Generic Zithromax

• Payment Options: VISA, Mastercard
• Availability: In stock
• Prescription required: No
• Active ingredient: Azithromycin
• Medical form: Pills
• Delivery time: Airmail (10 - 21 days), EMS Trackable (5-9 days)

Introduction

Package leaflet: information for the user

Citromax 500 mg film-coated tablets

Azithromycin

Read all instructions carefully before you start taking the medicine.

• Please keep this leaflet as you may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you personally and you should not give it to other people, even if you have the same symptoms, as it may harm them.
• If you think any of the side effects you are suffering from are serious, or if you notice any side effect not mentioned in this leaflet, please tell your doctor or pharmacist.

Contents of the package leaflet:

1. What is Zitromax 500 mg tablets and what is it used for?

2. Before taking Zitromax 500 mg film-coated tablets.

3. How to take Zitromax 500 mg tablets.

4. Possible side effects

5. How to store Zitromax 500 mg tablets?

6. Additional information.

1. What is Zitromax 500 mg tablets and what is it used for?

Azithromycin belongs to a group of antibiotics called macrolide antibiotics. Eliminates bacteria that cause infection.

Antibiotics are used to treat bacterial infections and do not work in viral infections such as the flu or the common cold.

It is important that you follow the directions for dose, interval and duration of treatment given by your doctor.

Do not store or reuse this medication. If you have any antibiotic left after treatment, return it to the pharmacy for proper disposal. Medicines should not be disposed of in the sewer or trash.

It is used to treat infections caused by bacteria in different parts of the body in adults and children weighing over 45 kg.

It is used to treat the following infections:

• Infections of the throat, tonsils, ears, or sinuses.
• Bronchitis and pneumonia (mild to moderate).
• Skin and soft tissue infections (mild to moderate).
• Urethral (urethritis) or cervical (cervicitis) infections, see Section 3.

Sexually transmitted infections (chancroid), see Section 3

2. Before taking Zitromax 500 mg tablets

Do not take Zitromax tablets.

• if you are allergic to azithromycin, erythromycin, another macrolide or ketolid antibiotic, or any of the other ingredients of this medicine (listed in section 6).

Warnings and Cautions

Talk to your doctor or pharmacist before taking this medication.

• During treatment with Citromax, serious allergic reactions may occur (itching, redness, skin rash, swelling or difficulty breathing, or an allergic reaction to a drug characterized by an increased white blood cell count and general symptoms). Tell your doctor, who may decide to stop treatment and prescribe appropriate treatment.
• If you suffer from liver problems or your skin and / or the whites of your eyes turn yellowish during treatment, discuss this with your doctor to confirm if you should stop treatment or if you need liver function tests.
• If you are being treated with ergot derivatives (which are used to treat migraines), tell your doctor, as concomitant azithromycin treatment can cause an adverse reaction called ergotism.
• During treatment with this drug, there is a possibility of superinfection with resistant microbes, including fungi. In this case, inform your doctor about it.
• During or after treatment with Cytromax, symptoms may appear that indicate colitis (diarrhea) associated with taking antibiotics. In this case, the treatment should be discontinued and your doctor will prescribe the treatment that he considers most appropriate for you.
• If you have a serious kidney problem, tell your doctor.
• If you have heart rhythm disturbances (arrhythmias) or factors that predispose you to them (some heart disease, changes in blood electrolyte levels, or certain medications), tell your doctor about it, as this medication may help to aggravate or cause these changes.
• If you have a condition called myasthenia gravis, or if muscle weakness and fatigue appear during treatment, tell your doctor, as Cytromax can cause or worsen the symptoms of this condition.

Children and adolescents

Children and adolescents weighing less than 45 kg.

The tablets are not indicated for this group of patients. Other dosage forms of azithromycin may be used. It should not be administered to children under 6 months of age.

Children and adolescents weighing more than 45 kg.

This medicine is not suitable for children who cannot swallow the tablets whole. Other dosage forms of azithromycin may be used.

Using Zitromax tablets with other medicines

Tell your doctor or pharmacist if you are taking, have recently taken or are about to take any other medicines.

