Azithromycin (Intravenous)

This article will discuss several aspects of the antibiotic Azithromycin, such as its conditions treated, side effects, dosage, interactions, and precaution

Overview

Azithromycin is a type of antibiotic known as a macrolide antibiotic, which is used to treat specific bacterial infections. Macrolide antibiotics, including Azithromycin, are medicines which are similar to the very common erythromycin antibiotic. This family of antibiotics works by killing bacteria present and preventing further growth into the infected site. Erythromycin type medicines are used to fight several types of infections, including ear infections, skin infection, and respiratory infection. Azithromycin is a much stronger antibiotic than others in its family and is normally only used to treat bacterial infections that are stronger or worse in nature.

Conditions Treated

  • Bacterial Infections
  • Lung Infections caused by bacteria
  • Female pelvic infections caused by bacteria
  • Some bacterial diseases in patients with HIV

Type of Medicine

  • Antibiotic
  • Intravenous

Side Effects

Some of the common side effects that can come with the use of Azithromycin can include the following:

  • Nausea
  • Vomiting
  • Diarrhea
  • Stomach pain
  • Pain or redness at the site of the injection

Most of the people who use this injection do not experience serious side effects. As with any medicine, however, there is a potential risk of side effects that are much more severe in nature. They are rare, but have been known to occur. If you experience any of the following, contact your doctor right away:

  • Hearing changes such as ringing in the ears or any hearing loss
  • Swelling in the legs and feet
  • Eye problems such as drooping eyelids or blurry vision
  • Slurred speech
  • Muscle weakness
  • Persistent nausea and/or vomiting
  • Severe abdominal or stomach pain
  • Unusual fatigue
  • Yellowing of the skin or eyes

Seek medical attention immediately if any of the following rare but severe side effects occurs:

  • Severe dizziness
  • Fainting
  • Fast or irregular heartbeat

It is incredibly rare to have an allergic reaction to this medication, but it is still possible. If you experience any of the signs of an allergic reaction, such as swelling of the tongue/face/throat/lymph nodes, fever, rash, severe dizziness or trouble breathing, please seek medical attention immediately. In some patients, allergic symptoms can return even after treatments to the allergic reaction are finished. To be safest, the drug should be discontinued after the first allergic reaction and after appropriate treatment for the allergic reaction is taken.

Sometimes serious skin reactions can occur while taking this medication. This may occur at the injection site or anywhere on the body. Azithromycin can also make a patient more susceptible to com/health/burns/">sunburns and damage from the sun, which can cause skin issues as well. Alert your doctor right away if you begin to experience any of the following symptoms at the injection site or on the body:

  • Severe acne
  • Severe rash
  • Skin lesions
  • Blistering
  • Pain or redness
  • Sores
  • Itching
  • Lumps
  • Swelling

Azithromycin may also cause a rare intestinal disorder due to resistant types of bacteria. This disorder is known as Clostridium difficile, and can range from mild to fatal diarrhea issues. This disorder may develop during treatment or any time afterward up to several months. Talk to your doctor if you experience persistent diarrhea, severe abdominal pain, or blood in your stool while taking Azithromycin. It is important to note that taking medicines that would normally stop diarrhea or abdominal pain can worsen these effects when taken at the same time as Arithromycin. Narcotics taken at the same time as Arithromycin can also make diarrhea worse

Use of this drug for a prolonged amount of time could result in oral thrust or a vaginal yeast infection. If you notice white patches or sores in your mouth, a new and unusual vaginal discharge, or any other unusual symptoms, contact your doctor.

Dosage

Most of the time, this medicine will be administered by a healthcare professional, usually a doctor or a nurse who is monitoring your condition. Azithromycin for injection, USP is supplied in lyophilized form in a 10 mL vial equivalent to 500 mg of azithromycin for intravenous administration. It is given through a needle that is administered to one of the veins in the patient's arms. Usually the injection will be given for at least 2 days but not more than 10. If the condition still has not improved after prolonged use of Azithromycin, doctors will normally switch the patient to an oral antibiotic instead. Azithromycin is normally injected once daily by a doctor over a period of about one hour. It should be used at evenly spaced intervals in order to work at its most efficient, so your doctor will probably administer the medication around the same time every day. The dosage and length of treatment depend on the therapy recommendations by your doctor. The disease being treated and the response of the disease to treatment can also affect the dosage and length of treatment.

