Azithromycin is an effective antibiotic that fights against a variety of bacterial infections. However, like all medications, it comes with important warnings and precautions that users should know to ensure safe and effective treatment.
Who Should Avoid Azithromycin?
Individuals allergic to Azithromycin, erythromycin, or other macrolide antibiotics should not use Azithromycin. Additionally, those allergic to any ingredients in the specific product should avoid it. Your pharmacist can provide a detailed list of ingredients.
Azithromycin should not be used if your liver is not functioning properly. If there are concerns about liver health, your healthcare provider may conduct tests before prescribing Azithromycin.
Precautions Before Using Azithromycin
Only use Azithromycin if a healthcare provider prescribes it and follows the dosage. Learn more about the correct Azithromycin Dosage.
Do not share Azithromycin with others, even if they have the same condition. Keep it out of children’s reach, especially if storing the oral liquid in a refrigerator.
Older adults (over 60) may be at higher risk for specific side effects. Discuss these risks with your healthcare provider. For more age-related considerations, visit Contraindications According to Different Age Groups.
Important Safety Information
Hypersensitivity Reactions
Severe allergic reactions, including angioedema, anaphylaxis, and severe skin conditions like Acute Generalized Exanthematous Pustulosis (AGEP), Stevens-Johnson Syndrome, and toxic epidermal necrolysis, have been reported in patients taking Azithromycin. These reactions can be fatal. Additionally, cases of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) have occurred. If an allergic reaction happens, stop the drug and start appropriate treatment. Be aware that symptoms may recur after discontinuing symptomatic therapy.
Hepatotoxicity
Azithromycin can cause liver damage, including abnormal liver function, hepatitis, cholestatic jaundice, hepatic necrosis, and hepatic failure, which can be fatal. Immediately discontinue Azithromycin if signs of hepatitis appear.
Infantile Hypertrophic Pyloric Stenosis (IHPS)
In newborns treated with Azithromycin, IHPS has been reported. Parents should contact their doctor if their baby shows vomiting or irritability during feeding.
QT Prolongation
Azithromycin can prolong the QT interval, increasing the risk of heart arrhythmias and torsades de pointes. This risk is higher in patients with:
- known QT prolongation or torsades de pointes history;
- congenital long QT syndrome;
- uncompensated heart failure or bradyarrhythmias;
- electrolyte imbalances like hypokalemia or hypomagnesemia;
- those taking drugs that prolong the QT interval.
Elderly patients may be more susceptible to these effects. Learn more about Azithromycin Side Effects.
Cardiovascular Death
Some studies suggest a short-term increased risk of cardiovascular death associated with Azithromycin compared to other antibiotics. This risk is most pronounced in the first five days of treatment and is not limited to those with pre-existing heart conditions. Consider this risk when prescribing Azithromycin. For comparisons with other antibiotics, visit Comparing Azithromycin with Other Antibiotics.
Clostridioides difficile-Associated Diarrhea (CDAD)
Azithromycin can lead to CDAD, ranging from mild diarrhea to life-threatening colitis. This condition can occur even after finishing antibiotic treatment. If CDAD is suspected, discontinue non-C. difficile antibiotics and manage with appropriate fluids, electrolytes, and possibly surgery.
Exacerbation of Myasthenia Gravis
Azithromycin can worsen symptoms of myasthenia gravis and trigger new myasthenic syndromes.
Use in Sexually Transmitted Infections
Azithromycin should not be relied upon to treat gonorrhea or syphilis. It may mask symptoms of these diseases. Patients with sexually transmitted infections should undergo serologic tests for syphilis and cultures for gonorrhea. For more information on the various Uses of Azithromycin, check out our detailed guide.
Development of Drug-Resistant Bacteria
Prescribing Azithromycin without a confirmed bacterial infection increases the risk of developing drug-resistant bacteria. Use Azithromycin only when necessary and based on a strong suspicion or confirmation of bacterial infection. Learn more about Azithromycin and Resistance to Antibiotics.
What to Tell Your Healthcare Provider
Before using Azithromycin, inform your healthcare provider about:
- All health conditions, including heart problems, myasthenia gravis, kidney and liver issues.
- Any prescription or over-the-counter medications, vitamins, herbal products, and supplements you are using. Learn more about Azithromycin Interactions.
- Pregnancy or breastfeeding status, as Azithromycin passes into breast milk.
By being aware of these warnings and precautions, you can ensure safe and effective use of Azithromycin. Always consult with a healthcare provider before starting treatment.
If you have more questions about this drug, check out our FAQ about Azithromycin or read our guide on Buying Azithromycin Online.