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Azithromycin differs from other antibiotics by its high tissue affinity. Azithromycin reaches levels up to 50 times higher in tissue than in plasma and tissue elimination half-life ranges between 2 to 4 days. Thus, azithromycin dose regimen differs from that of other antibiotics.
Dosage: Adults: In uncomplicated genital infections due to Chlamydia trachomatis or sensitive Neisseria gonorrhoeae, the dose is 1,000 mg azithromycin (given as a single oral dose).
For all other indications the dose is 1,500 mg, to be administered as 500 mg per day for three consecutive days. As an alternative, the same total dosage (1,500 mg) can also be administered over a period of five days with 500 mg on the first day and then 250 mg on the second to the fifth day.
A 5-day treatment regimen of azithromycin was shown to have sufficient efficacy in the treatment of pneumonia. In most cases, use of a 3-day treatment regimen also seems to be sufficient.
Older people: The same dose as in adult patients is used in older people. Since older patients can be patients with ongoing proarrhythmic conditions, a particular caution is recommended due to the risk of developing cardiac arrhythmia and torsades de pointes (see Precautions).
Paediatric population: Azithromycin tablets should only be administered to children weighing more than 45 kg when normal adult dose should be used. For children under 45 kg, other pharmaceutical forms of azithromycin, e.g. suspensions, may be used.
In patients with renal impairment: No dose adjustment is necessary in patients with mild to moderate renal impairment (GFR 10-80 mL/min) (see Precautions and Pharmacology: Pharmacokinetics under Actions).
In patients with hepatic impairment: A dose adjustment is not necessary for patients with mild to moderately impaired liver function (see Precautions and Pharmacology: Pharmacokinetics under Actions).
Method of administration: Azithromycin should be swallowed whole with liquid as a single daily dose. The tablets may be taken with food.
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