The antibiotic class known as macrolides includes azithromycin. By preventing mRNA translation, it hinders the creation of proteins in bacteria.

It is used to treat the following conditions:

• For the treatment of Chancroid (genital ulcer due to Haemophilus ducreyi).

• For Chronic obstructive pulmonary disease caused by:

  • Haemophilus influenzae

  • Moraxella catarrhalis

  • Streptococcus pneumoniae

• For Mycobacterium avium complex in patients with advanced HIV infection

• For the treatment of acute otitis media caused by the following bacteria:

  • Haemophilus influenzae

  • M. catarrhalis

  • S. pneumoniae

• For community-acquired pneumonia caused by:

  • Chlamydophila pneumoniae

  • H. influenzae

  • Legionella pneumophila

  • M. catarrhalis

  • Mycoplasma pneumoniae

  • Streptococcus pneumoniae

• Uncomplicated skin and soft tissue infections due to:

  • Staphylococcus aureus

  • Streptococcus pyogenes

  • Streptococcus agalactiae

• As an alternative therapy for the treatment of tonsillitis or pharyngitis due to Streptococcus pyogenes.

• For the treatment of Urethritis and cervicitis due to:

  • Chlamydia trachomatis

  • Neisseria gonorrhoeae

• Off Label Uses of Azithromycin in Adults include:

  • Acne vulgaris

  • Babesiosis

  • For the prevention of pulmonary exacerbations in patients with Bronchiectasis (non-cystic fibrosis)

  • Bronchiolitis obliterans syndrome (in patients with lung transplant)

  • Campylobacter infection

  • Cat scratch disease

  • For perioperative prophylaxis during Cesarean delivery

  • Chlamydia trachomatis infection of the pharynx

  • For expedited partner therapy of Chlamydia trachomatis infection

  • Cholera

  • Chronic obstructive pulmonary disease patients' pulmonary exacerbation prevention

  • Cystic fibrosis

  • Prophylaxis of endocarditis (prior to a dental or invasive respiratory tract procedure)

  • Disseminated gonococcal infection 

  • expedited partner therapy for Gonococcal infection

  • Uncomplicated Gonococcal infection of the rectum, pharynx, and conjunctiva

  • Granuloma inguinale

  • Lyme disease

  • Mycobacterium abscessus infection

  • Mycoplasma genitalium

  • Pertussis

  • For the prophylaxis of Sexually transmitted infections in individuals following a sexual assault

  • Shigella infection

  • Surgical prophylaxis in patients following uterine evacuation (after abortion or pregnancy loss)

  • Primary and Secondary Syphilis

  • Empiric treatment of Travelers' diarrhea

Azithromycin for the treatment of COVID-19 infection:

• Azithromycin has recently been studied in patients with coronavirus infection along with the antimalarial drug hydroxychloroquine.
• The author of the study suggested that the use of azithromycin in combination with hydroxychloroquine resulted in a significant reduction of positive cases after 6 days (25% vs 90%) [Ref].
• Since both Azithromycin and hydroxychloroquine can result in QTc prolongation, this combination should be used with extreme caution.
• Furthermore, more studies are needed before they are considered effective and safe.

Azithromycin Dose in Adults

Dose for Off-label use in the treatment of moderate to severe inflammatory Acne vulgaris as an adjunct to topical acne therapy:

• Dosing regimens varied in different clinical trials.
  • Regimen 1:
    • For three months in a row, take 500 mg once daily by mouth for 4 days straight.
  • Regimen 2:
    • In the first week, take 500 mg orally once a day for three days; after that, take 500 mg once a week till week 10.
  • Regimen 3:
    • In the first month, take 500 mg orally once a day for three days in a row every week, then for two days in a row every week in the second month, and finally for one day every week in the third month.

---

Dose for Off-label use in the treatment of Babesiosis:

• Mild to moderate disease:

  • In immunocompetent individuals, 500 mg orally on day 1, followed by 250 mg once day in conjunction with atovaquone for 7–10 days.

