What happens if I overdose Azithromycin 500 Mg?
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local, or emergency room immediately.
Proper storage of Azithromycin 500 Mg drops:
Store unopened bottles of Azithromycin 500 Mg drops in the refrigerator, between 36 and 46 degrees F (2 and 8 degrees C). Once the bottle is opened, it may be stored in the refrigerator or at room temperature below 77 degrees F (25 degrees C). Do not freeze. Store away from heat, moisture, and light. Do not store in the bathroom. Throw away any unused medicine after the bottle has been open for 14 days. Keep Azithromycin 500 Mg drops out of the reach of children and away from pets.
Overdose of Azithromycin 500 Mg in details
There are no data available on overdosage with Azithromycin 500 Mg. Typical symptoms of overdosage with macrolide antibiotic include hearing loss, severe nausea, vomiting and diarrhea. In case of overdosage, gastric lavage and general supportive measures are indicated.
What should I avoid while taking Azithromycin 500 Mg?
Do not take antacids that contain aluminum or magnesium within 2 hours before or after you take Azithromycin 500 Mg. This includes Acid Gone, Aldroxicon, Alternagel, Di-Gel, Gaviscon, Gelusil, Genaton, Maalox, Maldroxal, Milk of Magnesia, Mintox, Mylagen, Mylanta, Pepcid Complete, Rolaids, Rulox, and others. These antacids can make Azithromycin 500 Mg less effective when taken at the same time.
Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking Azithromycin 500 Mg and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.
Avoid exposure to sunlight or tanning beds. Azithromycin 500 Mg can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.
Azithromycin 500 Mg warnings
5.1 Hypersensitivity
Serious allergic reactions, including angioedema, anaphylaxis, and dermatologic reactions including Stevens-Johnson Syndrome and toxic epidermal necrolysis, have been reported rarely in patients on Azithromycin 500 Mg therapy.
Fatalities have been reported. Cases of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) have also been reported. Despite initially successful symptomatic treatment of the allergic symptoms, when symptomatic therapy was discontinued, the allergic symptoms recurred soon thereafter in some patients without further Azithromycin 500 Mg exposure. These patients required prolonged periods of observation and symptomatic treatment. The relationship of these episodes to the long tissue half-life of Azithromycin 500 Mg and subsequent prolonged exposure to antigen is presently unknown.
If an allergic reaction occurs, the drug should be discontinued and appropriate therapy should be instituted. Physicians should be aware that allergic symptoms may reappear when symptomatic therapy is discontinued.
Hepatotoxicity
Abnormal liver function, hepatitis, cholestatic jaundice, hepatic necrosis, and hepatic failure have been reported, some of which have resulted in death. Discontinue Azithromycin 500 Mg immediately if signs and symptoms of hepatitis occur.
QT Prolongation
Prolonged cardiac repolarization and QT interval, imparting a risk of developing cardiac arrhythmia and torsades de pointes, have been seen with treatment with macrolides, including Azithromycin 500 Mg. Cases of torsades de pointes have been spontaneously reported during postmarketing surveillance in patients receiving Azithromycin 500 Mg. Providers should consider the risk of QT prolongation which can be fatal when weighing the risks and benefits of Azithromycin 500 Mg for at-risk groups including:
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- patients with known prolongation of the QT interval, a history of torsades de pointes, congenital long QT syndrome, bradyarrhythmias or uncompensated heart failure
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- patients on drugs known to prolong the QT interval
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- patients with ongoing proarrhythmic conditions such as uncorrected hypokalemia or hypomagnesemia, clinically significant bradycardia, and in patients receiving Class IA (quinidine, procainamide) or Class III (dofetilide, amiodarone, sotalol) antiarrhythmic agents.
Elderly patients may be more susceptible to drug-associated effects on the QT interval.
Clostridium difficile-Associated Diarrhea (CDAD)
CDAD has been reported with use of nearly all antibacterial agents, including Azithromycin 500 Mg, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon, leading to overgrowth of C. difficile.
C. difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin-producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antibacterial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents.
If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated.
Exacerbation of Myasthenia Gravis
Exacerbations of symptoms of myasthenia gravis and new onset of myasthenic syndrome have been reported in patients receiving Azithromycin 500 Mg therapy.
Development of Drug-Resistant Bacteria
Prescribing Azithromycin 500 Mg in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.
What should I discuss with my healthcare provider before taking Azithromycin 500 Mg?
Some medical conditions may interact with Azithromycin 500 Mg tablets. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have liver or kidney problems, a slow or irregular heartbeat, or myasthenia gravis
- if you have a history of low blood potassium or magnesium levels
- if you are taking any medicine that may increase the risk of a certain type of irregular heartbeat (prolonged QT interval). Check with your doctor or pharmacist if you are unsure if any of your medicines may increase the risk of this type of irregular heartbeat
Some MEDICINES MAY INTERACT with Azithromycin 500 Mg tablets. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Many other prescription and nonprescription medicines (eg, used for allergies, blood thinning, cancer, depression or other mental or mood problems, heartburn, infections, involuntary movements, irregular heartbeat or other heart problems, narcotic addiction, nausea and vomiting, pain, Tourette disorder), multivitamin products, and herbal or dietary supplements (eg, herbal teas, coenzyme Q10, garlic, ginseng, St. John's wort) may interact with Azithromycin 500 Mg tablets. Ask your doctor or pharmacist if you are unsure if any of your medicines might interact with Azithromycin 500 Mg tablets
This may not be a complete list of all interactions that may occur. Ask your health care provider if Azithromycin 500 Mg tablets may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
Azithromycin 500 Mg precautions
As with erythromycin and other macrolides, rare, serious allergic reactions including angioneurotic oedema and anaphylaxis (rare, fatal) have been reported. Some of these reactions with Azithromycin 500 Mg have resulted in recurrent symptoms and required a longer period of observation and treatment.
Prolonged cardiac repolarisation and QT interval, imparting a risk of developing cardiac arrhythmia and Torsade de pointes, have been seen in treatment with other macrolides. A similar effect with Azithromycin 500 Mg cannot be completely ruled out in patients at increased risk for prolonged cardiac repolarisation.
As with any antibiotic preparation, observation for signs of superinfection with nonsusecptible organisms, including fungi is recommended.
Renal Impairment: In patients with severe renal impairment (GFR <10 mL/min), a 33% increase in systemic exposure to Azithromycin 500 Mg was observed.
Hepatic Impairment: As the liver is the principal route of excretion of Azithromycin 500 Mg, it should not be used in patients with hepatic disease.
Use in pregnancy: Animal reproduction studies have demonstrated that Azithromycin 500 Mg crosses the placenta but have revealed no evidence of harm to the foetus. There are no adequate and well-controlled studies in pregnant women. Since animal studies are not always predictive of human response, Azithromycin 500 Mg should be used during pregnancy only if adequate alternatives are not available.
Use in lactation: No data on secretion of Azithromycin 500 Mg in breast milk are available; Azithromycin 500 Mg should only be used in lactating women where adequate alternatives are not available.
What happens if I miss a dose of Azithromycin 500 Mg?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
References
- DailyMed. "AZITHROMYCIN: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- DrugBank. "azithromycin". http://www.drugbank.ca/drugs/DB00207 (accessed September 17, 2018).
- MeSH. "Anti-Bacterial Agents". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology