Zithromax (Azithromycin)

The timely appointment of an antibiotic helps in the fight against infections of the respiratory tract, genitourinary system, and other organs. And one of the most popular drugs in this group is Azithromycin. It attracts with low toxicity and long-term effect, due to which the medicine is taken only once a day, and the course of antibiotic therapy with Zithromax is often short.

Zithromax is available in various forms. These can be tablets, capsules, powder for suspension, and powder for intravenous solution. It is most convenient to use Zithromax in tablets – they are produced with different concentrations of the active substance, so it is easier to dose and use the drug in this form.

Action: how Zithromax works

Zithromax belongs to the group of macrolides. Such antibiotics have a fairly wide range of effects on harmful bacteria. After entering the patient’s body, they are transferred to the site of inflammation and penetrate both through tissue barriers and through cell walls.

The active substance of the drug is azithromycin dihydrate. Once in the body, this substance freely penetrates into the cells of the body and is quickly localized in areas affected by inflammatory processes. The substance reaches its highest concentration in the body within two hours, after which it is gradually excreted.

Surprisingly, the active substance reaches its maximum concentration precisely in the places of inflammation caused by the vital activity of bacteria.

In a moderate dose, Azithromycin is able to suppress the formation of proteins in bacterial cells, which slows down their reproduction. A high concentration of the drug has a bactericidal effect (destroys the pathogen).

What is Zithromax used for?

The main medical indication for the use of Zithromax tablets is an infectious pathology, the development of which is caused by bacteria sensitive to the active ingredient:

  • Diseases of the urogenital tract – urethritis (inflammation of the urethra), cervicitis (inflammatory process that develops in the cervix) in women, infections with a predominantly sexual transmission (chlamydia, ureaplasmosis, mycoplasmosis).
  • ENT pathology – sinusitis (pathology of the paranasal sinuses), tonsillitis (inflammation of the tonsils), otitis media (a pathological process localized mainly in the middle ear).
  • Infections in the lower respiratory tract – bronchitis (inflammation of the bronchi), pneumonia (inflammation of the lungs).
  • Pathological processes localized in the skin and soft tissues – the initial stage of Lyme disease, pyoderma, erysipelas, impetigo.

Depending on the severity of the course of an infectious disease, Zithromax may be prescribed alone or in combination with other antibacterial drugs of other groups.

Use & dosage

With acute respiratory infections

For treatment, adults need to take 500 mg per day once for 3 to 5 days. It is advisable to do this at the same time so as not to violate the 24-hour interval.

For children weighing up to 45 kg, the daily dose is calculated from the proportion of 10 mg per kg – it is taken for 3 days. With a weight of more than 45 kg and at the age of 12 years, 500 mg of Azithromycin is prescribed per day for a course of the same duration.

Skin infections, borreliosis

On the first day – 1 gram at a time, the next – 500 mg. Treatment continues for 5 days.

Urethritis and cervicitis

A single dose of 1 gram of Zithromax for inflammation caused by chlamidia.


In the first 3 days, take 500 mg at a time or 250 mg 2 times. After 4 days, drink another 500 mg of antibiotic. Take this dose once a week. In total, during the course for 10 weeks, you need to use 10 tablets or capsules of the drug.

With gastritis and ulcers due to the bacteria Helicobacter pylori

In the treatment of gastric diseases, it is indicated to take 1 gram of the drug per day for three days.

To avoid unwanted reactions, to prescribe an antibiotic, you need to consult a doctor who will calculate how and in what quantities to take medicine. Since food intake affects the rate of absorption of the active substance, you should drink the drug one hour before meals or 2 hours after it.

Interactions with other medicines

When taken simultaneously with antacids, which reduce the concentration of the active substance in the blood, it is necessary to maintain an interval of 2 hours; other antibiotics enhance the effect of azithromycin (for example, Levomycetin, Chloramphenicol, tetracycline group); increases the concentration of Digoxin (it is incompatible with Heparin).


Before prescribing Zithromax tablets for a patient, the doctor carefully reads the instructions, which indicate the features of using the drug:

  • If a tablet is missed, the next dose should be taken as soon as possible after the missed one.
  • Against the background of taking Zithromax, diarrhea (diarrhea) may develop due to an imbalance of the microorganism in the intestine.
  • On the electrocardiogram, taking the drug can provoke a prolongation of the QT interval.
  • The active component of Zithromax can interact with drugs of other pharmacological groups, so the attending physician should be warned about their possible use.
  • Do not take the drug for long courses.
  • Azithromycin does not directly affect the functional state of the central nervous system.

In the pharmacy network, Zithromax is dispensed by prescription. It is not recommended to take them on their own, as this can cause negative health effects.


If certain pathological processes or physiological conditions of the human body are detected, taking Zithromax pills is contraindicated:

  • Hypersensitivity, individual intolerance to the main active ingredient or excipients of the drug.
  • Severe violation of the functional state of the liver.
  • Severe renal failure.
  • The patient’s age is up to 12 years.
  • Simultaneous administration of the drug ergotamine or dihydroergotamine.

Zithromax side effects

Since Zithromax is a potent drug, its administration may be accompanied by a number of side effects. Given the degree of penetration into tissues, it can affect various organ systems.

From the nervous system, the drug can cause the following side effects:

  • dizziness;
  • headache;
  • drowsiness or nervous excitement;
  • increased fatigue;
  • tinnitus, and hearing impairment, which disappear with the withdrawal of the drug.

Most often, undesirable symptoms from the gastrointestinal tract are recorded. It can be nausea, increased gas formation, and flatulence, diarrhea. In addition, taking the drug can provoke a significant decrease in appetite, cholestasis and vomiting. These effects are common due to the fact that Azithromycin is absorbed precisely in the gastrointestinal tract.

Taking Zithromax can cause pain in the heart or chest area, increased heart rate.

With weak immunity in women, the medicine can provoke thrush.

There may also be manifestations of itching against the background of an allergic reaction to the drug, urticaria, and rash. When such symptoms appear, the medication should be discontinued as soon as possible.

Zithromax and alcohol

In the annotation, alcohol is not among the contraindications, however, the simultaneous administration of an antibiotic with alcoholic beverages is not recommended. Ethanol reduces the rate of absorption of the drug and the effectiveness of treatment, adversely affects the functioning of the liver, which during antibiotic therapy already experiences an increased load. You can drink a small dose of alcohol a couple of days after the completion of the course of treatment.

Zithromax analogs

The substance was first synthesized in the 80s by the Yugoslav pharmaceutical company Pliva. Then the antibiotic began to be sold under the name Sumamed and became widespread throughout the world. In the mid-2000s, the license ended, and azithromycin began to be used as the main component of a large number of analogs. Zithromax analogs include Azitral, Zitrolide, Tremak, Hemomycin, Sumaklid, and others. What is better to take in each case, the specialist determines based on the patient’s condition, concomitant pathologies, and contraindications.