• Severe disease:

  • For seven to ten days, combine atovaquone with 500 mg intravenously each day.

---

Dose for Off-label use in the treatment and prevention of pulmonary exacerbation of Bronchiectasis (non-cystic fibrosis):

• 500 mg three times orally
• All patients should be screened for non-tuberculous mycobacterial infection.

---

Dose for Off-label use in the treatment of Bronchiolitis obliterans syndrome in recipients of lung transplant:

• 250 mg taken orally once daily for five days, then 250 mg three times per week for at least three months.
• Depending on the outcome of the therapy, some professionals continue it permanently.

---

Dose for Off-label use in the treatment of Cat scratch disease:

• 500 mg taken orally in a single dose, followed by 250 mg once day for four more days.

---

Dose in the perioperative prophylaxis of Cesarean delivery:

• One hour prior to a surgical incision, 500 mg intravenous in a single dosage in addition to customary preoperative antibiotics.

---

Dose in the treatment of Chronic obstructive pulmonary disease:

• Treatment of Bacterial exacerbation:

  • On day 1, take 500 mg orally, then take 250 mg once a day for a total of 5 days, or take 500 mg orally once per day for 3 days.

• Prevention of exacerbations as off-label use:

  • 250 mg orally once a day, or 250 mg orally three times per week

---

Dose as Off label use in the treatment of Cystic fibrosis as an anti-inflammatory drug:

• 250 mg (individuals with a weight of less than 40 kg) or 500 mg (patients weighing more than 40 kgs) orally 3 times a week or
• 250 mg once a day.

---

Dose as off Label use in the treatment of infectious Diarrhea:

• Campylobacter infection:

  • 1 gm orally as a single dose (may administer 500 mg/day for 2 more days in symptomatic patients or
  • 500 mg orally once daily for three days
  • HIV infected patients should receive 500 mg once ay for 5 days.

• As an alternative agent in Cholera:

  • 1 gm orally as one dose

• Shigella infection:

  • 500 mg orally for three days one time daily 
  • HIV patients and those with Shigella dysenteriae type 1 infection should be given the drug for 5 days.

• Empiric treatment of Travelers' diarrhea:

  • 1 gm orally as a single dose (symptomatic patients may be advised the drug for 2 more days at a dose of 500 mg per day) or
  • 500 mg orally once daily for three days (it is considered the preferred regimen in febrile patients).

---

Off-label use for the prophylaxis of endocarditis prior to a dental or invasive respiratory procedure (as an alternative agent for penicillin-allergic patients):

• 500 mg orally 30 - 60 minutes prior to the procedure.

---

Dose as Off-label use in the treatment of Lyme disease (erythema migrans or borrelial lymphocytoma) as an alternative agent:

• • 500 mg orally once a day for 7 - 10 days.

---

Dose in the treatment of non-tuberculosis Mycobacterial infection:

• Mycobacterium avium complex (MAC) infection:

  • Disseminated disease in HIV-infected patients:

    • Treatment of MAC:

      • 500–600 mg used orally once a day as part of a combined therapy protocol

    • Primary prophylaxis (patients with CD4 count <50 cells/mm³ ):

      • 600 mg twice a week or 1,200 mg once a week is preferable.
      • When the CD4 count rises beyond 100 cells/mm3 for three months or longer in response to antiretroviral medication, prophylaxis may be stopped (ART).

    • Secondary prophylaxis:

      • 500 to 600 mg taken orally once per day along with other suitable regimens
      • When the patient has completed 12 months of therapy, is MAC disease-free, and has a sustained CD4 count of greater than 100 cells/mm3 in response to ART, it may be stopped (usually more than 6 months)

---

Off label use in the treatment of nodular or bronchiectatic pulmonary disease:

• 500 - 600 mg orally 3 times a week until the patient is culture-negative on therapy for one year or more (in combination with other appropriate therapy)

---

Off label use in the treatment of severe nodular/ bronchiectatic or cavitary Pulmonary disease:

• Once daily, 250–500 mg taken orally (in combination with other appropriate therapy)
• After receiving therapy for at least a year, the patient should remain on treatment until the patient is culture-negative.

