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Zithromax Injection (Azithromycin Injection) - Side Effects and Adverse Reactions

 
 



ADVERSE REACTIONS

In clinical trials of intravenous azithromycin for community-acquired pneumonia, in which 2-5 I.V. doses were given, most of the reported side effects were mild to moderate in severity and were reversible upon discontinuation of the drug. The majority of patients in these trials had one or more comorbid diseases and were receiving concomitant medications. Approximately 1.2% of the patients discontinued intravenous ZITHROMAX therapy, and a total of 2.4% discontinued azithromycin therapy by either the intravenous or oral route because of clinical or laboratory side effects.

In clinical trials conducted in patients with pelvic inflammatory disease, in which 1-2 I.V. doses were given, 2% of women who received monotherapy with azithromycin and 4% who received azithromycin plus metronidazole discontinued therapy due to clinical side effects.

Clinical side effects leading to discontinuations from these studies were most commonly gastrointestinal (abdominal pain, nausea, vomiting, diarrhea), and rashes; laboratory side effects leading to discontinuation were increases in transaminase levels and/or alkaline phosphatase levels.

CLINICAL:

Overall, the most common side effects associated with treatment in adult patients who received I.V./P.O. ZITHROMAX in studies of community-acquired pneumonia were related to the gastrointestinal system with diarrhea/loose stools (4.3%), nausea (3.9%), abdominal pain (2.7%), and vomiting (1.4%) being the most frequently reported. Approximately 12% of patients experienced a side effect related to the intravenous infusion; most common were pain at the injection site (6.5%) and local inflammation (3.1%).

The most common side effects associated with treatment in adult women who received I.V./P.O. ZITHROMAX® in studies of pelvic inflammatory disease were related to the gastrointestinal system. Diarrhea (8.5%) and nausea (6.6%) were most commonly reported, followed by vaginitis (2.8%), abdominal pain (1.9%), anorexia (1.9%), rash and pruritus (1.9%). When azithromycin was co-administered with metronidazole in these studies, a higher proportion of women experienced side effects of nausea (10.3%), abdominal pain (3.7%), vomiting (2.8%), application site reaction, stomatitis, dizziness, or dyspnea (all at 1.9%).

No other side effects occurred in patients on the multiple dose I.V./P.O. regimen of ZITHROMAX® in these studies with a frequency greater than 1%.

Side effects that occurred with a frequency of 1% or less included the following:

Gastrointestinal:    dyspepsia, flatulence, mucositis, oral moniliasis, and gastritis

Nervous System:    headache, somnolence

Allergic:    bronchospasm

Special Senses:    taste perversion

POST-MARKETING EXPERIENCE:

Adverse events reported with azithromycin during the post-marketing period in adult and/or pediatric patients for which a causal relationship may not be established include:

Allergic:    Arthralgia, edema, urticaria and angioedema.

Cardiovascular:    Arrhythmias including ventricular tachycardia and hypotension. There have been rare reports of QT prolongation and torsades de pointes.

Gastrointestinal:    Anorexia, constipation, dyspepsia, flatulence, vomiting/diarrhea rarely resulting in dehydration, pseudomembranous colitis, pancreatitis, oral candidiasis and rare reports of tongue discoloration.

General:    Asthenia, paresthesia, fatigue, malaise and anaphylaxis (rarely fatal).

Genitourinary:    Interstitial nephritis and acute renal failure and vaginitis.

Hematopoietic:    Thrombocytopenia.

Liver/Biliary:    Abnormal liver function including hepatitis and cholestatic jaundice, as well as rare cases of hepatic necrosis and hepatic failure, some of which have resulted in death.

Nervous System:    Convulsions, dizziness/vertigo, headache, somnolence, hyperactivity, nervousness, agitation and syncope.

Psychiatric:    Aggressive reaction and anxiety.

Skin/Appendages:    Pruritus, rarely serious skin reactions including erythema multiforme, Stevens-Johnson Syndrome and toxic epidermal necrolysis.

Special Senses:    Hearing disturbances including hearing loss, deafness and/or tinnitus and rare reports of taste perversion.

LABORATORY ABNORMALITIES:

Significant abnormalities (irrespective of drug relationship) occurring during the clinical trials were reported as follows:

with an incidence of 4-6%, elevated ALT (SGPT), AST (SGOT), creatinine

with an incidence of 1-3%, elevated LDH, bilirubin

with an incidence of less than 1%, leukopenia, neutropenia, decreased platelet count, and elevated serum alkaline phosphatase

When follow-up was provided, changes in laboratory tests appeared to be reversible.

In multiple-dose clinical trials involving more than 750 patients treated with ZITHROMAX (I.V./P.O.), less than 2% of patients discontinued azithromycin therapy because of treatment-related liver enzyme abnormalities.

Drug label data at the top of this Page last updated: 2006-05-09

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