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Note: Azithromycin is supplied from the manufacturers in boxes of 3 tablets. You will receive an extra tablet to make a total of 4. Original or blank medicine boxes may be used.

Azithromycin is a macrolide antibiotic used to treat infection that works by killing the bacteria causing the infection.

For further information see NHS - Azithromycin.

Dr Fox provides azithromycin for the treatment of chlamydia and traveller's diarrhoea only. Other infections need to be adequately assessed and azithromycin is not usually the first line treatment. Please do not order to self treat other infections as you may be taking the wrong treatment and are at risk of causing resistant strains of bacteria. The medical questions are designed for those patients who have had a positive chlamydia test only.

How to take azithromycin for chlamydia

• Take 2 azithromycin 500mg tablets on day 1 followed by 1 azithromycin 500g tablet on day 2 and day 3.
• Try to take the dose at the same time every day, they can be taken with or without food.
• The tablets should be taken with 1/2 glass of water.
• If you forget a dose, take it as soon as possible. If it is almost time for the next dose, just skip that dose and take the next one when it is due. Do not take a double dose.

Most people do not experience symptoms from a chlamydia infection. Any symptoms should subside after a few days of starting treatment but may take up to 14 days to completely settle. It is important to continue to finish the 3 day course. Azithromycin is 97% effective at treating chlamydia infection.

Alternative treatments for chlamydia

Chlamydia can also be treated with a 7-day course of an alternative antibiotic doxycycline. Doxycycline is advised as first line treatment unless intolerant or allergic to it.

Alternative antibiotics (not available from Dr Fox), include erythromycin and ofloxacin. These antibiotics are an option only in people who cannot take doxycycline or azithromycin. Contact your local sexual health clinic or your GP if you think you need a different treatment.

Azithromycin 1gm (2 x 500mg tablets) one-off dose is no longer the recommended first choice treatment of chlamydia due to increasing resistance in other sexually transmitted infections and it not being as effective in treating complicated chlamydia infections - see BASHH guidance

Cautions and warnings

Do not take azithromycin if you:

• Are pregnant, trying to become pregnant, or are breastfeeding.
• Have suffered an allergic reaction after taking azithromycin or any other macrolide antibiotic such as erythromycin or clarithromycin.
• Are intolerant or allergic to lactose

Talk to your doctor before taking azithromycin if you have any of the following:

• Severe liver problems are taking medicines which affect your liver.
• Severe kidney problems.
• Myasthenia gravis.
• Diarrhoea, or usually get diarrhoea when you take antibiotics, or have suffered from problems with your stomach or intestines.

Azithromycin and other medicines

Please tell your doctor if you are taking or have recently taken any of the following medicines:

• Warfarin or warfarin-type anticoagulants (regularly monitored with blood tests).
• Quinapril (used to lower high blood pressure).
• Kaolin (used to treat diarrhoea).
• Penicillin or rifampicin (antibiotics).
• Sucralfate (used to treat and prevent stomach ulcers).
• Barbiturates (strong sleeping tablets, e.g. phenobarbital).
• Ergotamine (used to treat cluster headaches).
• Typhoid vaccine oral capsules.
• Carbamazepine, phenytoin, primidone, or other drugs used to control epilepsy.
• Ciclosporin (used to affect the body's immune response following organ transplants).
• Methoxyflurane (an anaesthetic). If you need an operation, tell your doctor or dentist that you are taking doxycycline.
• Methotrexate (used to treat cancer, psoriasis, or rheumatoid arthritis).
• Medicines such as antacids (indigestion tablets or liquids) containing aluminium, calcium, magnesium, or other medicines containing iron, bismuth, or zinc salts.
• Retinoid, e.g. Roaccutane (used to treat various skin conditions).
• Lithium (used to moderate mood).

There is a very rare theoretical risk of abnormal heart rhythm if azithromycin is taken at the same time as some other medications - please check this list.

Side effects of azithromycin

The most common side effects of azithromycin are nausea, vomiting, diarrhoea, abdominal pain, and headache.

If you develop severe or prolonged or bloody diarrhoea during or after using azithromycin, tell your doctor immediately since it may be necessary to interrupt the treatment. This may be a sign of bowel inflammation (pseudomembranous colitis) which can occur following treatment with antibiotics.

Some people get thrush after taking antibiotics. Antibiotics kill bacteria including beneficial bacteria that protects against thrush.

For a full list of side effects and information see the manufacturer's patient information leaflet for azithromycin.

Note: The 1g one-off dose of azithromycin suggested in the patient information leaflet is no longer a recommended treatment regime due to increasing resistance in other sexually transmitted infections and it is not as effective in treating complicated infections.

Antibiotic guardianship

To combat antibiotic resistance please:

• Only use antibiotics when needed.
• Never share antibiotics.
• Always complete course as instructed.
• Take unused medicine to local pharmacy for disposal.