Drug Name: Zithromax
Antibiotics kill sensitive bacteria, including beneficial flora in the gut, which could affect digestion and/or elimination. Take probiotics - such as Lactobacillus casei, Lactobacillus acidophilus, Bifidobacterium longum, or Saccharomyces boulardii species - to help prevent common side effects of antibiotic therapy, such as diarrhea or yeast infections (Candida albicans) in the vagina or intestines.
- Bengmark S & Gianotti L: Nutritional support to prevent and treat multiple organ failure. World J Surg, 1996 May, 20:4, 474-81.
- Fuller R. Probiotics in human medicine. Gut 1991;32:439-42 [review].
- Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-76.
- Cummings JH, Macfarlane G: Role of intestinal bacteria in nutrient metabolism, JPEN J Parenter Enteral Nutr, 1997, 21(6): 357-65.
- Gorbach SL: Bengt E. Gustafsson Memorial Lecture, Function of the Normal Human Microflora, Scand J Infect Dis Suppl, 1986, 49:17-30.
Taking supplements and zithromax together may affect the absorption of both the medication and the supplementation. Therefore, zithromax should be taken at least 2 hours apart from supplementation with calcium, magnesium, zinc, and iron.
- Watson, A. et al: Severe hypomagnesaemia and hypocalcaemia following gentamicin therapy. Irish Med. J. 1983, 76: 381-383.
- Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
- Foulds G, Hilligoss DM, Henry EB, Gerber N. The effects of an antacid or cimetidine on the serum concentrations of azithromycin. J Clin Pharmacol 1991; 31:164-67.
Vitamin K - Zithromax may interfere with the absorption of vitamin K, which can cause excessive bleeding. Take 100 mcg of vitamin K per day to avoid depletion, or eat more leafy green vegetables while taking the drug.
- Suzuki K, Fukushima T, Meguro K, et al. Intracranial hemorrhage in an infant owing to vitamin K deficiency despite prophylaxis. Childs Nerv Syst 1999;15:292-4
- Huilgol VR, Markus SL, Vakil NB. Antibiotic-induced iatrogenic hemobilia. Am J Gastroenterol 1997;92:706-7
- Bandrowsky T, Vorono AA, Borris TJ, Marcantoni HW. Amoxicllin-related postextraction bleeding in an anticoagulated patient with tranexamic acid rinses. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82:610-2
- Kaiser CW, McAuliffe JD, Barth RJ, Lynch JA. Hypoprothrombinemia and hemorrhage in a surgical patient treated with cefotetan. Arch Surg 1991;126:524-5
Magnesium- and aluminum-containing antacids were reported to interfere with Zithromax absorption in a study of ten healthy people. People can avoid this interaction by taking Zithromax two hours before or after any aluminum/magnesium-containing antacids. No studies have yet shown that magnesium nutritional supplements negatively affect absorption of this drug.
- Foulds G, Hilligoss DM, Henry EB, Gerber N. The effects of an antacid or cimetidine on the serum concentrations of azithromycin. J Clin Pharmacol 1991; 31:164-7
Avoid using digitalis with zithromax due to possible increased cardiovascular side effects. Digitalis (Digitalis lanata, Digitalis purpurea) - also found in Foxglove plants. Digitalis glycosides may produce chemical reactions and toxicities similar to the prescription drug digoxin.
- Bizjak ED, Mauro VF. Digoxin-macrolide drug interaction. Ann Pharmacother 1997;31:1077-79.
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