Uses of Zitromax

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1. What is the effect of Zitromax?

What is the use of Zitromax? Zitromax oral suspension powder has the main ingredients Azithromycin dihydrate 209.64mg/5ml (equivalent to 200mg/5ml azithromycin base) and other excipients. Azithromycin is the first of a group of macrolide antibiotics. The component Azithromycin binds to the 23S rRNA portion of the 50S ribosomal subunit, blocking protein synthesis by inhibiting the translocation of peptides during protein synthesis, while also inhibiting the binding of the subunit. ribosome 50S.
Indications for the use of Zitromax in the treatment of infections caused by susceptible bacteria in:
Lower respiratory tract infections such as pneumonia, bronchitis; Oral infections; Skin and soft tissue infections; Acute otitis media ; Upper respiratory tract infections including pharyngitis, sinusitis, tonsillitis; STIs in women and men, treatment of uncomplicated genital infections caused by Chlamydia trachomatis, chancroid caused by Haemophilus ducreyi, uncomplicated genital infections caused by strains of Neisseria gonorrhoeae . Do not use the drug to treat infections caused by Treponema pallidum; Azithromycin alone or in combination with rifabutin for the prevention of Mycobacterium avium - intracellulare complex infection in patients with advanced HIV; Use of Azithromycin in combination with ethambutol for the treatment of Mycobacterium avium - intracellulare complex infection in patients with advanced HIV. The use of Zitromax is contraindicated in patients with hypersensitivity to Azithromycin, erythromycin, antibiotics of the macrolide family or ketolides, excipients of the drug.

2. Usage and dosage of Zitromax

2.1. How to use The drug is taken orally, 1 dose / day. Patients can take Zitromax with or without food.
2.2. Dosage In adults:
Treatment of sexually transmitted diseases caused by Chlamydia trachomatis, Haemophilus ducreyi: Use a single dose of 1000mg. For susceptible strains of Neisseria gonorrhoeae, a dose of 1000 mg or 200 mg of Azithromycin is given concomitantly with 250 mg or 500 mg of ceftriaxone. For patients allergic to penicillins or cephalosporins, the physician should consult other treatment guidelines; Prophylaxis of Mycobacterium avium - intracellulare complex infection in HIV patients: 1200mg/time/week; Treatment of Mycobacterium avium - intracellulare complex infection in HIV patients: 600mg/time/day. Azithromycin should be combined with other anti-Mycobacterium agents such as ethambutol at the approved dose. For other indications, the total dose is 1500mg, divided into 3 times, 500mg/day. The same total dose can be substituted but administered for 5 days, 500 mg/day first, then 250 mg/day from day 2 to day 5. In children:
Maximum recommended total dose for all treatment in children is 1500mg; Usually, the total therapeutic dose for children is 30mg/kg. Depending on the case of strep throat, the dose can be changed accordingly. Total dose of 30mg/kg, divided into 3 days, use 10mg/kg/time each day or use for 5 days with a single dose of 10mg/kg/day first, then use 5mg/kg/day from day 2 to day 5. It is also possible to replace the above method with a single dose of 30mg/kg to treat acute otitis media in children; Treatment of strep throat in children: 10mg/kg or 20mg/kg for 3 days, do not increase the dose to more than 500mg/day. However, penicillin is often chosen for the treatment of strep throat caused by Streptococcus pyogenes, including the prevention of fever in arthritis; For children weighing less than 15kg, the dose of Azithromycin suspension should be calculated as accurately as possible; For children weighing 15kg or more, use Azithromycin suspension according to the following instructions: Weight under 15kg: The 3-day course is 10mg/kg/time/day from day 1 to day 3; The 5-day course is 10mg/kg/day 1, then 5mg/kg/time/day 2 - day 5; Weight 15 - 25kg: The 3-day course is 200mg (equivalent to 5ml)/time/day from day 1 to day 3; The 5-day course is 200mg (equivalent to 5ml)/day 1, then 100mg (equivalent to 2.5ml)/time/day 2 - 5; Weight 26-35kg: The 3-day course is 300mg (equivalent to 7.5ml)/time/day from day 1 to day 3; The 5-day course is 300mg (equivalent to 7.5ml)/day 1, then 150mg (equivalent to 3.75ml)/time/day 2 - 5; Weight 36 - 45kg: The 3-day course is 400mg (equivalent to 10ml)/time/day from day 1 to day 3; The 5-day course is 400mg (equivalent to 10ml)/day 1, then 200mg (equivalent to 5ml)/time/day 2 - 5; Over 45kg: Use the same dose as adults. Efficacy and safety in the prevention or treatment of Mycobacterium avium - intracellulare complex infections in children have not been established. Based on data, a dose of 20 mg/kg in children is equivalent to a dose of 1200 mg in adults but the Cmax is greater. In other subjects:
Elderly: Use the same dose as adults. Elderly people may be more prone to arrhythmias and torsades de pointes than younger people; Patients with renal impairment: For patients with mild to moderate renal impairment (GFR 10 - 80ml/min), no dose adjustment is required. Azithromycin should be used with caution in patients with severe renal impairment (GFR < 10ml/min); Patients with hepatic impairment: Patients with mild to moderate hepatic impairment can take the same dose as those with normal liver function. Reactions to Zitromax at higher than recommended doses were similar to those observed with normal doses. In case of overdose, the patient is prescribed treatment on a case-by-case basis.
If you forget to take a dose of Zitromax, the patient should take it as soon as possible. If it is almost time for the next dose, the patient should skip the missed dose and take the next dose at the pre-specified time. Patients should not take twice the prescribed dose.

