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Zithromax

Brand names: Azovid / Azee / Azotik / Azithral / Zithromac / Vinzam / Zmax / Sumamed / Zitrocin / Aziswift

Generic name: Azithromycin

Zithromax (azithromycin) is a broad-spectrum antibiotic. It is an azalide antibiotic, a representative of a new subgroup of macrolide antibiotics. When you create inflammation in high concentrations has a bactericidal effect.

Zithromax
You can buy Zithromax online at AWC Canadian Pharmacy:

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  Product Description   Safety Information   Customer Reviews   Packaging   Video
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Before you buy Zithromax online

What It Does?

Zithromax fights bacteria affecting upper respiratory tract infection (otitis media, sinusitis and laryngitis, pharyngitis, tonsillitis) and respiratory tract (exacerbation of chronic bronchitis, pneumonia), uncomplicated urogenital system diseases (urethritis and cervicitis) caused by Chlamydia trachomatis, infections of the skin and soft tissues (erysipelas, impetigo, secondary infected dermatoses), consisting of charts eradication of Helicobacter pylori.

The bacteria sensitive to Zithromax are gram-positive cocci: Streptococcus pneumoniae, St. pyogenes, St. agalactiae, Streptococcus groups CF and G, Staphylococcus aureus, St. viridans; Gram-negative bacteria: Haemophilus influenzae, Moraxella catarrhalis, Bordetella pertussis, B. parapertussis, Legionella pneumophila, H. ducrei, Campylobacter jejuni, Neisseria gonorrhoeae and Gardnerella vaginalis; Some anaerobic bacteria: Bacteroides bivius, Clostridium perfringens, Peptostreptococcus spp; and Chlamydia trachomatis, Mycoplasma pneumoniae, Ureaplasma urealyticum, Treponema pallidum, Borrelia burgdoferi. Azithromycin is inactive against Gram-positive bacteria resistant to erythromycin.

How It Works?

Zithromax is a broad-spectrum antibiotic, a representative subgroup of macrolide antibiotics - azalides. By binding to the 50s ribosomal subunit, inhibits peptidyl translocase at the stage of translation, inhibits protein synthesis and slows the growth and reproduction of bacteria. Azithromycin contained in Zithromax acts bacteriostatically, at higher concentrations has a bactericidal effect. it operates on extra-and intracellular pathogens.

Zithromax is active against gram-positive cocci: Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus Group C, F and G, Streptococcus viridans, Staphylococcus aureus; Gram-negative bacteria: Haemophilus influenzae, Moraxella catarrhalis, Bordetella pertussis, Bordetella parapertussis, Legionella pneumophila, Haemophilus ducreyi, Campylobacter jejuni, Neisseria gonorrhoeae and Gardnerella vaginalis; Some anaerobic bacteria: Bacteroides bivius, Clostridium perfringens, Peptostreptococcus spp., and Chlamydia trachomatis, Mycoplasma pneumoniae, Ureaplasma urealyticum, Treponema pallidum, Borrelia burgdoferi.

Azithromycin is not active against gram-positive bacteria resistant to erythromycin.

How It Is Taken?

Azithromycin be given as a single dose daily. The duration for the various infectious diseases are listed below.

Children and adolescents weighing more than 45 kg, adults and elderly:

The total dose is 1,500 mg, administered as 500 mg once daily for 3 days. Alternatively, the same total dose (1500 mg) administered for 5 days with 500 mg as a single dose on day 1 and 250 mg once daily on day 2 through 5. In uncomplicated urethritis and cervicitis caused by Chlamydia trachomatis, the dosage is 1000 mg as a single oral dose.

Children and adolescents weighing less than 45 kg:

Zithromax tablets are not suitable for patients who weigh less than 45 kg. There are other dosage forms for this patient group. Elderly: older people should take the same dose as adults. Since elderly patients may be patients with ongoing proarrhythmic conditions, recommended caution because of the risk of developing cardiac arrhythmia and torsades de pointes.

Patients with renal impairment:

No dosage adjustment is necessary in patients with mild to moderate renal impairment (GFR 10-80 ml / min). Caution should be exercised when azithromycin is administered to patients with severe renal impairment (GFR <10 ml / min).

Patients with hepatic impairment:

No dosage adjustment is necessary in patients with mild to moderate hepatic impairment (Child-Pugh Class A or B). Since azithromycin is metabolised in the liver and excreted in the bile, azithromycin should be used with caution in patients with significant liver disease. No study on treating such patients with azithromycin have been performed.

