azithromycin dihydrate at a glance
Medicine class
Azalide macrolide antibiotic
Available forms
Tablets, capsules, oral suspension, intravenous infusion and eye drops
What is azithromycin dihydrate used for?
Selected products are licensed for susceptible bacterial infections. The appropriate formulation depends on the infection, age, weight, swallowing ability and need for hospital treatment.
Oral products: selected ear, sinus, throat, chest, skin and soft-tissue infections.
Selected oral tablets: early localised Lyme disease, periodontal infections, certain sexually transmitted and genital infections, chlamydial chronic prostatitis, chancroid, and treatment or prevention of Mycobacterium avium complex infection in specified people living with HIV.
Oral suspension: selected infections in children within licensed age and weight ranges, and certain uses in people unable to swallow solid formulations.
Intravenous formulation: community-acquired pneumonia and pelvic inflammatory disease when initial intravenous treatment is required.
Eye drops: purulent bacterial conjunctivitis and trachomatous conjunctivitis caused by susceptible organisms.
How does azithromycin dihydrate work?
Azithromycin binds to the bacterial 50S ribosomal subunit and inhibits protein production, limiting the growth of susceptible organisms. Resistance may be acquired or shared with other macrolides.
azithromycin dihydrate preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 500 mg
Oral suspension
Route: Oral
Strengths: 200 mg/5 mL
Tablet
Route: Oral
Strengths: 250 mg, 500 mg
How to take azithromycin dihydrate
Follow the dispensing label and product leaflet because administration differs between formulations.
Swallow tablets and capsules whole with water.
Selected tablets may be taken with or without food. Capsules require an empty stomach.
Shake reconstituted suspension before measuring it with the supplied oral syringe or measure; do not use a kitchen teaspoon.
For eye drops, wash your hands, avoid touching the eye with the container tip and discard the single-dose container after use. Do not wear contact lenses during bacterial conjunctivitis. Administer other eye drops separately and use azithromycin eye drops last.
The infusion is prepared and administered by healthcare professionals. It must be diluted and given intravenously, not as a bolus or intramuscular injection.
azithromycin dihydrate side effects
Common or expected effects
- Diarrhoea, nausea, vomiting or abdominal discomfort
- Headache, dizziness, tiredness or altered taste
- Reduced appetite
- With eye drops: brief burning, stinging, itching, blurred vision, stickiness or a feeling of something in the eye
Get urgent medical advice
- Serious allergic reaction, including facial or throat swelling and breathing difficulty
- Severe blistering, peeling or widespread skin reaction
- Fast or irregular heartbeat, fainting or another possible rhythm disturbance
- Jaundice, dark urine or other signs of liver injury
- Severe, persistent or bloody diarrhoea, including after treatment
- Hearing loss, tinnitus, severe vertigo or worsening myasthenia gravis
azithromycin dihydrate in pregnancy
Azithromycin can be used during pregnancy when a clinician considers it necessary, although another antibiotic may sometimes be more suitable. Available information does not show harm to the baby, but evidence about miscarriage after early exposure is inconclusive. Systemic exposure from selected eye drops is negligible.
azithromycin dihydrate while breastfeeding
Systemic azithromycin may be used cautiously while breastfeeding a healthy, full-term infant after discussion with a prescriber. Small amounts enter milk; monitor for diarrhoea, vomiting, poor feeding, thrush, rash, unusual irritability or sleepiness. Exposure from selected eye drops is expected to be negligible.
azithromycin dihydrate interactions
Tell the prescriber or pharmacist about all medicines and supplements. Important examples include:
Ergotamine or dihydroergotamine
Do not combine with systemic azithromycin because of potential ergot toxicity.
Medicines that prolong the QT interval
These may add to the risk of a serious rhythm disturbance.
Common questions about azithromycin dihydrate
Answers are fully visible for fast scanning and source review.
Is azithromycin dihydrate a penicillin antibiotic?
No. It is a macrolide antibiotic. A penicillin allergy does not automatically mean allergy to azithromycin, but previous macrolide allergy is important.
Does azithromycin dihydrate treat colds or flu?
No. Colds and flu are viral, while azithromycin acts against susceptible bacteria. Unnecessary use encourages resistance.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.