Azithromycin

CLINICAL USE

Antibacterial agent

DOSE IN NORMAL RENAL FUNCTION

  • Genital chlamydial infections: 1 g as single dose
  • All other indications: 500 mg daily for 3 days
  • Typhoid (unlicensed): 500 mg daily for 7 days

    PHARMACOKINETICS

  • Molecular weight                           :785
  • %Protein binding                           :12–52
  • %Excreted unchanged in urine     : 6–12
  • Volume of distribution (L/kg)       :31.1
  • half-life – normal/ESRD (hrs)      :48–96/–

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Dose as in normal renal function
  • 10 to 20     : Dose as in normal renal function
  • <10           : Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Not dialysed. Dose as in normal renal function
  • HD                     :Unknown dialysability. Dose as in normal renal function
  • HDF/high flux   :Unknown dialysability. Dose as in normal renal function
  • CAV/VVHD      :Unknown dialysability. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs

  • Antibacterials: possibly increased rifabutin concentration (increased risk of uveitis) – reduce dose of rifabutin)
  • Anticoagulants: effect of coumarins may be enhanced
  • Antidepressants: the manufacturer of reboxetine advises to avoid concomitant use
  • Antihistamines: may inhibit the metabolism of mizolastine (risk of hazardous arrhythmias) – avoid concomitant use
  • Antimalarials: avoid concomitant use with artemether/lumefantrine
  • Antipsychotics: possibly increased quetiapine concentration – reduce quetiapine dose; possibly increased risk of ventricular arrhythmias with sertindole – avoid concomitant use
  • Antivirals: concentration possibly increased by ritonavir
  • Ciclosporin: may inhibit the metabolism of ciclosporin (increased plasma ciclosporin levels)
  • Ergot alkaloids: increased risk of ergotism – avoid concomitant use
  • Theophylline: possibly increased theophylline concentration

    ADMINISTRATION

    Reconstition

    Powder for oral suspension to be reconstituted with water (200 mg/5 mL strength)

    Route

    Oral

    Rate of Administration

    Comments

    Administer as a once daily dose 1 hour before food or 2 hours after food.

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