This medication can be taken at home. If it is going to be administered at home, make sure you know all the instructions and procedures for administering the medication. These instructions should come from a healthcare provider. Before using the product, check visually for discoloration or particles floating within the product. Learn from your doctor or pharmacist how to properly dispose of the medication. Azithromycin can be taken with or without food present.

If there is a suspected overdose, contact poison control immediately and take the affected person to the nearest emergency room. It is important to take this drug as it is scheduled by your doctor. Contact your doctor if you miss a dose. Do not take extra doses to compensate for missed doses.

Interactions

There are several interactions with other drugs that could possible change how your drug works. It is important to keep a list of all medication you take presently to give to your doctor so they can give you the best treatment possible. This includes both prescription and over the counter medications, as well as herbal products and supplements. Because of this, it is important to discuss any medication changes with your doctor, and get all medication changes approved by your doctor.

Although most antibiotics including Azithromycin are not known to affect or interfere with birth controls such as the pill, patch, or the shot, it is still a possibility that antibiotics can decrease birth control effectiveness. This can lead to an increased risk for pregnancy. Talk to your doctor if you take any birth control pills and are sexually active about this potential increased risk.

There are several medications that can pose severe threats to anyone who takes Azithromycin at the same time. Most of these medications are medications that can also aggravate QT prolongation problems. QT prolongation is a heart rhythm condition in which the heart beats rapidly and in a chaotic manner. Azithromycin's interactions with these drugs can potentially worsen this condition. The drugs that Azithromycin should not be combined with are as follows:

  • Anagrelide
  • Domperidone
  • Amifampridine
  • Dronedarone
  • Disopyramide
  • Sertindole
  • Droperidol
  • Levomethadyl
  • Sparfloxacin
  • Halofantrine

There are many others that might also not interact well with Azithromycin. It can also interact with drugs such as lovastatin, which is a cholesterol lowering drug. It is important to consult with your doctor before taking any drug with Azithromycin, especially if it is a drug used to control heart rhythm or known to cause heart rhythm problems. Speak to your doctor about using the drug if you have any other known heart problems. Other tests, such as an EKG, may be necessary in order to determine if you can use the drug.

Low levels of potassium and magnesium in the blood can also increase risk of QT prolongation. Because of this, supplements or other medicines containing potassium or magnesium should be avoided while taking Arithromycin; otherwise, a doctor should be consulted for all possible interactions. Medicines containing aluminum, such as some antacids, should also be avoided. The risk may also be increased if you are on certain pills such as diuretics or if you have conditions that cause severe sweating, diarrhea, or vomiting. Arithromycin also contains sodium, so talk to your doctor if you are on a sodium restricted diet. It can also worsen conditions that may be worsened by increased sodium intake.

There are other medicines that treat certain diseases that might cause negative interactions with Azithromycin. Some of the diseases that might have medicines that interact with Azithromycin might include:

  • Heart disease
  • Liver disease
  • Some muscular diseases
  • Some medicines used to treat heart problems

As well, Azithromycin can make some of the listed conditions worse. Conditions such as heart disease, some muscular diseases such as Myasthenia gravis, liver disease, and kidney disease can all be worsened by the drug or change the effects of the drug. Be sure to tell your doctor if you have a history of any of the above diseases, as some patients who have a history of these diseases who do not presently have the disease still might have negative interactions with Azithromycin.

Some blood thinners such as warfarin or Jantoven can be taken while using Azithromycin, but their use should be closely monitored by your doctor. If you experience any of the above symptoms, talk to your doctor about your medications and medical history.