You should especially notify your doctor or pharmacist if you are taking any of the following medicines:

• Antacids (medicines used for digestive problems). It is recommended that you avoid taking both drugs at the same time of the day.
• Ergot derivatives (such as ergotamine, which is used to treat migraines), since coadministration with azithromycin can cause ergotism (a potentially serious side effect with numbness or tingling in the extremities, muscle cramps, headaches, cramps, or abdominal or chest pain).
• Digoxin (a medicine used to treat cardiac arrhythmias), because azithromycin can raise the level of digoxin in the blood and should be monitored.
• Colchicine (used for gout and familial Mediterranean fever).
• Cyclosporine (a medicine used in transplantation), because azithromycin can raise blood levels of cyclosporine and should be monitored.
• Dicumarin anticoagulants (drugs used to prevent blood clots), because azithromycin can increase the effect of these anticoagulants. Your doctor will need to monitor your clotting parameters (prothrombin time).
• Nelfinavir, zidovudine (medicines to treat infections with human immunodeficiency virus), as blood levels of azithromycin may be elevated.
• Fluconazole (medicines used to treat fungal infections), as the level of azithromycin in the blood may increase.
• Terfenadine (a medicine used to treat allergies) because the combination can cause heart problems.
• Rifabutin (a medicine used to treat pulmonary tuberculosis and non-lung infections caused by mycobacteria) because it can cause a decrease in the number of white blood cells in the blood.
• Medicines with active substances that prolong the QT interval, such as class IA (quinidine and procainamide) and class III antiarrhythmics (dofetilide, amiodarone, and sotalol), cisapride, terfenadine, antipsychotics (eg pimozide), antidepressants (eg, citalopram), and anti-infectious agents (fluoroquinolones such as moxifloxacin or levofloxacin and chloroquine), as they can cause serious heart rhythm disturbances and even lead to cardiac arrest.

No interactions were observed between azithromycin and cetirizine (for the treatment of allergic reactions); didanosine, efavirenz, indinavir (for the treatment of HIV infection); atorvastatin (to treat high cholesterol and heart problems); carbamazepine (to treat epilepsy), cimetidine (to treat excess stomach acid); methylprednisolone (to suppress the immune system); theophylline (for breathing problems); midazolam, triazolam (to relieve sedation); sildenafil (to treat impotence) and trimethoprim / sulfamethoxazole (to treat infections).

Zitromax tablets 500 mg with food and drink.

The tablets should be swallowed whole with water and taken with or without food.

Pregnancy, breastfeeding and fertility

If you are pregnant or breastfeeding, suspect that you are pregnant, planning to become pregnant or breastfeeding, tell your doctor or pharmacist before using this medicine.

There is insufficient information on the safety of azithromycin in pregnancy. Therefore, the use of azithromycin is not recommended if you are pregnant or wish to become pregnant, unless strictly necessary according to medical judgment.

Azithromycin is excreted in breast milk. Due to possible adverse reactions in an infant, the use of azithromycin is not recommended during lactation, although breastfeeding can be continued two days after stopping treatment with Citromax.

Driving and using cars

The effect of this medication on the ability to drive a car or machinery is nil or negligible.

Zitromax tablets contain lactose.

If your doctor has told you that you have an intolerance to some sugars, contact your doctor before taking this medicine.

3. How to take Zitromax 500 mg tablets.

Exactly follow the directions for use of the medicine contained in this leaflet or as directed by your doctor. If in doubt, consult your doctor or pharmacist.

Your doctor will determine the most appropriate dose and duration of treatment for you based on your condition and response to treatment. Typically, the recommended dose and frequency of medication are as follows:

Adults (including the elderly) and children weighing more than 45 kg:

The usual dose is 1500 mg, divided over 3-5 days as follows:

• When taken over 3 days, 500 mg per day.

• When taken over 5 days, 500 mg on the first day and 250 mg from the 2nd to the 5th day.

Elderly patients can be administered the same dose as adults. However, in the case of patients with irregular heart rhythms, your doctor will monitor you closely.

Infection of the urethra or cervix (cervicitis):

The usual dose is 1000 mg per day.

If the infection is due to N. gonorrohea, your doctor will prescribe the same dose in combination with another antibiotic (ceftriaxone (250 mg)).

Chancroid:

The usual dose is 1000 mg per day.

Sinusitis:

Treatment is indicated for adults and adolescents over 16 years of age.

Children and adolescents weighing less than 45 kg:

The tablets are not recommended for these patients. Other dosage forms of Citromax may be used.

Use in patients with impaired liver function

Tell your doctor if you have severe liver problems as your usual dose may need to be adjusted.

Use in patients with renal impairment

Tell your doctor if you have severe kidney problems as you may need to adjust your usual dose.

Management form

Orally.