Before administering you this drug, your doctor should determine sensitivity of the microflora that caused the disease in this patient towards azithromycin. Azithromycin should always be taken one hour before meals or 2 hours after a meal. The drug is taken once a day. Adults with infections of the upper and lower respiratory tract infections, skin and soft tissue appointed to 0.5 grams per day 1, followed by 0.25 g from the 2nd to the 5th day or 0.5 g daily within 3 days (course dose 1.5 g). In acute infections of urogenital (genitourinary) tract a single 1g dose is administered (2 tablets of 0.5 g). A Lyme disease (borreliosis) for the treatment of the first stage (erythemamigrans) Zithromax is appointed at 1g (2 tablets of 0.5 g) in 1 day and 0.5 grams daily from 2 to 5 days (course dose 3g). In children the drug dose should be prescribed based on body weight. For children weighing more than 10 kg the calculation is as follows: day 1 - 10 mg / kg body weight; and 5 mg / kg during the next 4 days. A 3-day course of treatment is admissable; in this case, a single dose of 10 mg / kg. (Heading dose of 30 mg / kg body weight). It is recommended to take a break of 2 hours between taking azithromycin and antacid (reducing stomach acidity) drugs in their simultaneous appointment.

Is It For Me?

Your prescriber will administer Zithromax for you if your condition is one of the following: infectious diseases caused by pathogens sensitive to the drug: infections of the upper respiratory tract and ENT - tonsillitis, sinusitis (inflammation of the sinuses), tonsillitis (inflammation of the tonsils / glands /), otitis media (inflammation of the middle ear cavity); scarlet fever; infections of the lower respiratory tract - bacterial and atypical pneumonia (pneumonia), bronchitis (inflammation of the bronchial tubes); infections of skin and soft tissue - rozha, impetigo (a superficial pustular skin lesions with formation of purulent crusts), secondarily infected dermatitis (skin disease); urinary tract infections - and negonoreyny gonorrheal urethritis (inflammation of the urethra) and / or cervicitis (inflammation of the cervix); Lyme disease (borreliosis - an infectious disease caused by the spirochete Borrelia).


Any Drug Interactions or Incompatibilities?

Antacids: In a pharmacokinetic study on the effect of concomitant administration of antacids and azithromycin there was no effect on overall bioavailability although peak serum levels were reduced by approximately 25 percents. Patients receiving both azithromycin and antacids should not take the medicines at the same time. Co-administration of azithromycin prolonged-release granules for oral suspension and a 20 mg dose of co-magaldrox (aluminum hydroxide and magnesium hydroxide) did not affect the rate and extent of azithromycin absorption.

Azithromycin should be taken at least one hour before or two hours after an antacid.

Cetirizine: In healthy volunteers, concomitant administration of a 5-day course of azithromycin upon reaching steady state of cetirizine 20 mg in any pharmacokinetic interaction or a significant change in the QT interval.

DdI (dideoxyinosine): Compared with placebo co-administration of 1200 mg of azithromycin daily and 400 mg of didanosine daily to six HIV-positive patients did not have any effect on the pharmacokinetics at steady state for didanosine.

Digoxin (P-gp substrate): Co-administration of macrolide antibiotics, including azithromycin, with P-glycoprotein substrates such as digoxin, has been reported to result in elevated serum levels of P-glycoprotein substrate. Hence the risk of elevated serum concentrations of the substrate considered if azithromycin and P-gp substrates such as digoxin are administered concomitantly.

Zidovudine: Single administration of 1000 mg azithromycin and multiple administrations of 600 mg or 1200 mg azithromycin had only a small effect on plasma kinetics or the renal excretion of zidovudine or its glucuronide metabolite. Administration of azithromycin increased the concentrations of phosphorylated zidovudine, the clinically active metabolite, in peripheral blood mononuclear cells. The clinical significance of this finding is unclear, but it may be beneficial to patients.

Azithromycin has no significant interactions with cytochrome P450 system in the liver. It is considered that azithromycin does not have the same pharmacokinetic interactions of the drug as erythromycin and other macrolide antibiotics. Complex formed between the cytochrome and azithromycin metabolites do not induce or disable the hepatic cytochrome P450 system.

Ergot alkaloids: Concomitant use of azithromycin and ergot derivatives is not recommended, as there is a theoretical possibility of ergotism.

Pharmacokinetic studies have been conducted between azithromycin and the following drugs known to undergo significant cytochrome P450-mediated metabolism.

Astemizole, alfentanil: There are no known data on interactions with astemizole or alfentanil. Caution required with concomitant use of these medicines and azithromycin because increased power by concomitant use of the macrolide antibiotic erythromycin has been described.

