What side effects can azithromycin have?
Below you will find the most important information about possible known side effects of azithromycin.
These side effects do not occur, but you can. Because every person reacts differently to medication. Please also note that the type and frequency of side effects may vary depending on the drug formulation (eg tablet, syringe, ointment).
Common side effects:
Diarrhea, loose stools, constipation, indigestion, abdominal pain, abdominal cramps, loss of appetite, nausea and vomiting.
Uncommon side effects:
bloating, changes in the blood count (reduction of white blood cells, reduction of platelets), odor disorders, taste disorders, drowsiness, fatigue, headache, nervousness, sensory disturbances (tingling, burning, paresthesia), drowsiness, vaginal inflammation, fungal infections, hypersensitivity reactions (with skin redness, hives, photosensitivity, swelling).
Rare side effects:
severe diarrhea with dehydration, tongue staining, pancreatitis, liver proliferation (transaminases), bilirubin increase, liver dysfunction (hepatitis, jaundice, liver cirrhosis, liver failure), nephritis, kidney failure, hearing impairment (hearing loss, deafness , Ear noises), drop in blood pressure, palpitations, cardiac arrhythmias, fainting, dizziness, convulsions, overactivity, aggression, restlessness, excitability, malaise, weakness, anxiety, severe allergic reactions (such as life-threatening skin reactions, Stevens-Johnson syndrome, dehydration of skin tissue (necrosis) , Angioedema, joint pain.
Very rare or isolated side effects:
allergic shock (anaphylactic shock).
During a long-term treatment with azithromycin may be a resistance of the pathogens against the active ingredient. Other macrolide antibiotics can then lose their effectiveness. In addition, an infestation of the large intestine by insensitive bacteria or fungi and subsequently to enteritis with diarrhea may occur (pseudomembranous colitis). The treatment should be discontinued immediately.
What interactions does azithromycin show?
Please note that the interactions may vary depending on the drug formulation of a drug (eg tablet, syringe, ointment).
Mineral acid-binding agents (such as Algeldrat, carbaldrate, magaldrate, magnesium trisilicate, magnesium hydroxide, sodium bicarbonate) should not be given together with azithromycin. They lower the blood concentration of the drug and make it less effective. Such acid-binding agents should therefore only be taken at intervals of two to three hours.
Co-administration of azithromycin with ergot alkaloids such as ergotamine or dihydroergotamine (for migraine and Parkinson’s disease) with azithromycin may have a vasoconstrictive effect with circulatory disorders, especially on the fingers and toes. For safety’s sake, it should therefore be dispensed with a simultaneous administration.
Azithromycin and the antibiotic rifabutin are sometimes used concurrently in people with tuberculosis or pneumonia due to AIDS. There is a risk of a blood picture change (lack of so-called “neutrophil” cells).
Azithromycin increases the blood levels of the zidovudine and didanosine virus agents used to fight HIV infection. This may enhance the effect of such agents.
Together with azithromycin, the administration of the cardiac glycoside digoxin leads to a delayed degradation of the same in the intestine. Thus, blood levels of digoxin may increase and side effects may increase, requiring a dose reduction by the physician. The same applies to the simultaneous administration of azithromycin and the asthma drug theophylline (as well as its chemical relatives). For coumarin-type blood thinners (such as warfarin and phenprocoumon), for the same reason, blood clotting should be checked more frequently.
Azithromycin enhances the action of cyclosporin, which is used to prevent organ rejection after transplantation. If co-administration of these drugs is necessary, the physician should carefully monitor the patient and adjust the dose of ciclosporin accordingly.
Bacteria against which erythromycin and lincomycin and clindamycin are inactive are usually also resistant to azithromycin. Therefore, no concomitant administration of several compounds from this group of substances should take place.