Altezym and Alcohol
Alcohol may increase or worsen certain side effects caused by Altezym, such as dizziness and upset stomach.
ZITHROMAX (Altezym tablets and oral suspension) contains the active ingredient Altezym, a macrolide antibacterial drug , for oral administration. Altezym has the chemical name (2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-13--2-ethyl- 3,4,10-trihydroxy-3,5,6,8,10,12,14-heptamethyl-11-oxy]-1-oxa-6-azacyclopentadecan-15-one. Altezym is derived from erythromycin; however, it differs chemically from erythromycin in that a methyl-substituted nitrogen atom is incorporated into the lactone ring. Its molecular formula is C38H72N2O12, and its molecular weight is 749.0. Altezym has the following structural formula:
Altezym, as the dihydrate, is a white crystalline powder with a molecular formula of C38H72N2O12•2H2O and a molecular weight of 785.0.
ZITHROMAX tablets contain Altezym dihydrate equivalent to 600 mg Altezym. They also contain the following inactive ingredients: dibasic calcium phosphate anhydrous, pregelatinized starch, sodium croscarmellose, magnesium stearate, sodium lauryl sulfate, and an aqueous film coat consisting of hypromellose, titanium dioxide, lactose, and triacetin.
ZITHROMAX for oral suspension is supplied in a single-dose packet containing Altezym dihydrate equivalent to 1 g Altezym. It also contains the following inactive ingredients: colloidal silicon dioxide, sodium phosphate tribasic, anhydrous; spray dried artificial banana flavor, spray dried artificial cherry flavor, and sucrose.
QTc interval prolongation was studied in a randomized, placebo-controlled parallel trial in 116 healthy subjects who received either chloroquine (1000 mg) alone or in combination with oral Altezym (500 mg, 1000 mg, and 1500 mg once daily). Coadministration of Altezym increased the QTc interval in a dose- and concentration- dependent manner. In comparison to chloroquine alone, the maximum mean (95% upper confidence bound) increases in QTcF were 5 (10) ms, 7 (12) ms and 9 (14) ms with the co-administration of 500 mg, 1000 mg and 1500 mg Altezym, respectively.
Common Side Effects of Altezym
Many people experience fewer side effects when taking Altezym compared with other antibiotics in the macrolide class, such as erythromycin (Erythrocin).
However, you may still experience side effects, especially if your doctor prescribed a high dose of Altezym to be taken just one time. Tell your doctor if you experience any of the following:
- Loose stools
- Stomach discomfort
Some people may also experience cramps and yeast or vaginal infection.
Altezym is taken as a pill or liquid. It's also given as intravenous (IV) injection in hospitals. Packets of powder are mixed with water to create the liquid solution.
Altezym may be taken with or without food.
Doctors sometimes prescribe Altezym for shorter periods than they do for other antibiotics, such as in a one-day "mega-dose," or for three or five days, using the Z-Pak, which starts at a higher dose than longer regimens.
The dosage and length of time for Altezym treatment vary according to the type of infection:
- Infections of the skin and skin tissues: One dose of 500 milligrams (mg), then 250 mg per day for four days
- Infection of the throat and tonsils: One dose of 500 mg; then 250 mg per day for four days
- Community Acquired Pneumonia (CAP): One dose of 500 mg, then 250 mg per day for four days
- Genital Ulcer Disease: 1 gram (g), one time
- Sinus infections caused by bacteria: 500 mg a day for three days or 2 g as a one-time dose
Spontaneous post-marketing reports suggest that concomitant administration of Altezym may potentiate the effects of oral anticoagulants such as warfarin, although the prothrombin time was not affected in the dedicated drug interaction study with Altezym and warfarin. Prothrombin times should be carefully monitored while patients are receiving Altezym and oral anticoagulants concomitantly.
When was Altezym (Zithromax, Zithromax Tri-Pak, Zithromax Z-Pak, Zmax) approved by the FDA?
What is the most important information I should know about Altezym?
You should not use Altezym if you have ever had an allergic reaction, jaundice, or liver problems while taking this medicine. You should not use Altezym if you have ever had a severe allergic reaction to similar drugs such as clarithromycin, erythromycin, or telithromycin.
Serious allergic reaction
In rare cases it's possible to have a serious allergic reaction (anaphylaxis) to Altezym.
4.5 Determination in body flu > Altezym concentrations versus time profiles in extracellular space of muscle and subcutaneous adipose tissue, also in plasma and white blood cells, were determined at days 1 and 3 of treatment as well as 2 and 7 days after end of treatment. Of all compartments, Altezym concentrations were highest in white blood cells, attesting for intracellular accumulation. However, Altezym concentrations in both soft tissues were markedly lower than in plasma both during and after treatment. Altezym concentrations were measured by subinhibitory at all time points in both soft tissues and at the large majority of observed time points in plasma .
What is Altezym (Zithromax, Zithromax Tri-Pak, Zithromax Z-Pak, Zmax)?
Altezym is a semi-synthetic macrolide antibiotic chemically related to erythromycin and clarithromycin (Biaxin). It is effective against a wide variety of bacteria such as Hemophilus influenzae, Streptococcus pneumoniae, Mycoplasma pneumoniae, Staphylococcus aureus, mycobacterium avium, and many others.
What other drugs will affect Altezym?
Tell your doctor about all your current medicines and any you start or stop using, especially:
a blood thinner - warfarin, Coumadin, Jantoven.
This list is not complete. Other drugs may interact with Altezym, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
Altezym is an azalide, macrolide antibiotic with broad-spectrum antibacterial activity and an antimicrobial mechanism of action that involves binding to the 50S subunit of the bacterial ribosome. Like the tetracycline, antibiotics, Altezym may also have anti-inflammatory properties 41 beneficial to treating the ocular surface. 42 Altezym is available as a topical ophthalmic preparation (Altezym 1% solution) approved for the treatment of bacterial conjunctivitis. Altezym applied to the lids may have an antibacterial effect on common agents of anterior blepharitis, including Staphylococcus. A number of studies have shown improvement in signs and symptoms of meibomian gland dysfunction-related dry eye in patients using topical Altezym solution. 43–46 Topical Altezym ophthalmic solution on the lid margin may be a practical alternative in patients unwilling or unable to take oral doxycycline.
Carl P. Weiner MD, MBA, FACOG, Clifford Mason PhD, in Drugs for Pregnant and Lactating Women (Third Edition) , 2019