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Zithromax is an antibiotic related to erythromycin. It is prescribed for adults to treat certain mild to moderate skin infections; upper and lower respiratory tract infections, including pharyngitis (strep throat), tonsillitis, worsening of chronic obstructive pulmonary disease, and pneumonia; sexually transmitted infections of the cervix or urinary tract; and genital ulcer disease in men. In children, Zithromax is used to treat middle ear infection, pneumonia, tonsillitis, and strep throat.

Brand Name: Zithromax

Generic Name: Azithromycin

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Most important fact about Zithromax

There is a possibility of rare but very serious reactions to Zithromax, including angioedema (swelling of the face, lips, and neck that impedes speaking, swallowing, and breathing), anaphylaxis (a violent, even fatal allergic reaction), and serious skin diseases. If you develop these symptoms, stop taking Zithromax and call your doctor immediately.

How should you take Zithromax?

Take Zithromax capsules at least 1 hour before or 2 hours after a meal. Zithromax tablets and oral suspension can be taken with or without food. Do not take any form with an antacid that contains aluminum or magnesium, such as Di-Gel, Gelusil, Maalox, and others.

If you are using single-dose packets of Zithromax powder for oral suspension, mix the entire contents of each packet with 2 ounces of water, drink immediately, then add an additional 2 ounces of water, mix again, and drink to make sure you’ve taken the entire dose. When giving the pediatric suspension, shake the bottle thoroughly before each use and measure the dose with the supplied calibrated dropper. Use the pediatric suspension within 10 days and throw out any that remains.

Be sure to take all the Zithromax prescribed. If you stop taking Zithromax too soon, some germs may survive and the illness may return.

If you miss a dose of Zithromax

Take the forgotten dose of Zithromax as soon as you remember. If you don’t remember until the next day, skip the dose and go back to your regular schedule. Never try to “catch up” by doubling the dose.

Storage instructions for Zithromax

Zithromax should be stored at room temperature.

What side effects may occur when taking Zithromax?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Zithromax.

More common side effects may when taking Zithromax include:

Abdominal pain, diarrhea or loose stools, nausea or vomiting.

Less common side effects may when taking Zithromax include:

Blood in the stools, chest pain, dizziness, drowsiness, fatigue, gas, headache, heart palpitations, indigestion, itching, jaundice (yellowing of the skin and the whites of the eyes), kidney infection, light sensitivity, rash, severe allergic reaction including swelling (as in hives), vaginal inflammation, vertigo, yeast infection.

Other uncommon side effects sometimes seen in children with Zithromax include:

Agitation, constipation, cough, facial swelling, feeling of illness, fever, fungal infection, insomnia, loss of appetite, nervousness, overactivity, pinkeye, runny nose, shortness of breath, sore throat, stomach inflammation, sweating.

The single large dose of Zithromax that is prescribed to treat sexually transmitted infection of the cervix or urinary tract is more likely to cause stomach and bowel side effects than the smaller doses prescribed for a skin or respiratory tract infection.

Why should Zithromax not be prescribed?

Do not take Zithromax if you have ever had an allergic reaction to it or to similar antibiotics such as erythromycin (E.E.S., PCE, and others).

Special warnings about Zithromax

Like certain other antibiotics, Zithromax may cause a potentially life-threatening form of diarrhea called pseudomembranous colitis. Pseudomembranous colitis may clear up spontaneously when Zithromax is stopped; if it doesn’t, hospital treatment may be required. If you develop diarrhea, check with your doctor immediately.
If you have a liver problem, your doctor should monitor you very carefully while you are taking Zithromax.

Possible food and drug interactions when taking Zithromax

Do not take Zithromax with antacids containing aluminum or magnesium, such as Maalox and Mylanta.
If Zithromax is taken with certain other drugs, the effects of either could be increased, decreased, or altered.

It is especially important to check with your doctor before combining Zithromax with the following:

Nelfinavir (Viracept)
Warfarin (Coumadin)
Digoxin (Lanoxin, Lanoxicaps)
Ergot-containing drugs such as Cafergot and D.H.E.
Cyclosporine (Neoral and Sandimmune)
Phenytoin (Dilantin)

Special information on Zithromax if you are pregnant or breastfeeding

If you are pregnant or plan to become pregnant, inform your doctor immediately. You should take Zithromax during pregnancy only if it is clearly needed. It is not known whether Zithromax can make its way into breast milk. If the drug is essential to your health, your doctor may advise you to stop breastfeeding until your treatment of Zithromax is finished.

Recommended dosages for Zithromax

Respiratory Diseases, Tonsillitis, Strep Throat, and Skin Infections

The usual dose of Zithromax is 500 milligrams in a single dose the first day. This is followed by 250 milligrams once daily for the next 4 days. Alternatively, patients with chronic obstructive pulmonary disease may be prescribed 500 milligrams a day for 3 days.

Genital Ulcer Disease

The usual dose is a single gram (1,000 milligrams) one time only.

Sexually Transmitted Diseases

The usual dose is a single 2-gram (2,000 milligrams) dose.

Middle Ear Infection

For children aged 6 months and up, treatment may be given three ways. One option is a single dose of 30 milligrams per 2.2 pounds of body weight. Another option is a dose of 10 milligrams per 2.2 pounds given each day for 3 days. Zithromax can also be given over a period of 5 days, starting with a dose of 10 milligrams per 2.2 pounds on the first day and continuing with daily doses of 5 milligrams per 2.2 pounds for the next 4 days.


For children aged 6 months and up, the usual dose is 10 milligrams of Zithromax suspension per 2.2 pounds of body weight in a single dose the first day, followed by 5 milligrams per 2.2 pounds for the next 4 days.

Strep Throat and Tonsillitis

For children aged 2 years and up, the usual dose is 12 milligrams per 2.2 pounds of body weight once daily for 5 days.

Overdosage with Zithromax

Although no specific information on Zithromax overdose is available, any medication taken in excess can have serious consequences. If you suspect an overdose of Zithromax, seek medical attention immediately.

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