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Zithromax is an organic substance from the group of macrolides, a subclass of azalides. The antibiotic blocks the production of certain vital proteins by bacteria, which allows them to stop their growth and reproduction. Thus, this drug has a bacteriostatic rather than bactericidal effect. However, this does not mean that this drug is weaker than bactericidal antibiotics because stopping the growth of bacteria in most cases leads to the death of the stamm. By the way, in large doses, Zithromax provides a bactericidal effect.

Bacteria sensitive to the effects of the drug:

  • streptococci;
  • staphylococci;
  • legionella;
  • chlamydia;
  • mycoplasma;
  • toxoplasma;
  • clostridia;
  • Borelli;
  • hemophilic sticks.

Indications

The drug is used to treat infectious diseases:

  • upper respiratory tract (throat, nasopharynx, sinus);
  • lower respiratory tract (bronchi and trachea);
  • lungs;
  • genitourinary organs;
  • skin diseases.

Respiratory diseases in which this drug may be prescribed:

  • bronchitis;
  • pneumonia (including atypical);
  • pharyngitis;
  • rhinitis;
  • sinusitis;
  • scarlet fever;
  • otitis media;
  • sinusitis.

Genitourinary diseases in which the drug can be used:

  • urethritis;
  • cervicitis;
  • cystitis;
  • adnexitis;
  • prostatitis.

Also, the drug can be used in the early stages of borreliosis (Lyme disease), various skin infections and soft tissue infections (erysipelas, impetigo, dermatosis, moderate acne).

As part of combination therapy, the drug can be used to destroy Helicobacter pylori, which causes various digestive diseases – gastritis and ulcers.

Release form

The drug can be produced in various dosage forms – film-coated tablets, absorbable tablets, capsules, suspension for children, powder for the preparation of a solution for parenteral administration. But the most commonly used forms are tablets and capsules. They have a dosage of 125, 250, 500 mg of the active substance. Typically, packages contain 3 tablets or 3 capsules. Powder for the preparation of an oral suspension may have a dosage of 15, 30 or 75 mg of azithromycin per gram of powder.

Dosage and administration

For oral administration without chewing, 1 time per day, at least 1 hour before or 2 hours after a meal, 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: 500 mg 1 time per day for 3 days (course dose of 1.5 g). The initial stage of Lyme disease: 1 time per day for 5 days: 1st day -1000 mg, then from the 2nd to 5th day – 500 mg (course dose 3.0 g). In the case of urinary tract infections caused by Chlamydia trachomatis (urethritis, cervicitis): uncomplicated urethritis/cervicitis -1000 mg once. Common acne of moderate severity: the course dose is 6 g: 500 mg 1 time per day for 3 days, then 500 mg 1 time per week for 9 weeks. The first weekly pill should be taken 7 days after taking the first daily pill (8th day from the start of treatment), the next 8 weekly tablets – with an interval of 7 days. Children aged 3 to 12 years with a bodyweight of less than 45 kg. For infections of the upper and lower respiratory tract, ENT organs, skin and soft tissues: at the rate of 10 mg/kg body weight 1 time per day for 3 days (course dose 30 mg/kg).

Contraindications

  • Hypersensitivity to antibiotics of the macrolide group;
  • Severe violations of the liver and kidneys;
  • Pregnancy;
  • Breastfeeding (at the time of treatment is suspended).

Use with caution in cases of severe impaired liver, kidney, cardiac arrhythmias (ventricular arrhythmias and prolongation of the QT interval are possible).

Side effects

Undesirable effects are possible, such as:

  • allergic reactions: rash, accompanied by itching, skin redness, angioedema, rarely – anaphylactic shock.
  • dyspeptic symptoms in the form of nausea, vomiting, pain in the stomach or intestines, constipation, frequent loose stools, digestive disorders of a functional nature, excessive accumulation of gases in the intestines.
  • headache of various localization and severity.
  • dizziness, numbness and crawling in the limbs, tinnitus, loss of appetite, up to anorexia.
  • sensation of palpitations, pain in the heart.
  • Pancreatic inflammation.
  • Impaired liver function up to necrosis.
  • Catching infection, including fungal in the genitourinary system.
  • Increased levels of eosinophils in the blood.
  • If side effects occur, you must consult a specialist to resolve the issue of further use of the medication.

In a biochemical blood test, there is an increase in the activity of liver enzymes: ALT, AST, alkaline phosphatase.

Overdose

There are no data on cases of taking doses in larger quantities than recommended at a consultation with a specialist or in recommendations for use. Symptoms are similar to common side effects: dyspeptic disorders in the form of nausea, vomiting, pain in the stomach and intestines, as well as temporary reversible hearing loss. The treatment is symptomatic. A medication of a specific action that stops or decreases the effect of large doses taken (antidote) has not been developed. Dialysis is not used.

Drug interactions

  • Antacids (containing aluminum, magnesium) significantly reduce the absorption of azithromycin, so the drug should be taken at least 1 hour before or 2 hours after taking these drugs.
  • It does not bind to enzymes of the cytochrome P450 complex and, unlike macrolide antibiotics, no interaction with theophylline, terfenadine, carbamazepine, triazolam, digoxin has been observed.
  • Macrolides with concomitant use with cycloserine, indirect anticoagulants, methylprednisolone, felodipine and microsomal oxidation preparations (cyclosporine, hexobarbital, ergot alkaloids, valproic acid, disopyramide, bromocriptine, phenytoin inhibitor, peroxidation) while when using azalides, such an interaction has not been noted.
  • If co-administration with warfarin is necessary, it is recommended to carefully monitor the prothrombin time.
  • With the simultaneous administration of macrolides with ergotamine and dihydroergotamine, their toxic effects (vasospasm, dysesthesia) are possible.
  • Lincosamides weaken, and tetracycline and chloramphenicol enhance azithromycin effectiveness.
  • Pharmaceutically incompatible with heparin.