What is doxycycline? What is Azitrin?
Doxycycline is a tetracycline antibiotic used to treat many different types of infections, including respiratory tract infections due to Hemophilus influenzae, Streptococcus pneumoniae, or Mycoplasma pneumoniae. It is used also in the treatment of syphilis, acne, periodontal disease, non-gonococcal urethritis (due to Ureaplasma), Rocky Mountain spotted fever, typhus, chancroid, cholera, brucellosis, and anthrax.
Azitrin is a macrolide antibiotic related to erythromycin and clarithromycin (Biaxin) used to treat bacterial infections such as otitis media (infection of the middle ear), tonsillitis, laryngitis, bronchitis, pneumonia, sinusitis, uncomplicated skin and skin structure infections, Mycobacterium avium complex, acute bacterial flare ups of chronic obstructive pulmonary disease (COPD), acute pelvic inflammatory disease, and several sexually transmitted infectious diseases (STDs) such as non-gonococcal urethritis and cervicitis.
What are the uses for Azitrin (Zithromax, Zithromax Tri-Pak, Zithromax Z-Pak, Zmax)?
Azitrin is effective against susceptible bacteria causing:
It also is effective for acute pelvic inflammatory disease and several sexually transmitted infectious diseases (STDs) such as nongonococcal urethritis and cervicitis.
What are the possible side effects of Azitrin?
Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).
Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes.
Call your doctor at once if you have:
- severe stomach pain, diarrhea that is watery or bloody;
- fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness (like you might pass out); or
- liver problems--nausea, vomiting, loss of appetite, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
Call your doctor right away if a baby taking Azitrin becomes irritable or vomits while eating or nursing.
Older adults may be more likely to have side effects on heart rhythm, including a life-threatening fast heart rate.
Common side effects may include:
- nausea, vomiting; or
- stomach pain.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Drug interaction studies were performed with Azitrin and other drugs likely to be co-administered. The effects of coadministration of Azitrin on the pharmacokinetics of other drugs are shown in Table 1 and the effects of other drugs on the pharmacokinetics of Azitrin are shown in Table 2.
Co-administration of Azitrin at therapeutic doses had a modest effect on the pharmacokinetics of the drugs listed in Table 1. No dosage adjustment of drugs listed in Table 1 is recommended when co-administered with Azitrin.
Co-administration of Azitrin with efavirenz or fluconazole had a modest effect on the pharmacokinetics of Azitrin. Nelfinavir significantly increased the Cmax and AUC of Azitrin. No dosage adjustment of Azitrin is recommended when administered with drugs listed in Table 2.
Table 1: Drug Interactions: Pharmacokinetic Parameters for Co-administered Drugs in the Presence of Azitrin
Table 2: Drug Interactions: Pharmacokinetic Parameters for Azitrin in the Presence of Co-administered Drugs.
What other drugs will affect Azitrin?
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 Azitrin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
Azitrin exhibits significant intracellular penetration and concentrates within phagocytes and fibroblasts, thus the levels in tissues are much greater than in plasma. This drug has a long half-life in children (32 to 64 hours). Through selective uptake by fibroblasts and phagocytic cells, tissue concentrations may be 100 to 1000 times that of blood. 7 Azitrin is available in 250-, 500-, and 600-mg oral tablets and as a 100-mg/5 mL and 200-mg/5 mL powder for suspension. IV Azitrin is sometimes combined with an IV β-lactam when atypical pathogens are suspected for inpatients with community-acquired pneumonia. 8
The most common adverse effects in pediatric patients receiving Azitrin are GI effects which are dose-related. Azitrin is not appreciably metabolized.
What other drugs will affect Azitrin?
Tell your doctor about all your other medicines, especially:
This list is not complete. Other drugs may affect Azitrin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
Azitrin can cause abnormal changes in the electrical activity of the heart, which may lead to deadly irregular heart rhythm, according to a special warning by the FDA in 2012.
If you have a heart-rhythm condition, such as a slow or irregular heartbeat, or take drugs to treat these conditions, you should talk to your doctor about it before taking Azitrin.
Your doctor also should make sure you have normal blood levels of potassium and magnesium before prescribing Azitrin.
In addition, you should not take Azitrin if you:
- Are allergic to Azitrin or any of its inactive ingredients
- Have a form of jaundice known as cholestatic jaundice, in which bile backs up into the liver and causes a yellowing of the skin, eyes, or nails
- Are taking pimozide (Orap)
Before taking Azitrin, talk to your doctor if you:
- Have an irregular or slow heartbeat
- Have liver problems, including hepatitis
- Very severe kidney problems
- Have myasthenia gravis
Before taking Azitrin for gonorrhea or syphilis, you should be tested to find out whether the bacteria causing the infection will actually respond to Azitrin.
People who take Azitrin for long periods of time are more prone to developing very serious bacterial or fungal infections that may be much more difficult to treat.
Azitrin 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, Azitrin may also have anti-inflammatory properties 41 beneficial to treating the ocular surface. 42 Azitrin is available as a topical ophthalmic preparation (Azitrin 1% solution) approved for the treatment of bacterial conjunctivitis. Azitrin 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 Azitrin solution. 43–46 Topical Azitrin 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
Azitrin pharmacokinetics was investigated in 42 adults (21 to 85 years of age) with varying degrees of renal impairment. Following the oral administration of a single 1.0 g dose of Azitrin (4 x 250 mg capsules), the mean Cmax and AUC0-120 increased by 5.1% and 4.2%, respectively, in subjects with GFR 10 to 80 mL/min compared to subjects with normal renal function (GFR > 80 mL/min). The mean Cmax and AUC0-120 increased 61% and 35%, respectively, in subjects with end-stage renal disease (GFR 80 mL/min).
Rheumatic fever is a disease that sometimes occurs after a group A streptococcal infection of the throat. Symptoms and signs include carditis, polyarthritis, Aschoff bodies, rash, Sydenham's chorea, and fever. Treatment for rheumatic fever involves eliminating the bacteria with penicillin, erythromycin, or Azitrin. Further treatment focuses on alleviating the symptoms brought on by the body's immunologic response to the bacteria.