrhagia, impaired testicular function.
  • Local reactions: often – pain and inflammation at the injection site.
  • Other: infrequently – asthenia, malaise, feeling tired, face swelling, chest pain, fever, peripheral edema.

Pregnancy and lactation

Azithromycin is able to penetrate the placental barrier. Use during pregnancy is possible only in cases when the intended benefit to the mother outweighs the potential risk to the fetus. Terminate breastfeeding during the intake of Zithromax.