---

Dose as Off-label use in patients with cystic fibrosis: 

• 250–500 mg taken once daily by mouth (in addition to other necessary treatment) until the patient has been culture-negative for at least a year.
• Patients with cystic fibrosis should not be advised intermittent (3 times a day) therapy.

  ---

Dose for Mycobacterium abscessus infection (off-label use):

• Pulmonary, skin, soft tissue, or bone infection:

  • Once daily, 250–500 mg taken orally (in combination with other appropriate therapy)
  • Treatment should be continued for 6 to 12 months for the treatment of lung and bone infections, and for 4 months or longer in patients with skin and soft tissue infections.

---

Off Label use in the treatment of Pertussis:

• On day 1, take 500 mg orally, then take 250 mg once every day for the next 5 days.

---

Dose in the treatment of community-acquired Pneumonia:

• Outpatient management:

  • On day 1, take 500 mg orally, then 250 mg once a day for four days, or 500 mg orally once a day for three days.

• Inpatient management:

  • For a minimum of three days, take 500 mg orally or intravenously once each day.

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Dose in the treatment of Sexually transmitted infections:

• Empiric therapy for Cervicitis:

  • 1 gm of ceftriaxone taken orally in a single dose.

• Chancroid (caused by Haemophilus ducreyi ):

  • 1 gm orally as a single dose.

• Chlamydia trachomatis infection of the urethra, cervix, or pharynx (as off-label use:

  • 1 gm orally as one time dose

• Chlamydia trachomatis infection for the treatment of expedited partner (off-label use):

  • 1 gm orally as a single dose.

• Disseminated Gonococcal Infection ( including arthritis, arthritis-dermatitis, meningitis, and endocarditis) as off label use:

  • 1 gm orally one dose in combination with ceftriaxone.

• Gonococcal infection for expedited partner therapy (as off- label use):

  • 1 gm orally as a single dose in combination with cefixime.

• Uncomplicated gonococcal infection (infection of the cervix, urethra, rectum, pharynx, or conjunctiva):

  • Dual-therapy regimen (as off-label use):

    • 1 gm orally iwith ceftriaxone  as one dose

  • Patients with allergy to cephalosporins (as off-label use):

    • 2 gms as a single dose in combination with gemifloxacin or intramuscular gentamicin.

• Granuloma inguinale (donovanosis) as off-label use:

  • 500 mg once a day for at least three weeks, or 1 gm orally once per week, until the lesions have healed.
  • Gentamicin may be added to the therapy if the lesions are not healed within one week.

• Mycoplasma genitalium (as off-label use):

  • 500 mg orally on day 1, then 250 mg once day for four days, or 1 g orally as a single dose.

• Prophylaxis against sexually transmitted infections following sexual assault (as off-label use):

  • 1 gm given as a single dosage along with metronidazole or tinidazole and ceftriaxone.

• Primary and Secondary Syphilis in penicillin-allergic patients (off-label use):

  • 2 gms orally as a single dose.

• For the empiric therapy of Urethritis:

  • 1 gm orally as a single dose in combination with ceftriaxone.

---

Dose in the treatment of group A streptococcal pharyngitis as an alternative agent for the severely penicillin-allergic patients:

• On day 1, take 500 mg orally, then 250 mg once a day for four days, or 500 mg orally once a day for three days.

---

Off label use for the surgical prophylaxis of uterine evacuation in patients with abortion or a pregnancy loss:

• One hour prior to the surgery, take 500 mg by mouth in a single dose.

---

Dose in the treatment of drug-resistant Typhoid fever:

• 1 gm of meropenem taken orally in a single dose, followed by 500 mg once day for seven to ten days.

Azithromycin dose in the treatment of coronavirus infection:

• 500 mg twice daily for five days along with hydroxychloroquine 400 mg twice daily on day one then 200 mg twice daily for four days.

