Azithromycin

What is Azithromycin?

Azithromycin is an antibiotic used in the treatment of various infections, including chlamydia. Azithromycin is a type of antibiotic known as a macrolide. It works by inhibiting the growth and reproduction of bacteria and causing them to die off.

How effective is Azithromycin for chlamydia?

Azithromycin cures chlamydia in 97% of cases. If your symptoms are still present after you have completed your treatment, you should see your doctor and you may need to be re-tested. As with all antibiotics, bacteria can become resistant, which may mean the treatment might not work as well. You may need a different antibiotic if the first treatment has not cleared the infection.

How do I know if I have chlamydia?

Chlamydia is readily passed on through sexual contact with an infected partner and can affect the vagina, rectum and/or throat (pharynx). It can be asymptomatic in up to 90% of women and 50% of men. Symptoms in men include discharge from the penis, pain on urination (dysuria) and painful testicles. Symptoms in women include an increase or change in vaginal discharge, abdominal pain, pain during sex (dyspareunia) and unscheduled vaginal bleeding (e.g. bleeding after sex, or between periods).  

Anyone who has had unprotected sex, including oral or anal, should get tested for chlamydia. It's recommended to get tested for chlamydia, and other STIs, each time you change partners. 

If you have symptoms, it is important to not only get tested for chlamydia, but for other STIs which may be the cause for your symptoms.

Will the chlamydia infection come back after treatment?

Chlamydia is easily cured with antibiotics. In 97–98% of cases, the infection will be cured with the first course of treatment. Very rarely, antibiotic therapy may not work and symptoms of chlamydia can return. However, most people who get another chlamydia infection after treatment have been reinfected by a partner, or the medication was not taken correctly. To reduce the chance of treatment failure, you should follow the doctor’s instructions exactly and complete the course of treatment. You should also ensure your sexual partners are tested and treated as well and you should avoid sexual contact until you and your partner(s) have completed the course of treatment. Using barrier methods of contraception, such as condoms, is one of the most effective ways to protect against catching chlamydia.

Active ingredients

The active ingredient in Azithromycin is, azithromycin monohydrate or azithromycin dihydrate, which are both forms of an antibiotic used to treat a range of infections.

Inactive ingredients

The inactive ingredients in Azithromycin are croscarmellose sodium (E468), magnesium stearate (E572), microcrystalline cellulose (E460), silicium dioxide, (E551), poloxamer, povidone (E1201), hypromellose (E464), hydroxypropylcellulose, macrogol and titanium dioxide (E171), talc, and lactose.

Please Note: Inactive ingredients can vary between different brands of generic doxycycline. Check the Patient Information Leaflet provided for more information.

How to take Azithromycin for chlamydia

You should take Azithromycin according to the prescribing doctor’s instructions. The usual dose of Azithromycin for treatment of chlamydia is 1g in a single dose. This may involve taking four 250mg tablets, or two 500mg tablets. 

Each tablet should be swallowed whole with a glass of water and should be taken at least one hour before, or two hours after, eating food.

Azithromycin dosage

The usual dose of Azithromycin for treatment of chlamydia is 1g in a single dose. This may involve taking four 250mg tablets, or two 500mg tablets.

Azithromycin side effects

Common side effects of Azithromycin include:

• Abdominal pains
• Diarrhoea
• Nausea
• Vomiting
• Feeling dizzy or tired
• Headaches
• Changes to your sense of taste
• Flatulence (wind)

Serious side effects:
If you experience any of these serious side effects, you should stop taking the medicine and seek immediate medical attention:

• Symptoms of an allergic reaction, including wheezing or difficulty breathing, chest pain or tightness, swelling of the face, lips, tongue, throat, hands or feet, fever, rash, or collapse
• Yellowing of the skin and eyes (jaundice)
• Symptoms of DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms), such as fever, swollen lymph nodes or skin rash
• Severe skin reactions with irregular patches, flushing, blisters, ulcers, reddening, peeling and swelling, which could indicate conditions such as erythema multiforme, Stevens-Johnson syndrome or toxic epidermal necrolysis.
• Symptoms of infection including sore throat and high temperature. This may indicate leukopenia, a reduction in white blood cells.
• Severe abdominal pain. This may indicate pancreatitis.
• Severe or persistent diarrhoea or blood in the stool. This may indicate gut inflammation.

