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Zithromax is a broad-spectrum antibacterial drug from the group of macrolides-azalides, acts bacteriostatically. By binding to the 50S subunit of ribosomes, it inhibits the peptide translocase at the translation stage, inhibits protein synthesis, slows the growth and reproduction of bacteria. It also has a bactericidal effect in high concentrations. It acts on extra- and intracellularly located pathogens.

Microorganisms may be initially resistant to the action of the antibiotic or may become resistant to it.


Zithromax is prescribed in infectious and inflammatory diseases caused by microorganisms sensitive to the drug:

  • infections of the upper respiratory tract and ENT organs: pharyngitis, tonsillitis, sinusitis, otitis media;
  • lower respiratory tract infections: acute bronchitis, exacerbation of chronic bronchitis, pneumonia, including caused by atypical pathogens;
  • infections of the skin and soft tissues: acne of moderate severity, erysipelas, impetigo, secondarily infected dermatoses;
  • the initial stage of Lyme disease (borreliosis) – erythema migrans (erythema migrans);
  • urinary tract infections caused by Chlamydia trachomatis (urethritis, cervicitis).

Dosage regimen

Zithromax is taken orally 1 time/day at 500 mg, regardless of food intake.

Adults (including older people) and children over 12 years old with body weight over 45 kg:

  • infections of the upper and lower respiratory tract, ENT organs, skin and soft tissues: 500 mg 1 time / day for 3 days (course dose – 1.5 g).
  • acne vulgaris of moderate severity: 2 caps. 250 mg 1 time / day for 3 days, then 250 mg 2 times a week for 9 days. The course dose – 6.0 g.
  • migratory erythema: on the first day at the same time 2 caps. 500 mg, then from the 2nd to the 5th day, 500 mg daily. Course dose 3.0 g.
  • urinary tract infections caused by Chlamydia trachomatis (urethritis, cervicitis): 2 caps. 500 mg each.

Side effects

  • Digestive system: nausea, vomiting, diarrhea, abdominal pain, loose stools, flatulence, digestive upset, anorexia, constipation, discoloration of the tongue, pseudomembranous colitis, cholestatic jaundice, hepatitis, changes in laboratory parameters of liver function, liver failure, liver necrosis (possibly fatal).
  • Allergic reactions: itching, skin rashes, angioedema, urticaria, photosensitivity, anaphylactic reaction (in rare cases, fatal), erythema multiforme, Stevens-Johnson syndrome, toxic epidermal nscrolysis.
  • Cardiovascular system: palpitations, arrhythmia, ventricular tachycardia, increased QT interval, bidirectional ventricular tachycardia.
  • Nervous system: dizziness / vertigo, headache, cramps, drowsiness, paresthesia, asthenia, insomnia, hyperactivity, aggressiveness, anxiety, nervousness.
  • Sensory organs: tinnitus, reversible hearing loss up to deafness (when taking high doses for a long time), impaired perception of taste and smell.
  • Circulatory and lymphatic systems: thrombocytopenia, neutropenia, eosinophilia.From the musculoskeletal system: arthralgia.
  • Genitourinary system: interstitial nephritis, acute renal failure.
  • Other: vaginitis, candidiasis.


  • Severe hepatic and / or renal failure;
  • Cchildren under 12 years old with a body weight of less than 45 kg (for this dosage form);
  • Breast-feeding;
  • Concomitant use with ergotamine and dihydroergotamine;
  • Hypersensitivity to antibiotics of the macrolide group.

Take the antibiotic carefully in the following cases:

  • moderate hepatic and renal impairment;
  • arrhythmias or a predisposition to arrhythmias and lengthening of the QT interval;
  • the combined use of terfenadine, warfarin, digoxin.

Pregnancy and lactation

Zithormax is recommended to be used during pregnancy only in cases when the expected benefits for the mother outweighs the potential risk to the fetus. During treatment with Zithromax, breastfeeding is discontinued.

Drug interaction

  • The simultaneous use of macrolide antibiotics, including azithromycin, with P-glycoprotein substrates such as digoxin, leads to an increase in serum P-glycoprotein substrate concentration.
  • The simultaneous use of digoxin or digitoxin with Zithromax, a significant increase in the concentration of cardiac glycosides in blood plasma and a risk of developing glycoside intoxication are possible.
  • The simultaneous use of Zithromax has little effect on the pharmacokinetics, including the excretion of zidovudine or its glucuronide metabolite by the kidneys.
  • The simultaneous use of erythromycin with warfarin, shows increased effects of the latter.
  • Erythromycin weakly interacts with isoenzymes of the cytochrome P450 system.
  • The simultaneous use of erythromycin with ergot alkaloids derivatives is not recommended.
  • The simultaneous use of atorvastatin (10 mg daily) and Zithormax (500 mg daily) did not cause a change in plasma concentrations of atorvastatin.