Azithromycin Dose in Children

General dosing for susceptible infections:

• Mild to moderate infection:

  • 5 to 12 mg/kg/dose given orally (often 10 to 12 mg/kg/dose on day 1 and thereafter 5 to 6 mg/kg once a day).
  • The usual maximum dose for the total course is 1,500 - 2,000 mg.

• Serious infection:

  • 10 mg/kg intravenous once a day to a maximum dose of 500 mg/dose.

---

Dose in the treatment of Babesiosis:

• In conjunction with atovaquone, administer 10 mg/kg orally once on day 1 up to a maximum dose of 500 mg/dose, then 5 mg/kg once daily from days 2 through 10 (maximum dose of 250 mg/dose).

---

Dose in the treatment of Bartonellosis (Cat scratch disease) with extensive lymphadenopathy in HIV-negative patients:

• Infants, Children, and Adolescents weighing 45 kgs or less:

  • 5 mg/kg once daily for 4 days with a maximum dose of 250 mg/dose, starting with 10 mg/kg orally once on day 1 up to a maximum dose of 500 mg/dose.

• Children and Adolescents weighing more than 45 kgs:

  • On day 1, take 500 mg orally in a single dosage; the next 4 days, take 250 mg once daily.

---

Cutaneous bacillary angiomatosis (caused by B. henselae or B. quintana) in HIV-Positive patients:

• 5 - 12 mg/kg orally once a day to a maximum dose of 600 mg/dose for 3 months.

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Dose in the treatment of Chancroid:

• Children weighing less than 45 kgs:

  • 20 mg/kg orally as a single dose (to a maximum dose of 1,000 mg/dose)

• Children weighing more than 45 kgs:

  • 1,000 mg orally as one dose

---

Dose in the treatment of Chlamydial infections:

• Cervicitis and urethritis:

  • Children and Adolescents weighing more than 45 kgs:
    • 1,000 mg orally as a single dose

  • Conjunctivitis (infants):

    • 20 mg/kg intravenously or orally once per day for three days.

  • Community-acquired Pneumonia:

    • Mild infection or step-down therapy:

      • 5 mg/kg once daily for 4 days with a maximum dose of 250 mg/dose, starting with 10 mg/kg orally once on day 1 up to a maximum dose of 500 mg/dose.

    • Severe infection:

      • 10 mg/kg intravenous, once daily, for a minimum of two days.
      • To finish the course, switch to oral azithromycin at a single dose of 5 mg/kg (maximum 500 mg/dose) every day.

  • For the treatment of patients with Cystic fibrosis to improve lung function and reduce the frequency of exacerbations:

  • Children older than 6 years and Adolescents:

    • 18 - 35.9 kg:

      • 3 times weekly, 250 mg taken orally (Monday, Wednesday, Friday)

    • More than 36 kgs:

      • 3 times weekly, 500 mg taken orally (Monday, Wednesday, Friday)

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Dose in the treatment of infectious Diarrhea:

• Campylobacter:

  • 10 mg/kg orally once a day for 3 days to a maximum dose of 500 mg/dose

• Shigellosis:

  • AAP Recommendation:

    • A maximum dose of 12 mg/kg/day orally given once on day 1 is followed by 4 doses of 6 mg/kg/day given orally for 4 days with a maximum dose of 250 mg/dose.

  • Alternate dosing:

    • For three days, take 10 mg/kg orally once a day.
    • Up to 20 mg/kg/dose is recommended by WHO guidelines.

---

Use in the prophylaxis Endocarditis:

• 15 mg/kg/dose orally 30 - 60 minutes prior to the procedure to a maximum dose of 500 mg/dose.

---

Use in the treatment of uncomplicated gonococcal cervicitis, urethritis, and anorectal disease:

• Children less than 45 kgs:

  • 20 mg/kg orally as a single dose to a maximum dose of 1,000 mg/dose.

• Children older than 8 years and weighing more than 45 kgs:

  • 1,000 mg orally as a single dose.