Atorvastatin: Co-administration of atorvastatin (10 mg daily) and azithromycin (500 mg daily) did not affect the plasma concentrations of atorvastatin (based on a HMG-CoA reductase inhibition assay). Cases of rhabdomyolysis in patients receiving azithromycin with statins has been reported after marketing.

Carbamazepine: In a pharmacokinetic interaction study in healthy volunteers, there was no significant effect on the plasma levels of carbamazepine or its active metabolite in patients receiving concomitant azithromycin.

Cisapride: Cisapride is metabolized in the liver by the enzyme CYP3A4. Because macrolides inhibit this enzyme, concomitant administration of cisapride may cause the increase of QT interval, ventricular arrhythmias and torsades de pointes.

Cimetidine: In a pharmacokinetic study examining the effects on the pharmacokinetics of azithromycin in a single dose of cimetidine (given 2 hours before azithromycin), there was no change in the pharmacokinetics of azithromycin.

Oral anticoagulants: In a pharmacokinetic interaction study, azithromycin did not change the anticoagulant effect of a 15 mg dose of warfarin administered to healthy volunteers. There are reports received after the launch of enhanced anticoagulant effect after co-administration of azithromycin with oral coumarin anticoagulants. Although no causal relationship has been established the prothrombin time monitoring should be considered when azithromycin is administered to patients receiving anticoagulants.

Cyclosporine: In a pharmacokinetic study with healthy volunteers who were administered a single oral dose of 500 mg / day azithromycin for 3 days and then administered a single oral dose of 10 mg / kg cyclosporine, where the resulting Cmax and AUC0-5 ciclosporin significantly elevated. Consequently, caution should be exercised before considering concurrent administration of these drugs. If the combination of these drugs is deemed necessary levels of ciclosporin closely monitored and the dose adjusted accordingly.

Efavirenz: Co-administration of a single dose of 600 mg of azithromycin and 400 mg efavirenz daily for 7 days did not result in any clinically significant pharmacokinetic interaction.

Fluconazole: Co-administration of a single dose of 1200 mg azithromycin did not alter the pharmacokinetics of a single dose of 800 mg fluconazole. Total exposure and half-life of azithromycin were unchanged by concomitant administration of fluconazole although a clinically insignificant decrease in Cmax (18 percents) of azithromycin was observed.

Neutropenia was observed in subjects receiving concomitant treatment with azithromycin and rifabutin. Although neutropenia has been associated with the use of rifabutin, a causal relationship to combination with azithromycin has not been established.

Sildenafil: In normal healthy male volunteers, there was no evidence of effect of azithromycin (500 mg daily for 3 days) on the AUC and Cmax of sildenafil or its principal circulating metabolite.

Terfenadine: Pharmacokinetic studies have reported no evidence of any interaction between azithromycin and terfenadine. A few cases have been reported where the risk of such interaction is not completely been ruled out, but no evidence exists not.

Theophylline: There is no evidence of any clinically significant pharmacokinetic interaction between azithromycin and theophylline when co-administered to healthy volunteers. Since interactions of other macrolides with theophylline were reported, one should be alert to signs of increased teofyllinnivaer.

Triazolam: Concomitant administration of 500 mg of azithromycin day 1 and 250 mg on Day 2 with 0.125 mg triazolam day 2 to 14 in healthy volunteers had no significant effect on any of the pharmacokinetic parameters for triazolam compared to triazolam and placebo.

Trimethoprim / sulfamethoxazole: Coadministration of trimethoprim / sulfamethoxazole (160 mg / 800 mg) for 7 days with azithromycin 1200 mg on Day 7 had no significant effect on peak concentrations, total exposure or urinary excretion, either trimethoprim or sulfamethoxazole. Serum concentrations of azithromycin were similar to those seen in other studies

What Side Effects Should I Brace Myself For?

Digestive system: nausea, vomiting, diarrhea, flatulence, stomach pain, melena, transient increase in liver enzymes; rarely - cholestatic jaundice, flatulence, anorexia, dyspepsia, pseudomembranous colitis.

Allergic reactions: seldom - skin rash, itching, angioedema, eosinophilia, Stevens-Johnson syndrome.

Skin: rarely - photosensitivity, erythema multiforme, toxic epidermal necrolysis.

Central nervous system: dizziness, headaches, cramps, distortion of taste; syncope; rarely - drowsiness, weakness, nervous excitement, anxiety, hyperkinesia.

Hemopoiesis system: seldom - a leukopenia, neutropenia, thrombocytopenia.

Cardiovascular system: rarely - palpitatins, chest pain, arrhythmia, including ventricular tachycardia.

Urogenital system: possible vaginitis, rarely - candidiasis, nephritis.

Other: rarely - hyperkalemia, arthralgia, hearing loss.

Any Important Tips?

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