Azithromycin – Low dose prophylactic for chronic Respiratory Infections

Patient Information Leaflet

Why have I been prescribed Azithromycin?

You have been prescribed Azithromycin to reduce the number of chest infection and there is evidence that Azithromycin works in two different ways:

1. It is an antibiotic and is capable of killing a number of the bugs (bacteria) that cause chest infections.

2. It has an anti-inflammatory effect in the airways and can significantly reduce the number of infections that patients get and help with symptoms such as cough, sputum production and breathlessness.

What dose do I take?

The usual dose is to take one 250mg or 500mg tablet/capsule, three times a week which is usually Monday, Wednesday and Friday.  Azithromycin should be taken whole with a glass of water, with or without food.

Avoid taking any indigestion medication such as lansoprazole or omeprazole two hours before and two hours after as this will affect how well the medication will work.

Azithromycin used in this way, is “off-label” and is different to that described in the patient information leaflet however, It is endorsed by the British Thoracic Society so, it’s important to take the medication as your Respiratory Consultant has advised.

Possible side effects?

• Azithromycin is very well tolerated and the majority of patients are able to continue with this treatment without side effects.  However, some people cannot tolerate Azithromycin usually due to tummy upset, diarrhoea, constipation, dizziness or development of a skin rash.
• Azithromycin can cause changes in the rhythm in the heart but your doctors will routinely check your heart rhythm prior to starting the medication. If you experience any symptoms of light headedness, dizziness or palpitations contact your doctor.
• Azithromycin can also very occasionally upset the liver, your liver function will be checked before starting the medication and it should be checked about 2 weeks after starting treatment.  If you experience any yellowing of the skin or whites of the eyes or any severe stomach pains contact your doctor.
• Extremely rarely, Azithromycin can lead to hearing loss. The first symptom of this can be tinnitus (ringing in the ears). If you experience any problems with your hearing contact your doctor. Azithromycin can also make you more prone to sunburn so it is recommended that sun block is used on hot sunny days or when on holiday.

Your doctor will ask you to provide sputum samples to check for particular type of infection caused by a bacteria similar to tuberculosis. It is important that we exclude this infection prior to starting Azithromycin as treatment can mask the infection.

What if I forget to take my Azithromycin?

If you forget to take your Azithromycin, there is no cause for concern and you should just take your next dosage as scheduled.

How long will I be on this medication?

You will usually take Azithromycin for 3 months before deciding if it is working.  If it is reducing the number of infections that you suffer from and / or significantly reducing your symptoms such as cough, sputum production and breathlessness, then it will become a regular medication and your GP should issue a repeat prescription.

Azithromycin is generally ok be taken with other medications however, check with your doctor and/or pharmacist before starting any new medication.

Feeling unwell?

If you have a flare up of your chest disease, you will still need to take An additional course of antibiotics in the usual way. You do not need to stop your Azithromycin when starting a course of Antibiotics however if you are prescribed erythromycin or clarithromycin should inform your doctor.

Can I drink alcohol when taking Azithromycin?

Yes, in moderation – there is no interaction with alcohol.

Is Azithromycin safe in pregnancy or breastfeeding?

It is not fully understood if Azithromycin is safe during pregnancy or breastfeeding therefore, is only recommended if there is on other alternatives. It is recommended that an alternative contraception be used whilst taking Azithromycin.  If you are planning on getting pregnant whilst on Azithromycin, please contact your GP or Consultant.

If you have any questions, or if there is anything you do not understand, please contact the Russells Hall Hospital switchboard number on 01384 456111 and ask for the relevant department who issued this leaflet.

If you have any feedback on this patient information leaflet please email dgft.patient.information@nhs.net

This leaflet can be made available in large print, audio version and in other languages, please call 0800 073 0510.

Originator: Respiratory. Review date: July 2024. Next Review Date: April 2027. Version: 1  DGH ref: DGH/PIL/02205