Warnings

Before using Arithromycin, let your doctor know if you are allergic to it or if you have any allergies to other antibiotics. There might be certain inactive ingredients in the drug that could cause an allergic reaction. If you are experiencing any symptoms of an allergic reaction, stop taking the drug immediately and seek medical attention. Symptoms of allergic reaction can still occur even after treatment has stopped.

If you are pregnant, this drug should only be used if absolutely needed. The drug can be passed through breast milk, so also talk to your doctor if you are breast feeding. If the drug is passed on to babies through the breast milk or if the babies require the drug, they may be at risk for serious stomach problems resulting from the drug. Contact your child's pediatrician right away if your child experiences nausea or vomiting while taking Arithromycin or being breast fed by someone taking Arithromycin. Elderly adults may be more sensitive to the effects of this drug, especially if they have heart related conditions. Elder patients may experience the side effects of the drug m more frequently or strongly than normal. Children younger than age sixteen should take precautions when using this drug; consult with your doctor to make sure it is alright to take this drug at a younger age, as there have not been many tests into the effects on young children. Those with liver disease should also be aware of potentially harmful interactions with the drug. If any signs or symptoms of hepatitis appear while taking Azithromycin, stop taking the drug immediately and talk to your doctor.

Some live bacterial vaccines can have negative interactions with the drug. Talk to your doctor if you are planning to get a bacterial vaccine while taking the drug to make sure it is okay. Arithromycin can cause these vaccines to not work as well or not work at all.

Azithromycin is a strong antibiotic and carries many potential risks. To be taken, the benefit must outweigh the potential risks. It is important to never take Azithromycin without the consent of a doctor and without first thoroughly reviewing the risks involved. Antibiotics should be taken until they are completely finished, even if the condition appears to have gotten better or gone away. Stopping any antibiotic treatment before it is fully complete can cause bacterial growth to return and sometimes make the condition worse. You will normally be closely monitored by your doctor during the course of taking the medication. If the antibiotic does not seem to help, your doctor may choose an alternate route for treatment.

Storage

You should consult the individual product description and your pharmacist for how to store this drug. The drug is most often refrigerated and can last up to seven days when it is refrigerated. After this point any medicine in liquid form should be thrown out. This medicine should be stored out of reach of children at all times. You should not flush this medicine down the drain or the toilet unless instructed to do so. Consult medicine instructions to find out how to properly dispose of this product once it has expired.

Summary

Azithromycin is an antibiotic that can be used to treat some stronger types of bacterial infections, such as pneumonia caused by bacteria, some bacterial infections that appear in HIV patients, or female pelvic infections caused by bacteria. Because of its strength, Azithromycin must be used with many precautions and must only ever be used when the benefits outweigh the potential risks. It has several precautions one must consider when thinking about taking the drug. Most notably, it should not be taken when the patient has heart conditions such as bradycardia, QT prolongation, heart disease, or other issues that might cause an irregular heartbeat. The drug should also not be taken in patients with liver disease or a history of liver problems, as it can worse these conditions. Allergic reactions are not common, but should still be monitored for, especially if one has already had an allergic reaction to an antibiotic.

Individuals who are considered elderly, who are under the age of 16, pregnant or plan to become pregnant, or currently breast feeding should consult with their doctor before beginning the use of this antibiotic. Drugs that contain aluminum or magnesium should not be taken in conjunction with this drug. Other drugs that treat heart conditions or other severe conditions may interact with this drug and cause these conditions to worsen. Certain blood thinners or cholesterol lowering drugs may interact with Azithromycin as well and should be monitored while taking the antibiotic. There are many side effects of the drug, some of which can be worsened by other factors such as age, other drugs being taken, or a history of certain other diseases. Your doctor should be contacted if any of the side effects appear worse than normal or any of the listed worse side effects appear. While serious side effects and other negative responses are not very common when the medication is administered correctly, they are still a risk when taking this medication. It is important to talk to your doctor thoroughly about your medical history and medications being taken, and to be monitored closely by your doctor while this medication is being administered.

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Last Reviewed:
December 24, 2017
Last Updated:
April 02, 2018
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