---

Use in the treatment of Group A streptococcal tonsillopharyngitis:

• Manufacturer's labeling and AHA recommendations:

  • 2 mg/kg/dose orally once a day for 5 days to a maximum dose of 500 mg/dose.

• Alternate dosing (IDSA recommendations):

  • On day 1, administer 12 mg/kg orally up to a maximum of 500 mg/dose; the following day, administer 6 mg/kg orally up to a maximum of 250 mg/dose once daily for four days.

• Three-day regimen:

  • 20 mg/kg/dose orally once a day for 3 days to a maximum dose of 1,000 mg/dose.

---

Use for the prophylaxis of Meningococcal disease in high-risk contacts:

• 10 mg/kg orally as a single dose to a maximum dose of 500 mg/dose

---

Dose in the treatment of Mycobacterium avium complex (MAC) infection in HIV-positive patients:

• Infants and Children:

  • Treatment of MAC infection:

    • Ethambutol (with or without rifabutin) at a maximum dose of 500 mg/dose in combination with 10–12 mg/kg once day for at least a year.

  • Primary prevention of first episode:

    • The recommended dosage is 20 mg/kg once a week, with a dose cap of 1,200 mg/dose, or 5 mg/kg once a day, with a dose cap of 250 mg/dose.

  • Secondary prevention of recurring episodes:

    • Ethambutol (with or without rifabutin) at a maximum dose of 250 mg/dose in conjunction with 5 mg/kg once day.
• Adolescents:

  • Treatment:

    • 500 to 600 mg taken orally once per day together with ethambutol

  • Primary prophylaxis:

    • 1,200 mg once per week or

    • as an alternative, 600 mg twice weekly

  • Secondary prophylaxis:

    • 500 - 600 mg once a day in combination with ethambutol

---

Use in the treatment of acute Otitis media (Should not be given routinely because of resistance):

• Infants older than 6 months, Children, and Adolescents:

  • Single-dose regimen:

    • 30 mg/kg orally as a single dose to a maximum dose of 1,500 mg/dose.

  • Three-day regimen:

    • 500 mg/dose maximum, given orally once daily for three days at 10 mg/kg.

  • Five-day regimen:

    • 10 mg/kg, orally, once on day 1 up to a maximum dose of 500 mg/dose, then 5 mg/kg, orally, once daily for 4 days up to a maximum dose of 250 mg/dose.

---

Dose in the treatment of peritonitis in patients on peritoneal dialysis and for the prophylaxis for patients receiving peritoneal dialysis prior to a dental procedure:

• 15 mg/kg orally administered 30 - 60 minutes prior to a dental procedure to a maximum dose of 500 mg/dose.

---

Dose in the treatment of Pertussis:

• Infants 1 - 5 months:

  • 10 mg/kg once daily for five days.

• Infants older than 6 months, Children, and Adolescents:

  • 10 mg/kg once on day 1 with a 500 mg maximum dose per dose, then 5 mg/kg once per day for 4 days with a 250 mg maximum dose per dose.

---

Dose in the treatment of community-acquired Pneumonia (excluding mycoplasma pneumonia and chlamydial infections):

• Immediate release:

  • Infants older than 3 months, Children, and Adolescents:

    • 10 mg/kg, orally, once on day 1 up to a maximum dose of 500 mg/dose, then 5 mg/kg, orally, once daily for 4 days up to a maximum dose of 250 mg/dose.

• Extended-release oral suspension:

  • Infants older than 6 months, Children, and Adolescents:

    • 60 mg/kg orally as a single dose to a maximum dose of 2,000 mg/dose

  • Infants older than 3 months, Children, and Adolescents:

    • 10 mg/kg intravenously given once daily for no less than two days.
    • To finish a 5-day course of therapy, oral medication with a single dose of 5 mg/kg (maximum dose of 500 mg/dose) per day should be given.

