I.V.: Infusate concentration and rate of infusion for azithromycin for injection should be either 1 mg/mL over 3 hours or 2 mg/mL over 1 hour. Other medications should not be infused simultaneously through the same I.V. line.
Ophthalmic: Shake bottle once prior to each administration. Wash hands before and after instillation.
Oral: Immediate release suspension and tablet may be taken without regard to food; extended release suspension should be taken on an empty stomach (at least 1 hour before or 2 hours following a meal), within 12 hours of reconstitution.
Take this medicine with or without food. Take
with food if it causes an upset stomach.
Stop tube feeding for 2 hours before giving this medicine. Restart tube feeding 1 hour after giving.
Effects of food: minimal, no effect on AUC
Effects of Food
1) Oral suspension and tablets may be taken with or without food (Prod Info Zithromax(R), 2004; Simicevic et al, 1998). Bioavailability decreased with capsules (Drew & Gallis, 1992b; Hopkins, 1991c), which is not available in the U.S.
a) The presence of food in the gastrointestinal tract
may reduce the bioavailability of azithromycin CAPSULES by 50% (Drew &
Gallis, 1992b; Hopkins, 1991c). Capsules should be taken at least 1 hour before
or 2 hours after eating.
b) The oral tablets may be taken with or without food. However, when a 500 mg dose (2 x 250 mg tablets) was administered with food, the peak concentration increased by 23%. There was no change in the area under the curve (Prod Info Zithromax(R), 2004).
c) The oral suspension may be taken with or without food. However, when azithromycin suspension was administered with food to 28 healthy, adult males, the peak concentration increased by 56%. There was no effect on the area under the curve (Prod Info Zithromax(R), 2004).
d) A high-fat meal does not significantly affect the bioavailability of the oral, 500-mg tablet. The peak concentration and area under the time-concentration curve for azithromycin is not significantly (p greater 0.05) altered by a high-fat meal; however, the time to peak concentration was slightly delayed (p less than 0.05) (Simicevic et al, 1998).
2) Oral, extended-release suspension should be taken on an empty stomach (at least 1 hour before or 2 hours following a meal) (Prod Info Zmax extended-release oral suspension, 2005).
a) Compared with the fasting state, a high-fat meal increased the mean azithromycin Cmax by 115% and the mean AUC by 23% and a standard-meal increased the mean Cmax by 119% and the mean AUC by 12% (Prod Info Zmax extended-release oral suspension, 2005).