Azithromycin

Azithromycin is not suitable for some people. For example, check with your doctor if you have liver, kidney or heart problems

Azithromycin comes as capsules, tablets or a liquid that you take once a day. Follow the instructions that come with your medicine.

Side effects of azithromycin include feeling or being sick and diarrhoea. More serious side effects can happen in rare cases.

You can take azithromycin during pregnancy. However, check with a doctor as other antibiotics may be more suitable.

It can cause problems to take azithromycin with some other medicines, such as antacids, warfarin, colchicine or digoxin.

Most adults and children can take azithromycin.

Azithromycin is not suitable for some people. To make sure it's safe for you, tell your doctor if you have:

• ever had an allergic reaction to azithromycin or any other medicine
• liver or kidney problems
• heart problems, including irregular heartbeats (arrhythmia)
• ever had diarrhoea when you have taken antibiotics before
• myasthenia gravis – azithromycin can make the symptoms of this muscle-weakening condition worse
• diabetes – azithromycin liquid contains sugar

Azithromycin comes as tablets, capsules and liquid. The liquid is available for children and people who find it difficult to swallow tablets or capsules.

Azithromycin tablets come in strengths of 250mg or 500mg. The capsules are 250mg. The liquid comes as 200mg in 5ml.

The usual adult dose is 500mg a day for 3 to 10 days depending on the infection being treated.

For some infections, you'll be given a one-off higher dose of 1g or 2g.

The dose may be lower for children or if you have liver or kidney problems.

Azithromycin is sometimes prescribed long-term to prevent chest infections if you keep getting them. In this case you will usually need to take it 3 times a week, often on a Monday, Wednesday and Friday.

Carry on taking this medicine until the course is completed, even if you feel better. If you stop your treatment early, your infection could come back.

You'll usually take azithromycin once a day. Try to take your medicine at the same time each day.

Swallow tablets and capsules whole with a drink of water. Do not chew them.

If you're taking azithromycin capsules or tablets, take them at least 1 hour before food or 2 hours after eating. If you're taking it as liquid, you can take it with or without food.

The liquid can have a bitter aftertaste, so it can be a good idea to offer children a drink of fruit juice afterwards.

If you, or your child, are taking azithromycin as a liquid, your pharmacist will usually make it up for you. The medicine will come with a syringe or spoon to help you measure the right dose. If you do not have a syringe or medicine spoon, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount.

If you’re taking antacid medicines for indigestion or heartburn, take azithromycin at least 1 hour before the antacid or at least 2 hours after. Antacids can affect how much azithromycin your body takes in.

These common side effects of azithromycin happen in more than 1 in 100 people. There are things you can do to help cope with them:

Stick to simple meals and do not eat rich or spicy food while you're taking this medicine.

Drink lots of fluids such as water or squash to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.

If you take the combined contraceptive pill or progestogen-only pill and you have severe, watery diarrhoea, or any diarrhoea that lasts for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.

Take small frequent sips of water or squash to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee.

Do not take any other medicines to treat vomiting without speaking to a pharmacist or doctor.

If you take the combined contraceptive pill or progestogen-only pill and you're being sick, your contraception may not protect you from pregnancy. Check the pill packet for advice.

Eat when you would usually expect to be hungry. If it helps, eat smaller meals more often than usual. Snack when you're hungry. Have nutritious snacks that are high in calories and protein, such as dried fruit and nuts.

Rest and drink plenty of water. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller if you need one. Talk to your doctor if the headaches do not go away or are severe.

If you feel dizzy when you stand up, try getting up very slowly or stay sitting down until you feel better. If you begin to feel dizzy, lie down so you do not faint, then sit until you feel better.

Do not drive, ride a bike or use tools or machinery if you feel dizzy or tired.

Do not drink alcohol as it may make you feel worse.

Talk to your doctor if this is bothering you.

Keep taking the medicine, but talk to your doctor or pharmacist if the advice on how to cope does not help and a side effect bothers you or does not go away.

Azithromycin is OK to take during pregnancy if you have an infection that needs treatment. However, other antibiotics may be more suitable for you, depending on your type of infection.

Talk to your doctor about taking azithromycin as it should only be used if the benefits outweigh the possible risks.

If your baby is healthy, it may be OK to take azithromycin while breastfeeding. Talk to your doctor or pharmacist first.

Azithromycin passes into breast milk in small amounts and is unlikely to cause any side effects in breastfed babies.

If you have an infection, or are at risk of infections coming back, it's important that this is treated.

It's very rare for breastfed babies to have side effects from medicines you're taking. But it's important to keep monitoring your baby if you're taking any medicine while breastfeeding.

Contact your healthcare professional or call 111 as soon as possible if you notice that your baby:

• is not feeding as well as usual or putting on weight as expected
• has an upset stomach, such as diarrhoea or being sick (vomiting)
• has a rash
• has oral thrush (a fungal infection in their mouth)
• seems unusually sleepy or irritable

If your baby has any symptoms that are not listed, or if you're worried about them, you can also call 111 or contact any healthcare professional.

Some medicines and azithromycin can affect each other.

Tell your doctor before you start azithromycin if you're taking any other medicines, including:

• antacids for indigestion
• ergotamine or dihydroergotamine – for migraine
• medicines used to treat or prevent blood clots, such as warfarin, dabigatran, or edoxaban
• hydroxychloroquine or chloroquine – medicines for rheumatoid arthritis and other inflammatory conditions
• ciclosporin or tacrolimus – medicines to stop your immune system overreacting
• colchicine, a medicine used for gout and some other inflammatory conditions
• digoxin for some heart problems
• rifabutin, an antibiotic
• a statin medicine to lower your cholesterol, such as simvastatin or atorvastatin

Azithromycin can affect your heartbeat, so it's best not to take it with other medicines that have the same side effect.

Tell your doctor if you're taking medicines that can affect your heartbeat, including:

• any medicines for an irregular heartbeat (arrhythmia), such as amiodarone or sotalol
• antidepressants such as citalopram
• antipsychotics used to treat mental health conditions
• some anti-sickness medicines, such as domperidone
• some antibiotics, such as moxifloxacin

These are not all the medicines that may cause problems if you take them with azithromycin. For a full list, see the leaflet inside your medicine packet. Talk to a pharmacist or your doctor if you're worried.