Glazi 500 Abbott treats acute sinusitis, acute otitis media, sore throat, tonsillitis (2 blisters x 3 tablets)

Be cautious when using

too hypersensitivity

As with Erythromycin and other macrolids, there have been reports on rare serious allergic reactions, including angioedema and anaphylactic shock (rarely death), and skin reactions including acute overseas blusty rehabiles (AGEP), Stevens-Johnson syndrome (SJS), and poisoning epidermis (Ten) (rare). Eosin and systemic symptoms (dress). A few reactions with this azithromycin have caused recurrent symptoms and need to be monitored and treated longer.

If allergic reactions, immediately stop the drug and use appropriate treatment. Doctors need to know allergic reactions may reappear when they have stopped symptomatic treatment.

Liver poisoning

Because the liver is the main excretion of azithromycin, the use of azithromycin needs to be cautious in patients with severe liver disease.

There have been reports on abnormal liver function, hepatitis, jaundice due to biliary obstruction, liver necrosis and liver failure, some of these cases have led to death. When there are signs and symptoms of hepatitis, azithromycin must be stopped immediately.

Enlargement pylorus in young children

In the process of monitoring the use of azithromycin on newborn babies (taking up 42 days old), there was a report on the case of hypertrophic pyloric stenosis in young children. Father Mę and the babysitter need to be instructed immediately to the doctor if the child vomits or irritated when feeding.

Medicines of naked spurs (ERGOT)

In patients who are taking vasoconstrictor of vasoconstriction (ERGOT), the likelihood of Ergotin poisoning will increase when used in combination with antibiotics in the Macrolid family. There is no data on the ability to interact between vascular spurs (ergot) and azithromycin. However, theoretically can occur Ergotin poisoning, so it should not be used in combination with drugs of naked spurs (ERGOT) with azithromycin.

superinfection

Like any antibiotic preparation, it is necessary to observe the signs of superinfection of non -sensitive microorganisms, including fungi.

diarrhea caused by Clostridium difficile

diarrhea caused by Clostridium Difficile (Clostridium Difficile Associated Diarrhea - CDAD) has been reported when using most antibacterial substances, including azithromycin, and severity of mild diarrhea to death colitis. Treatment with antibacterial agents will change the natural microbiological population of the intestine leading to the excessive development of C. Difficile.

c. Difficile produces toxins A and B contribute to CDAD development. C. Difficile superlative strains increase the incidence of disease and death, as these infections may be resistant to antibiotics and may need to be a tip of colon removal. CDAD must be considered in all patients with diarrhea after antibiotic use, need to ask the history carefully because the CDAD report occurs after more than 2 months after using antibiotics.

kidney failure

In patients with severe renal impairment (GFR

extends the range of qt

There has been a prolonged condition of the heart muscle and QT interval, causing risk of arrhythmia and torsion when using macrolids, including azithromycin (see unwanted effect section). The prescriptioner needs to consider the risk of extending QT about QT that can be fatal when considering the risk and benefits of azithromycin for high -risk groups including:

My body weakness

There have been reports on the acute phase of symptoms of myasthenia gravis in patients treated with azithromycin.

Use drugs for women during pregnancy and lactation

Pregnancy

Animal reproductive studies have been conducted at doses close to the concentration of mild toxicity to reproduction. In these studies, there is no evidence of harmful to the embryo of azithromycin. However, there is no adequate and controlled research on pregnant women. Because animal reproductive studies do not always be forecasted to be met in humans, azithromycin should only be used during pregnancy if really necessary.

Breastfeeding period

Azithromycin is reported as breast milk, but there is no complete clinical research and well controlled in breastfeeding women about dynamic pharmacokinetic properties of azithromycin secretion through breast milk. Be careful when breastfeeding women use azithromycin.

The effect of drugs on driving and operating machinery

There is no evidence that azithromycin has an influence on the patient's ability to drive and operate machinery. However, unwanted effects such as dizziness, convulsions, dizziness, drowsiness and fainting have been reported when using azithromycin can affect the ability to drive and operate machinery.

Interactive drug

antacids: In the pharmacokinetics study, investigating the effects when combining antacids with azithromycin, no effect on generalized bioavailability, although the peak concentration in plasma has decreased by about 24%. In patients who are used both azithromycin and antacids, do not take both of these drugs at the same time.

Cetirizin: Use a combination of azithromycin with cetirizin 20mg in healthy volunteers for 5 days, seeing stable results is no pharmacokinetic interactions and no change significantly to the QT range.

Didanosin (Dideoxyinosine): When compared to the placebo, use azithromycin 1200 mg/day at the same time with DIDANOSIN 400 mg/day in 6 HIV patients positive, there is no effect on pharmacokinetics in the stable state of Didanosin.

Digoxin: Concomitance the antibiotics of the macrolid family, including azithromycin with the substrate of p-glycoprotein, like digoxin, is reported to increase the substrate concentration of p-glycoprotein in serum. Therefore, if azithromycin and substrate of P-Glycoprotein such as Digoxin are simultaneously used, it is necessary to consider the ability to increase the concentration of Digoxin in the serum, need clinical monitoring, and maybe also the serum digoxin level, throughout the treatment with azithromycin and after stopping the drug.

Medicines of naked spurs (ERGOT): Theoretically, the interaction may occur between azithromycin and drugs of naked spurs (ERGOT).