This medication should be taken as a single daily dose. The tablets should be swallowed whole with water and taken with or without food.

If you take more Zitromax tablets than you should

In case of overdose, you may experience reversible hearing loss, severe nausea, vomiting, and diarrhea.

Prescribing Information

In case of an overdose, the administration of activated charcoal is indicated, and general symptomatic measures and general support of vital functions should be applied.

In case of overdose or accidental ingestion, consult your doctor or pharmacist immediately or call the Poison Information Service on 91 562 04 20 for the medication and the amount administered.

If you forget to take Zitromax tablets

If you forget a dose, use the medicine as soon as possible, continuing your treatment as directed. However, if the next dose is close, it is better to skip the missed one and wait for the next one. Do not take a double dose to make up for a missed dose. Continue to use Zitromax exactly as your doctor has told you to.

If you stop taking Zitromax tablets

If you stop taking Dalacin earlier than your doctor recommended, your symptoms may worsen or return.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Side effects reported during clinical trials and post-marketing studies were classified by frequency:

Very common side effects (in at least 1 in 10 people):

• Diarrhea.

Common side effects (in at least 1 in 100 people):

• Headache.
• Vomiting, abdominal pain, nausea.
• Changes in the number of certain types of leukocytes (lymphocytes, eosinophils, basophils, monocytes and neutrophils), a decrease in the level of bicarbonate).

Uncommon side effects (in at least 1 in 1000 people):

• Candidal fungal infection in the mouth or generalized, vaginal infection, pneumonia, fungal or bacterial infection, pharyngitis, gastroenteritis, respiratory disorders, rhinitis.
• Decrease in the number of certain types of white blood cells (white blood cells, neutrophils and eosinophils).
• An allergic reaction, including an inflammatory process deep in the skin (angioedema).
• Changes in eating behavior (anorexia).
• Nervousness, insomnia
• Drowsiness, dizziness, taste disturbance, loss of tactile sensations.
• Visual impairment.
• Hearing impairment, dizziness.
• Palpitations
• Tides.
• Breathing problems, nosebleeds.
• Constipation, flatulence, indigestion, gastritis, difficulty swallowing, bloating, dry mouth, belching, mouth ulcers, increased salivation.
• Rash, itching, raised red bumps, dermatitis, dry skin, increased sweating, redness.
• Joint swelling, muscle pain, back pain, neck pain.
• Difficulty urinating, kidney pain.
• Vaginal bleeding, change in the testes.
• General edema, weakness, malaise, fatigue, facial edema, chest pain, fever, pain and swelling of the limbs.
• Changes in liver function indicators (an increase in the number of liver enzymes, gpt and alkaline phosphatase) and an increase in the level of bilirubin, urea, creatinine, chloride, glucose, bicarbonate and platelets in the blood, changes in sodium and potassium levels, a decrease in hematocrit.
• Complications after surgery

Rare side effects (affects at least 1 in 10,000 people):

• Agitation.
• Liver dysfunction, yellowing of the skin.
• Sensitivity to sunlight (photosensitivity), drug reaction with increased white blood cell count (eosinophilia) and generalized symptoms (multiple organ damage) (DRESS syndrome).
• A skin rash characterized by the rapid appearance of patches of red skin dotted with small pustules (small blisters filled with white / yellow fluid).

Side effects of unknown frequency (frequency cannot be estimated from the available data):

• Diarrhea caused by Clostridium difficile.
• Decrease in the number of platelets in the blood, anemia.
• Severe allergic reaction
• Reactions of aggression, anxiety, delirium, hallucinations.

• Loss of consciousness, seizures, decreased sensitivity, hyperactivity, change and / or loss of smell, loss of taste, weakness and muscle fatigue (myasthenia gravis).
• Hearing impairment including deafness and whistling.
• Heart rhythm disorders Torsade de pointes, lengthening of the QTc interval on the electrocardiogram
• Decrease in blood pressure.
• Inflammation of the pancreas, discoloration of the tongue.
• Severe liver damage and liver failure, which can rarely be fatal, death of liver tissue, fulminant hepatitis.
• The appearance of bulging reddish scars, a generalized rash with blisters and peeling of the skin, especially around the mouth, nose, eyes and genitals (Stevens-Johnson syndrome), severe skin reactions such as erythema multiforme, toxic epidermal necrolysis.
• Joint pain
• Acute renal failure and inflammation of the tissue between the renal tubules (interstitial nephritis).

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