Azithromycin

Azithromycin can be taken with or without food. The tablets should be taken at the same time every day, with half a glass of water. The usual dose is one 500mg tablet, once a day, for 3 days. You may feel better within a few days of treatment but you should always finish your course of antibiotics. If you do not, your traveller’s diarrhoea might come back. If you feel worse, or do not get better when your course is finished, speak to your doctor.

If you forget your dose, take it as soon as you remember. If your next dose is almost due, do not take your missed dose. Continue treatment and take your missed dose at the end of the treatment course. This will mean your treatment will last a day longer. Never take a double dose. If you take more than you should, speak to your doctor or visit A&E straight away.

Traveller’s diarrhoea will usually clear up on it’s own within 3 to 7 days without any treatment. Azithromycin can help to clear up the symptoms more quickly if they are severe.

If you have traveller’s diarrhoea, you can treat it at home by:

• getting plenty of rest
• drinking lots of fluids to replace those lost from diarrhoea
• using over the counter rehydration treatment, such as Dioralyte
• avoiding alcohol, caffeine, and products containing dairy, as this may make your diarrhoea worse
• introducing bland foods to your diet when your diarrhoea is getting better, such as dry toast or bananas

Before using azithromycin, speak to your doctor if you have:

• severe liver or kidney problems
• myasthenia gravis, which is a muscle weakness illness
• heart problems
• symptoms of another infection
• low magnesium or potassium levels in your blood
• intolerance to some sugars, as Azithromycin 500 contains lactose

You must stop using the tablets and speak to your doctor straight away if you suddenly feel faint or dizzy, feel your heart beating in your chest, have an abnormal heartbeat, or get muscle weakness. If you are pregnant or breastfeeding, speak to your doctor before using azithromycin.

Very common side effects include:

• nausea (feeling sick)
• wind
• diarrhoea
• stomach pains

Common side effects include:

• dizziness
• lack of appetite
• tiredness
• pins and needles
• headaches
• vomiting (being sick)
• skin rashes or itching
• joint pain
• changes to your vision

Uncommon side effects include:

• feeling nervous
• thrush
• drowsiness
• reduced sense of touch (hypoaesthesia)
• difficulty sleeping
• heart palpitations
• weakness
• swelling
• chest pain
• constipation
• ringing in your ears
• gastritis, which is inflammation of the stomach lining
• a skin rash (hives)

Rare side effects include:

• a spinning sensation (vertigo)
• feeling agitated
• a change in your liver function

There are some side effects which you may get whilst using azithromycin, but it is not known how often these happen.

These include:

• fainting
• fits (seizures)
• colour changes on your tongue
• change in your sense of smell or taste
• feeling hyperactive
• anxiety or aggression
• low blood pressure

You cannot take these tablets if you are allergic to azithromycin or any other macrolide antibiotics, such as clarithromycin or erythromycin. You also cannot take ergotamine (a medicine for migraines) whilst taking azithromycin, as this could cause serious side effects.

Azithromycin is also not suitable for patients of any age who weigh less than 45kg. If you weigh less than this, you will need to take a lower dose and should inform your doctor. If you have problems with your kidney or liver, your doctor may need to prescribe you a different dose.

If you get any mild side effects that do not go away after a few days of taking Azithromycin, speak to your doctor. If you have a severe allergic reaction, such as a skin rash and breathlessness, go to A&E straight away, or call 999. For more information on side effects, read the patient information leaflet.

There are some medications that may interact with azithromycin or stop it from working. Speak to your doctor before using this medicine if you also take:

• warfarin, or other medicines to thin your blood
• antacids, used to treat heartburn
• terfenadine, used for allergies
• ergotamine, used to treat migraines
• HIV treatment
• rifabutin, used to treat tuberculosis (TB)
• ciclosporin, medicine used after an organ transplant
• quinidine, used to treat heart rhythm problems
• colchicine, used to treat gout
• digoxin, used to treat heart problems