Other side effects:
If you experience any of these side effects, you should consult your doctor:

• Unusual or rapid heartbeat
• Skin rash
• Fever or chills
• Easy bruising or bleeding
• Reduced urine output or blood in the urine
• Visual changes
• Changes in your hearing
• Changes in sensation (e.g. pins and needles)
• Joint pain
• Yeast infection

This list of side effects is not exhaustive, there is more information contained within the package.

Drug interactions

You should inform the prescribing doctor if you are taking, have taken or are planning to take any other medications, including non-prescription medications purchased over the counter, herbal remedies, vitamins and recreational drugs. 
Azithromycin may interact with other medications. It is important to tell your doctor if you are taking any of the following medications: 

• Antacids
• Ergotamine or dihydroergotamine
• Blood-thinning drugs such as warfarin, apixaban and ticagrelor
• Immunosuppressants such as ciclosporin or tacrolimus 
• Colchicine
• Digoxin 
• Any other antibiotic
• Nelfinavir
• Statins e.g. atorvastatin or simvastatin

This list does not include all medications that may interact with Azithromycin, so it is important that you let your doctor know about any other medications, alternative medicines, supplements, over the counter treatments and recreational drugs that you may be taking.

Azithromycin and alcohol

Alcohol does not reduce the effectiveness of treatment, but it can cause dehydration, compromise your liver function and cause side effects. Therefore you should avoid drinking alcohol when taking Azithromycin. 

Azithromycin and pregnancy/breastfeeding?

Existing research suggests that Azithromycin is safe to take during pregnancy and should not cause harm to you or your baby. If you are pregnant, it is always worth checking that no new research has been undertaken causing this advice to be changed.

Azithromycin is not known to be harmful during pregnancy and is often prescribed to pregnant women for the treatment of chlamydia. However, if you are pregnant, there is a chance you may be pregnant, or you plan on becoming pregnant you should disclose this to the prescribing doctor. 

Aciclovir is passed into the breast milk of breastfeeding women. It is not thought to be harmful to the child, however, if you are breastfeeding and require Azithromycin, it is important to disclose this to the prescribing doctor.

Can I still have sex when taking Azithromycin?

You and your partner(s) should avoid sexual contact until you have completed treatment for chlamydia. It is also important for your partner(s) to be tested and treated if required to avoid re-infection. 

If you have been prescribed a single 1g dose of Azithromycin, you should avoid sexual contact for 1 week after taking the tablet(s).

Can you buy Azithromycin over the counter?

In 2008, the MHRA announced that Azithromycin may be made available over the counter without prescription as Clamelle. This is only available in selected pharmacies and is only for use for those who are asymptomatic but who have tested positive for chlamydia, or who have a partner who has tested positive for chlamydia.

Is it safe to order Azithromycin online?

It is safe to order Azithromycin from a registered and regulated pharmacy, including an online pharmacy. In the UK, you should look for:

• MHRA registration with green cross logo (discontinued after Brexit)
• General Pharmaceutical Council registration with GPhC green cross logo
• General Medical Council registered doctors
• General Pharmaceutical Council registered pharmacy
• Registered company with UK business address
• Positive customer reviews

Dr Felix is a registered UK online pharmacy, using only GMC registered doctors. For more information, please visit: https://www.drfelix.co.uk/about-us/

What is Zithromax?

Zithromax is a brand of Azithromycin available on prescription for the treatment of chlamydia and other bacterial infections.

References