Indications of ZiMax

ZiMax is used to treat infections in the lower respiratory tract, such as bronchitis and pneumonia, as well as infections in the upper respiratory tract, such as sinusitis and pharyngitis/tonsillitis, otitis media, and skin and soft tissue infections. ZiMax is used to treat non-gonococcal urethritis and cervicitis caused by Chlamydia trachomatis in both men and women with sexually transmitted infections.

Pharmacology of ZiMax

Azithromycin is acid-stable and can subsequently be taken orally with no requirement of assurance from gastric acids. It is promptly ingested; its assimilation is more noteworthy on a purge stomach. Time to crest concentration in grown-ups is 2.1 to 3.2 hours for verbal measurement shapes. Due to the tall concentration in phagocytes, azithromycin is effectively transported to the location of contamination. Amid dynamic phagocytosis, huge concentrations of azithromycin are discharged. The concentration of azithromycin within the tissues can be over 50 times higher than in plasma. Typically due to particle catching and the tall lipid dissolvability.

Because of azithromycin’s long half-life, a large single dose can be given and bacteriostatic levels in infected tissue can be maintained for several days. Plasma concentrations of azithromycin decreased in a polyphasic fashion after a single 500 mg dose, with a mean apparent plasma clearance of 630 mL/min and a terminal elimination half-life of 68 hours. The extended terminal half-life is attributed to the drug’s substantial absorption and subsequent release from tissues. A main route of elimination for azithromycin is biliary excretion, which is mostly unaltered. Approximately 6% of the prescribed dose shows in urine as unmodified medication over the course of a week.

• Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pneumoniae, and Streptococcus pyogenes are gram-positive bacteria that are aerobic and facultative.
• Haemophilus ducreyi, Haemophilus influenzae, Moraxella catarrhalis, and Neisseria gonorrhoeae are examples of aerobic and facultative gram-negative bacteria.
• Microorganisms that aren’t bacteria: Mycoplasma pneumonia, Chlamydia pneumonia, Chlamydia trachomatis The synthesis of beta-lactamase should have no influence on azithromycin action.
• Streptococci (Groups C, F, G), and Viridans group streptococci are examples of aerobic and facultative gram-positive bacteria.
• Bordetella pertussis and Legionella pneumophila are gram-negative bacteria that are both aerobic and facultative.

ZiMax Dosage & Administration

Oral–
Adult:

• 500 mg once daily orally for 3 days or 500 mg once on day 1, then 250 mg once on days 2-5 for 4 days.
• For sexually transmitted diseases caused by Chlamydia trachomatis in adults, the dose is 1 gm given as a single dose or 500 mg once on day 1, followed by 250 mg once daily for the next 2 days may also be given.

Children:

• 10 mg/kg body weight once daily for 3 days for children over 6 months
• 200 mg (1 teaspoonful) for 3 days if body weight is 15-25 kg
• 300 mg (1½ teaspoonfuls) for 3 days if body weight is 26-35 kg; 400 mg (2 teaspoonfuls) for 3 days if body weight is 36-45 kg.
• In typhoid fever, 500 mg (2½ teaspoonfuls) once daily for 7-10 days is given.

Azithromycin Injection (For IV Infusion only): The recommended dose of Azithromycin for injection for the treatment of adult patients with community-acquired pneumonia due to the indicated organisms is:

• 500 mg as a single daily dose by the intravenous route for at least two days. Intravenous therapy should be followed by Azithromycin by the oral route at a single, daily dose of 500 mg, administered as two 250-mg tablets to complete a 7 to 10-day course of therapy. The timing of the switch to oral therapy should be done at the discretion of the physician and in accordance with clinical response.
• The recommended dose of Azithromycin for the treatment of adult patients with pelvic inflammatory disease due to the indicated organisms is: 500 mg as a single daily dose by the intravenous route for one or two days. Intravenous therapy should be followed by Azithromycin by the oral route at a single, daily dose of 250 mg to complete a 7-day course of therapy. The timing of the switch to oral therapy should be done at the discretion of the physician and in accordance with clinical response. If anaerobic microorganisms are suspected of contributing to the infection, an antimicrobial agent with anaerobic activity should be administered in combination with Azithromycin.
• The safety and effectiveness of azithromycin for injection in children or adolescents under 16 years have not been established.

Reconstitution procedure of suspension-

• Step 01: Shake the bottle well to loosen the powder.
• Step 02: Add boiled and cooled water up to the watermark on the bottle label.
• Step 03: Shake until powder is completely mixed with water.

ZiMax should be taken at least 1 hour before or 2 hours after a meal.

Interaction of ZiMax

ZiMax absorption is reduced in presence of food and antacid. In patients receiving ergot alkaloids ZiMax should be avoided because of the possibility of ergotism resulting from the interaction of Azithromycin with the cytochrome P-450 system. As macrolides increase the plasma concentration of digoxin and cyclosporin, caution should be exercised while co-administration. There have been no drug interactions between Azithromycin and Warfarin, Theophylline, Carbamazepine, Methylprednisolone, or Cimetidine

Contraindications of ZiMax

Patients who are hypersensitive to azithromycin or any other macrolide antibiotic should avoid taking it. Ergot derivatives and azithromycin should not be taken together. Patients with hepatic disorders should avoid azithromycin.

ZiMax Side Effects

ZiMax is a well-tolerated antibiotic with few adverse effects. Nausea, vomiting, abdominal discomfort (pain/cramps), flatulence, diarrhea, headache, dizziness, and skin rashes are among the side effects, which are reversible as the medication is stopped.

Pregnancy & Lactation

ZiMax is in the B pregnancy category. Azithromycin has been shown to have no negative effects on the fetus in animal reproduction experiments. Pregnant women have been the subject of insufficient and well-controlled research. Because animal reproduction studies do not always reflect human response, azithromycin should only be administered during pregnancy if there are no other options. The presence of ZiMax in breast milk is unknown. As a result, if Azithromycin is given to a nursing woman, vigilance should be observed.

Precautions & Warnings

Observation for signs of superinfection with non-susceptible organisms, especially fungus, is suggested with any antibiotic. In patients with renal impairment, there is no need to alter the dose.

Therapeutic Class of ZiMax

Macrolides

Storage Conditions

Protect from light and moisture by storing in a cool, dry place below 30°C. Keep out of children’s reach.

Generic of ZiMax

Azithromycin Dihydrate

Pharmaceutical Name of ZiMax

Square Pharmaceuticals Ltd