Zidovudin: Use single doses of 1000mg and multi -doses of 1200mg or 600mg azithromycin that has little effect on pharmacokinetics in plasma or excretion of zidovudine or its glucuronide metabolites via urinary tract. However, the use of azithromycin increases the concentration of zidovudin phosphorylate, the metabolites have clinical activity, in single -type leukemia in the peripheral blood. The clinical significance of this finding is not clear, but may benefit the patient. Azithromycin does not have a significant interaction with the Cytochrom P450 system in the liver. It is not thought to be interactive with pharmacokinetic drugs as met with erythromycin or other macrolides. With azithromycin, there is no touch or inhibition of the liver's cytochrom P450 through a complex of cytochrom metabolism.

Dynamic studies have been conducted between azithromycin and the following drugs known as significant metabolism through cytochrom P450 intermediaries.

Atorvastatin: simultaneously use Atorvastatin (10mg daily) and azithromycin (500mg per day) does not change the concentration of plasma of Atorvastatin (based on quantitative inhibition of HMG CoA reducing enzymes). However, there were reports after the drug circulated on cases of muscle pattern on patients using simultaneously azithromycin and statin group.

Carbamazepin: In a study of pharmacokinetic interaction in healthy volunteers, it does not observe azithromycin that has a significant influence on carbamazepine concentration or its metabolites in plasma in patients using Azithromycin simultaneously.

cimetidin: Research pharmacokinetics survey on the effect of only 2 -hour cimetidin before using azithromycin, on the pharmacokinetics of azithromycin, there is no change in pharmacokinetics of azithromycin.

Oral oral oral oral medications of Coumarin group: In the study of pharmacokinetics interactions, Azithromycin does not change the anticoagulant effect of the only dose of 15mg Warfarin used on healthy volunteers. After the drug was circulated, the notice of anticoagulants increased after simultaneous use of azithromycin and the anticoagulant oral oral oral oral drug group. Although the causal relationship has not been established, periodic prothrombin should be monitored when used simultaneously azithromycin and anticoagulant drugs orally, Coumarin.

Cyclosporin: In the pharmacokinetics research in a healthy volunteer person, the dose of Azithromycin 500 mg/day through oral for 3 days and then given a single dose of Cyclosporin 10 mg/kg by oral, see CMAX and AUC0-5 increased significantly. Therefore, it is necessary to be careful before considering simultaneous use of these drugs. If it is necessary to simultaneously use these drugs, the concentration of cyclosporin should be monitored and adjusted by the dose.

Efavirenz: simultaneously use 600mg of a single dose azithromycin and 400mg Efavirenz per day for 7 days does not cause any pharmacokinetic interactions of clinical significance.

fluconazole: Simultaneously using a single dose of 1200mg azithromycin does not change the pharmacokinetic properties of the only dose of 800mg fluconazole. The total amount of drugs in plasma and the semi -exhaust time of azithromycin is not changed when used simultaneously with fluconazole, however, observations have a clinical reduction in clinical concentration of cmax peak (18%) of azithromycin.

indinavir: simultaneously using a single dose of 1200mg azithromycin has no statistical significance on the pharmacokinetic properties of Indinavir for use at a dose of 800mg, 3 times daily for 5 days.

Methylprednisolon: In the pharmacokinetic interaction research in healthy volunteers, Azithromycin has no significant impact on the pharmacokinetics of Methylprednisolon.

Midazolam: In healthy volunteers, simultaneous use of azithromycin 500 mg/day for 3 days does not cause clinical changes to the pharmacokinetic and pharmacodynamic properties of Midazolam using a single dose of only 15mg. Nelfinavir: simultaneously use azithromycin (1200mg) and Nelfinavir in a stable state (750 mg, 3 times daily), leading to an increase in azithromycin level. No observations of unwanted effects are clinically significant and do not need to adjust the dose. Rifabutin: Concomitance azithromycin and rifabutin does not affect the plasma concentrations of both drugs.

Observed neutropenia in those treated simultaneously with azithromycin and rifabutin. Despite neutropeniasis related to the use of rifabutin, causal relationships when used simultaneously with azithromycin has not been established (see unwanted effect section).

Sildenafil: In volunteers who are normal healthy men, there is no evidence of the influence of azithromycin (500mg, daily for 3 days) to AUC and CMAX of Sildenafil or its main metabolites during the circulation.

Terfenadin: Dynamic studies have shown no evidence of interactive between azithromycin and terfenadin. There have been rare cases in which the possibility of this interaction cannot be completely excluded; However, there is no concrete evidence of this interaction.

Theophylllin: There is no evidence of clinical pharmacokinetics interactions between azithromycin and theophylllin when used simultaneously in healthy volunteers.

Triazolam: In 14 healthy volunteers, the simultaneous use of Azithromycin 500mg on the day 1 and 250mg on 2 with 0.125mg Triazolam on the 2nd day without any significant effects on triazolam pharmacokinetics compared to triazolam and placebo.

trimethoprim/sulfamethoxazole: The simultaneous use of trimethoprim/sulfamethoxazole (160mg/800mg) for 7 days with azithromycin 1200mg on the 7th day does not cause any significant impact on the peak concentration, the total amount of drugs in the circulation or excretion through trimethrim trend sulfamethoxazol. Azithromycin's plasma concentrations are similar to being observed in other studies.