3. Side effects of the drug Zitromax

Overall, Azithromycin is well tolerated with a fairly low rate of side effects. However, when using Zitromax, patients are still at risk of experiencing some side effects such as:
Blood and lymphatic system: Mild transient neutropenia, thrombocytopenia; Hearing and Inner Ear: Hearing loss (hearing loss, tinnitus, deafness) - mostly reversible; Gastrointestinal: Nausea, vomiting, diarrhea, flatulence, loose stools, dyspepsia, constipation, pancreatitis, pseudomembranous colitis, tongue color change, abdominal discomfort (pain, spasms); Hepatobiliary: Abnormal liver function, hepatitis and jaundice due to biliary obstruction, hepatic necrosis and liver failure; Metabolism: Anorexia; Psychiatric: Aggressive reactions, anxiety, stress, extremes; Neurological: Dizziness, dizziness, convulsions, headache, decreased sensation, somnolence, syncope, paresthesia, hyperactivity, loss of taste, loss of smell; Skin and subcutaneous tissue: Allergic reactions including rash and angioedema, skin pruritus, photosensitivity, urticaria, erythema multiforme, toxic epidermal necrolysis, Stevens - Johnson syndrome; Cardiovascular: Palpitations, arrhythmias (including ventricular tachycardia), prolongation of the QT interval or torsades de pointes; Microvascular: Lower blood pressure; Musculoskeletal: Joint pain; Urology: Acute renal failure, interstitial nephritis; Other side effects: Abnormal vision, Candida infection, vaginitis, anaphylaxis (rarely fatal), feeling of loss of balance, weakness, weakness, fatigue,... As a side effect of Zitromax, patients should immediately notify their doctor to receive advice on the most appropriate treatment and response.

4. Precautions when using Zitromax

Before and while taking Zitromax, patients should be aware of:
Users of Zitromax may experience serious (rarely) allergic reactions including anaphylaxis, angioedema and skin reactions such as Toxic epidermal necrolysis, Stevens-Johnson syndrome. If an allergic reaction occurs, the patient should discontinue the drug and initiate appropriate therapy. Allergic reactions may reappear once symptomatic therapy has been discontinued, so caution should be exercised; Azithromycin should be used with caution in patients with liver disease because the liver is the main route of elimination of this active substance. There have been cases of hepatitis, obstructive jaundice, abnormal liver function, necrosis and liver failure in patients receiving the drug. In the presence of the above symptoms, Azithromycin should be discontinued immediately; In patients receiving ergot-derived drugs, the risk of ergotin toxicity is increased when used in combination with macrolide antibiotics. Therefore, it is not recommended to combine drugs of ergot origin with Azithromycin; When using Zitromax, it is recommended to monitor for superinfections of microorganisms (including fungi) that are not sensitive to the active substance Azithromycin; When using antibacterial agents, including Azithromycin, patients may develop diarrhea associated with Clostridium difficile. Diarrhea can range from mild to ulcerative colitis, even leading to death. This risk should be considered in all patients with diarrhea following antibiotic administration; In patients with severe renal impairment (glomerular filtration rate less than 10 ml/min) there was an increase of approximately 33% in plasma concentrations of Azithromycin; Use Zitromax with caution in diabetics; Because Zitromax contains sucrose, it should not be used for patients with fructose intolerance, saccharase - isomaltase deficiency or glucose - galactose malabsorption; Azithromycin use may lead to prolongation of cardiac repolarization time, prolongation of the QT interval, and increased risk of arrhythmias and torsades de pointes. Therefore, consideration should be given to the use of the drug in high-risk patients; Patients treated with Azithromycin may experience exacerbations of systemic myasthenia gravis and onset of myasthenic syndrome; There are no adequate studies on the efficacy and safety of Azithromycin in pregnant women. Therefore, Azithromycin should be used during pregnancy only when absolutely necessary, with the permission of the doctor; Azithromycin is excreted in human milk, but safety in the nursing infant is unknown. Therefore, Zitromax should be used with caution in nursing women, only if approved by a doctor.

5. Zitromax drug interactions

Some drug interactions of Zitromax include:
There are drug interactions between Azithromycin and antacids. If both drugs must be used, they should not be used at the same time; Concomitant use of Azithromycin with digoxin may increase digoxin serum concentrations. Therefore, clinical signs and serum digoxin levels should be monitored during treatment with Azithromycin and after drug discontinuation; Possible drug interactions between Azithromycin and drugs derived from ergot; Azithromycin increases the concentration of zidovudine phosphorylate, the clinically active metabolite in peripheral blood mononuclear cells; Co-administration of Atorvastatin 10 mg/day and Azithromycin 500 mg/day did not change plasma concentrations of Atorvastatin. However, there are cases of patients with rhabdomyolysis when taking Azithromycin and statin group simultaneously; The anticoagulant effect is increased following concomitant administration of Azithromycin with coumarin-type oral anticoagulants. Prothrombin time should be regularly monitored when Azithromycin is co-administered with coumarin-type oral anticoagulants; Caution should be exercised when combining Azithromycin with cyclosporin. If co-administration is necessary, the concentration of cyclosporin should be monitored and the dose adjusted accordingly; Azithromycin has a negligible interaction with fluconazole ; Concomitant administration of Azithromycin 1200 mg and nelfinavir at steady state plasma concentrations of 750 mg three times daily resulted in increased concentrations of Azithromycin. However, no significant side effects were observed, so no dose adjustment was required; Concomitant administration of Azithromycin and rifabutin may cause neutropenia. When using Zitromax, patients should strictly follow the specific instructions of the doctor. This ensures the best therapeutic effect and significantly reduces the risk of many adverse side effects.

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