Adults

Dosage for children varies based on weight and infection type. General recommendation for most infections: 10 mg/kg body weight once daily for 3 days, or 10 mg/kg on day 1 followed by 5 mg/kg on days 2-5. (Adult dosing is typically higher for Azithromycin, consult specific adult formulations).

Elderly

No specific dose adjustment is required for elderly patients with normal renal and hepatic function. However, caution is advised due to potential for prolonged QT interval.

Renal_impairment

Mild to moderate renal impairment (creatinine clearance > 10 mL/min): No dose adjustment. Severe renal impairment (creatinine clearance < 10 mL/min): Use with caution, as data are limited.

Onset

Clinical effects typically begin within 2-3 days, with peak plasma concentrations occurring within 2-3 hours after administration.

Excretion

Primarily excreted unchanged in the bile; a small percentage is excreted in urine.

Half life

The terminal elimination half-life is long, approximately 2-4 days, which allows for once-daily dosing and shorter treatment durations.

Absorption

Rapidly absorbed from the gastrointestinal tract. Peak plasma concentrations are reached within 2-3 hours. Bioavailability is approximately 37%.

Metabolism

Primarily metabolized in the liver by N-demethylation to inactive metabolites.

Digoxin

May increase serum digoxin levels; monitor digoxin levels.

Warfarin

Increased anticoagulant effects have been reported; monitor prothrombin time carefully.

Antacids (containing aluminum or magnesium)

May reduce peak plasma concentrations of azithromycin; administer azithromycin at least 1 hour before or 2 hours after antacids.