Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. Hypertoxin producing strains of C.
CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents.
Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. Azithromycin for injection should be reconstituted and diluted as directed and administered as an intravenous infusion over not less than 60 minutes. Prolonged cardiac repolarization and QT interval, imparting a risk of developing cardiac arrhythmia and torsades de pointes, have been seen in treatment with other macrolides.
A similar effect with azithromycin cannot be completely ruled out in patients at increased risk for prolonged cardiac repolarization. Exacerbation of symptoms of myasthenia gravis and new onset of myasthenic syndrome have been reported in patients receiving azithromycin therapy.
Prescribing azithromycin in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria. Information for Patients Patients should be directed to discontinue azithromycin and contact a physician if any signs of an allergic reaction occur. Patients should be counseled that antibacterial drugs including azithromycin should only be used to treat bacterial infections.
They do not treat viral infections e. When azithromycin is prescribed to treat a bacterial infection, patients should be told that although it is common to feel better early in the course of the therapy, the medication should be taken exactly as directed. Skipping doses or not completing the full course of therapy may 1 decrease the effectiveness of the immediate treatment and 2 increase the likelihood that bacteria will develop resistance and will not be treatable by azithromycin or other antibacterial drugs in the future.
Diarrhea is a common problem caused by antibiotics which usually ends when the antibiotic is discontinued. Sometimes after starting treatment with antibiotics, patients can develop watery and bloody stools with or without stomach cramps and fever even as late as two or more months after having taken the last dose of the antibiotic. Rash, photosensitivity, and angioedema. Five percent of patients experienced reversible hearing impairment in the pivotal clinical trial for the treatment of disseminated MAC in patients with AIDS.
Hearing impairment has been reported with macrolide antibiotics, especially at higher doses. Arthralgia, edema, urticaria, angioedema. Arrhythmias including ventricular tachycardia, hypotension. There have been rare reports of QT prolongation and torsades de pointes. Asthenia, paresthesia, fatigue, malaise and anaphylaxis rarely fatal. Interstitial nephritis and acute renal failure, vaginitis.
Aggressive reaction and anxiety. Pruritus, rarely serious skin reactions including erythema multiforme, Stevens Johnson Syndrome, and toxic epidermal necrolysis. When follow-up was provided, changes in laboratory tests appeared to be reversible. In multiple-dose clinical trials involving more than patients, 3 patients discontinued therapy because of treatment-related liver enzyme abnormalities and 1 because of a renal function abnormality. Chronic therapy median duration: Causality of these laboratory abnormalities due to the use of study drug has not been established.
Azithromycin tablets may be taken without regard to food. This dose of azithromycin may be combined with the approved dosage regimen of rifabutin. Other antimycobacterial drugs that have shown in vitro activity against MAC may be added to the regimen of azithromycin plus ethambutol at the discretion of the physician or health care provider.
Caution should be exercised when azithromycin is administered to subjects with severe renal impairment. No dosage adjustment recommendations can be made in patients with impaired hepatic function. Azithromycin, at the recommended dose, should not be relied upon to treat syphilis.
Antimicrobial agents used in high doses for short periods of time to treat non-gonococcal urethritis may mask or delay the symptoms of incubating syphilis. All patients with sexually-transmitted urethritis or cervicitis should have a serologic test for syphilis and appropriate cultures for gonorrhea performed at the time of diagnosis. Appropriate antimicrobial therapy and follow-up tests for these diseases should be initiated if infection is confirmed.
Appropriate culture and susceptibility tests should be performed before treatment to determine the causative organism and its susceptibility to azithromycin. Therapy with azithromycin may be initiated before results of these tests are known; once the results become available, antimicrobial therapy should be adjusted accordingly. To reduce the development of drug-resistant bacteria and maintain the effectiveness of azithromycin and other antibacterial drugs, azithromycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria.
When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice. Store clarithromycin tablets at room temperature, protect them from light and moisture, and keep them out of the reach of children.
Store clarithromycin oral suspension at room temperature with the bottle tightly closed and protected from light. Any unused oral suspension should be thrown away after 14 days.
Rinse the dose measuring oral syringe between uses. Do not store the suspension in the syringe. Do not dispose of medications in wastewater e. Tissue levels were determined following a single oral dose of mg azithromycin in 7 gynecological patients. Approximately 17 hours after dosing, azithromycin concentrations were 2. Following a regimen of mg on the first day followed by mg daily for 4 days, concentrations in the cerebrospinal fluid were less than 0.
Metabolism In vitro and in vivo studies to assess the metabolism of azithromycin have not been performed. Azithromycin except Zmax can be taken with or without food, but food reduces stomach upset. Zmax should be taken on an empty stomach 1 hour before or 2 hours after a meal since food reduces its absorption. The adult azithromycin dose is mg in multiple or single doses.
However, azithromycin of the theoretical possibility of ergotism, azithromycin and ergot derivatives should not be co-administered see apotex 4. Als u stopt met het gebruik van dit middel Stop niet met het innemen van Azitromycine Apotex zonder overleg met uw arts, azithromycin apotex 500mg. Indinavir Coadministration of a single dose of mg azithromycin had no statistically significant effect on the pharmacokinetics of indinavir administered as mg three times daily for 5 days. While you are taking this medicine Things you must do 500mg the symptoms of your infection do not improve within a few azithromycin, or if they become worse, tell your doctor. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents. Atorvastatin Coadministration of atorvastatin 10 mg daily and azithromycin mg daily apotex not alter the plasma concentrations of atorvastatin based on a HMG CoA-reductase inhibition assay. Azithromycin works by killing or stopping the growth of bacteria causing your infection. The total sodium content from dietary and non-dietary sources may be clinically important with regard to such diseases as congestive heart indikasi acyclovir 400mg. Carcinogenesis and Mutagenesis and Impairment of Fertility Long-term studies in animals have not been performed to evaluate carcinogenic potential, azithromycin apotex 500mg. No overall differences in safety were observed between these subjects and younger subjects in terms of adverse events, laboratory abnormalities, and discontinuations. If you are taking any of these you may need a different dose or you may need to take different medicines. Neem geen dubbele dosis om een vergeten dosis in te halen. Shake the oral suspension liquid well just before you measure a dose. Azithromycin must be taken for the recommended duration of tab lasix 20mg, even if you are feeling better. The geriatric population may respond with a blunted natriuresis to salt loading. However, concurrent use of macrolides and theophylline has been associated with increases in the serum 500mg of theophylline.
Other drugs may interact with azithromycin, including prescription and over-the-counter medicines, vitamins, and herbal products. Hypertoxin producing strains of C. No evidence of impaired fertility due to azithromycin was found. Biliary 500mg is a major route of elimination for unchanged drug, azithromycin apotex 500mg, following oral administration. Special Populations Apotex Insufficiency Azithromycin pharmacokinetics were investigated in 42 adults 21 to 85 years of age with varying degrees of renal impairment. Before you start to take it Before you start taking this medicine, tell your doctor if: Do not dispose of apotex in wastewater e. The most common side effects associated with treatment in adult azithromycin who received I. Azithromycin therapy should be followed by azithromycin by the oral route at 500mg single, daily dose of mg, administered as two mg tablets to complete a 7 to 10 day course of therapy. To make sure you get the entire dose, add a little more water to the same glass, swirl gently and drink right away, azithromycin apotex 500mg. Throw away any unused liquid medicine after 10 days. Co-administration with efavirenz or fluconazole had a modest effect on the pharmacokinetics of azithromycin.
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