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Azithromycin Extended-Release Suspension

Azithromycin extended-release suspension is an antibiotic medication that treats bacterial infections. You can take this medication by mouth on an empty stomach. The brand name of this medication is Zmax®.

What is this medication?

AZITHROMYCIN (az ith roe MYE sin) treats infections caused by bacteria. It belongs to a group of medications called antibiotics. It will not treat colds, the flu, or infections caused by viruses.

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This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Zmax, Zmax Pediatric

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

  • History of blood diseases, like leukemia
  • History of irregular heartbeat
  • Kidney disease
  • Liver disease
  • Myasthenia gravis
  • An unusual or allergic reaction to azithromycin, erythromycin, other macrolide antibiotics, foods, dyes, or preservatives
  • Pregnant or trying to get pregnant
  • Breast-feeding

How should I use this medication?

Take this medication by mouth. Follow the directions on the prescription label. Take this medication on an empty stomach, 1 hour before or 2 hours after meals. Drink your full dose at once. Do not split the dose. If you vomit within 1 hour of taking the dose, let your care team know immediately, you may need more medication.

Talk to your care team regarding the use of this medication in children. While this medication may be prescribed for infants as young as 6 months for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

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What if I miss a dose?

This does not apply because you will take all of the medicine as 1 dose.

What may interact with this medication?

Do not take this medication with any of the following:

  • Cisapride
  • Dronedarone
  • Pimozide
  • Thioridazine

This medication may also interact with the following:

  • Antacids that contain aluminum or magnesium
  • Birth control pills
  • Colchicine
  • Cyclosporine
  • Digoxin
  • Ergot alkaloids like dihydroergotamine, ergotamine
  • Nelfinavir
  • Other medications that prolong the QT interval (an abnormal heart rhythm)
  • Phenytoin
  • Warfarin

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Tell your care team if your symptoms do not start to get better or if they get worse.

This medication may cause serious skin reactions. They can happen weeks to months after starting the medication. Contact your care team right away if you notice fevers or flu-like symptoms with a rash. The rash may be red or purple and then turn into blisters or peeling of the skin. Or, you might notice a red rash with swelling of the face, lips or lymph nodes in your neck or under your arms.

Do not treat diarrhea with over the counter products. Contact your care team if you have diarrhea that lasts more than 2 days or if it is severe and watery.

Contact your care team if vomiting and fussiness with feeding occurs in a treated infant.

This medication can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and use sunscreen. Do not use sun lamps or tanning beds/booths.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

  • Allergic reactions or angioedema—skin rash, itching, hives, swelling of the face, eyes, lips, tongue, arms, or legs, trouble swallowing or breathing
  • Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
  • Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
  • Rash, fever, and swollen lymph nodes
  • Redness, blistering, peeling, or loosening of the skin, including inside the mouth
  • Severe diarrhea, fever
  • Unusual vaginal discharge, itching, or odor

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

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  • Diarrhea
  • Nausea
  • Stomach pain
  • Vomiting

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of reach of children and pets.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Keep the bottle closed tightly until ready to use. Use within 12 hours.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

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Note: Introduction and Additional Common Questions written and medically approved by Cleveland Clinic professionals.

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