Zithromax 200mg Sus 30ml(yellow Bx)

Azithromycin is a macrolide antibiotic that inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit of susceptible microorganisms. This binding interferes with the translocation of peptides, thereby inhibiting RNA-dependent protein synthesis.

Urgent Side Effects: Seek Medical Help Right Away

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Chest pain or pressure
Fast heartbeat or abnormal heartbeat
Dizziness or fainting
Changes in hearing
Fever
Changes in eyesight
Diarrhea, especially if it is severe, bloody, or watery (note: diarrhea is a common side effect of antibiotics, but rare cases of C. diff-associated diarrhea (CDAD) can be severe and potentially life-threatening)
Stomach pain, cramps, or very loose, watery, or bloody stools (if you experience these symptoms, contact your doctor before treating diarrhea)
Signs of liver problems, such as:
+ Dark urine
+ Tiredness
+ Decreased appetite
+ Upset stomach or stomach pain
+ Light-colored stools
+ Vomiting
+ Yellow skin or eyes
Severe skin reactions, including:
+ Stevens-Johnson syndrome (SJS)
+ Toxic epidermal necrolysis (TEN)
+ Other serious reactions, which can affect body organs and be life-threatening
+ Signs of severe skin reactions may include:
- Red, swollen, blistered, or peeling skin
- Red or irritated eyes
- Sores in the mouth, throat, nose, eyes, genitals, or skin
- Fever
- Chills
- Body aches
- Shortness of breath
- Swollen glands

Other Possible Side Effects

Most people do not experience severe side effects, and some may not have any side effects at all. However, if you notice any of the following side effects, contact your doctor or seek medical attention if they bother you or do not go away:

Headache
Diarrhea
Stomach pain
Upset stomach
Vomiting

Reporting Side Effects

This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following conditions to ensure safe treatment:

Any allergies you have, including allergies to this medication, its components, or other substances. Be sure to describe the allergic reaction and its symptoms.
If you have previously experienced liver problems or jaundice (yellowing of the skin or eyes) while taking this medication.
Certain health conditions, such as:
+ Abnormal heart rhythms, including a prolonged QTc interval on an electrocardiogram (ECG) or other irregular heartbeats.
+ Slow heartbeat or low levels of potassium or magnesium in your blood.
+ Heart failure, also known as a weak heart.
+ A history of torsades de pointes, a specific type of abnormal heartbeat.
If you are taking any medications that can cause abnormal heart rhythms, particularly those that prolong the QT interval. There are many medications that can have this effect, so it is crucial to consult your doctor or pharmacist if you are unsure.

This list is not exhaustive, and it is vital to discuss all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. They will help you determine whether it is safe to take this medication in combination with your other treatments and health conditions. Never start, stop, or change the dosage of any medication without first consulting your doctor.

Important Warnings and Cautions for Patients Taking This Medication

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Adhere to the prescribed duration of treatment, as prolonged use may increase the risk of a second infection.

Severe Heart Rhythm Changes
This medication can cause severe heart rhythm changes, including prolonged QT interval, which may be life-threatening or fatal. If you have any questions or concerns, consult your doctor.

Myasthenia Gravis
If you have myasthenia gravis, discuss your treatment with your doctor. Monitor your symptoms closely, and contact your doctor if they worsen. Additionally, be aware that myasthenia gravis symptoms can occur in people without a prior diagnosis. Seek immediate medical attention if you experience new or worsening muscle weakness, difficulty chewing or swallowing, breathing problems, droopy eyelids, or changes in vision, such as blurred vision or double vision.

Special Considerations
If you are 65 years or older, use this medication with caution, as you may be more susceptible to side effects.

Pregnancy and Breastfeeding
If you are pregnant, plan to become pregnant, or are breastfeeding, consult your doctor to discuss the potential benefits and risks to you and your baby.

Newborns
In newborns taking this medication, a severe stomach problem can occur. If your child vomits or becomes irritable during feeding, contact your doctor immediately.

• QT prolonging drugs (e.g., Class IA and III antiarrhythmics, cisapride, pimozide, terfenadine, astemizole, some antipsychotics, tricyclic antidepressants, fluoroquinolones, antifungals) - increased risk of Torsades de Pointes.
• Nelfinavir - significantly increases azithromycin concentrations, monitor for adverse effects.

• Antacids (containing aluminum or magnesium) - decrease peak serum levels of azithromycin; administer azithromycin at least 1 hour before or 2 hours after antacids.
• Warfarin - increased anticoagulant effect (monitor INR).
• Digoxin - increased serum digoxin levels (monitor digoxin levels).
• Ergot alkaloids (e.g., ergotamine, dihydroergotamine) - theoretical risk of acute ergot toxicity (vasospasm with peripheral ischemia and dysesthesia); avoid concomitant use.
• Cyclosporine - increased cyclosporine levels (monitor cyclosporine levels).
• Statins (e.g., atorvastatin, simvastatin) - theoretical risk of rhabdomyolysis due to potential inhibition of CYP3A4, though azithromycin is a weak inhibitor. Monitor for myopathy.

• Zidovudine - increased phosphorylation of zidovudine's active metabolite (clinical significance uncertain).
• Carbamazepine - no significant interaction, but monitor levels if co-administered.

• Diarrhea (especially severe or bloody)
• Abdominal pain
• Nausea/Vomiting
• Rash or itching (signs of allergic reaction)
• Swelling of face, lips, tongue, or throat (angioedema)
• Difficulty breathing or swallowing
• Yellowing of skin or eyes (jaundice)
• Dark urine
• Unusual fatigue or weakness
• Palpitations or irregular heartbeat
• Dizziness or fainting

Category B. Studies in animals have not shown harm to the fetus, and there are no adequate and well-controlled studies in pregnant women. Generally considered safe for use during pregnancy when clearly needed, especially for specific infections like Chlamydia.

L3 (Moderately safe). Azithromycin is excreted in human milk in low concentrations. While generally considered compatible with breastfeeding, monitor breastfed infants for potential gastrointestinal disturbances (e.g., diarrhea, vomiting, candidiasis) and theoretical risk of effects on infant gut flora.

Dosing is weight-based and varies by indication. Caution advised in infants younger than 6 months due to potential association with infantile hypertrophic pyloric stenosis (IHPS), particularly with erythromycin, but also reported with azithromycin. Benefits must outweigh risks.

No overall differences in safety or effectiveness observed between elderly and younger patients. However, elderly patients may be more susceptible to QT prolongation and Torsades de Pointes, especially if they have pre-existing cardiac conditions or are on other QT-prolonging medications. Monitor carefully.

• Azithromycin has a very long half-life, allowing for once-daily dosing and shorter treatment durations (e.g., 3-day or 5-day courses, or single dose).
• Known for its excellent tissue penetration and accumulation in phagocytes, leading to high concentrations at infection sites.
• Commonly causes GI upset (nausea, diarrhea, abdominal pain); taking with food may help, but may reduce absorption of the oral suspension.
• Important to counsel patients on the risk of C. difficile-associated diarrhea, which can occur even weeks after completing therapy.
• While generally well-tolerated, be mindful of the rare but serious risks of QT prolongation, Torsades de Pointes, and hepatotoxicity, especially in susceptible patients.
• Not effective against viral infections.

• Other macrolides (e.g., erythromycin, clarithromycin)
• Beta-lactam antibiotics (e.g., amoxicillin, amoxicillin/clavulanate, cephalexin)
• Tetracyclines (e.g., doxycycline)
• Fluoroquinolones (e.g., levofloxacin, moxifloxacin)
• Clindamycin

If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about this medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide details about the medication, including the amount taken and the time it happened.