---

Use in the treatment of community-acquired pneumonia due to mycoplasma pneumonia or chlamydial infection:

• Infants older than 3 months, Children, and Adolescents:

  • Mild infection or step-down therapy:

    • 5 mg/kg once daily for 4 days with a maximum dose of 250 mg/dose, starting with 10 mg/kg orally once on day 1 up to a maximum dose of 500 mg/dose.

  • Severe infection:

    • 500 mg is the maximum dose per dose of 10 mg/kg intravenous given once daily for at least two days.
    • To finish the course, switch to the oral method and administer a single dose of 5 mg/kg (up to 250 mg/dose) each day.

---

Dose in the treatment of bacterial Rhinosinusitis:

• Infants older than 6 months, Children, and Adolescents:
  • 10 mg/kg orally once a day for 3 days to a maximum dose of 500 mg/dose.

---

Dose in the prophylaxis of Sexual victimization:

• Children less than 45 kgs:

  • Cefixime or ceftriaxone in conjunction with a single dose of 20 mg/kg

• Children older than 45 kg and Adolescents:

  • 1,000 mg as a single dose in combination with cefixime or ceftriaxone

---

Dose in the treatment and prevention of Toxoplasmosis in HIV-positive patients:

• pyrimethamine and leucovorin together with 900–1,200 mg orally once daily for six weeks (or longer if an extensive disease or incomplete response at 6 weeks).

Pregnancy Risk Factor B

• However, Azithromycin can cross the placental boundary, but adverse fetal outcomes were not observed in animal studies.
• Several infections are advised to be treated during pregnancy, including:
  • Chlamydia
  • Gonococcal Infections
  • Mycobacterium avium complex (MAC)

Use of azithromycin while breastfeeding

• It is excreted from breast milk.
• Maternal macrolides can cause nausea, vomiting, diarrhea, rash and somnolence in nursing infants.
• Breastmilk can also contain antibiotics that may cause non-dose-related changes in the bowel flora. Monitor infants for signs and symptoms of gastrointestinal problems.
• The data are inconsistent, but infantile hypertrophic Pyloric Steenisis has been linked to maternal use of macrolides during the first two weeks.
• It is recommended to be used in breastfeeding women according to the manufacturer's instructions.
• It is advised for the treatment of granuloma inguinale and as a substitute medication for the treatment of lymphogranuloma venereum in nursing mothers, according to the CDC's Sexually Transmitted Diseases Treatment Guidelines.

Azithromycin Dose in Renal Disease:

• Adjustment in the dose has not been provided by the manufacturer in patients with renal disease.
• Patients with a CrCl of less than 10 ml/minute should be advised the drug with caution.

Azithromycin Dose in Liver Disease:

• Adjustment in the dose has not been provided by the manufacturer in patients with liver disease.
• However, because it is hepatically removed, people with liver problems should use it cautiously.
• Patients who develop symptoms of hepatic impairment should immediately discontinue therapy.

Common Side Effects of Azithromycin Include:

• Gastrointestinal:

  • Loose stools
  • Vomiting
  • Diarrhea

Less Common Side Effects of Azithromycin Include:

• Cardiovascular:

  • Chest Pain
  • Palpitations

• Central Nervous System:

  • Dizziness
  • Drowsiness
  • Fatigue
  • Headache
  • Vertigo

• Dermatologic:

  • Skin Rash
  • Dermatitis
  • Pruritus
  • Skin Photosensitivity

• Endocrine & Metabolic:

  • Increased Lactate Dehydrogenase
  • Increased Gammaglutamyl Transferase
  • Increased Serum Potassium
  • Decreased Serum Bicarbonate
  • Decreased Serum Glucose

• Gastrointestinal:

  • Abdominal Pain
  • Anorexia
  • Dysgeusia
  • Dyspepsia
  • Flatulence
  • Gastritis
  • Melena
  • Mucositis
  • Oral Candidiasis

• Genitourinary:

  • Vaginitis
  • Genital Candidiasis

• Hematologic & Oncologic:

  • Decrease In Absolute Neutrophil Count
  • Decreased Hematocrit
  • Decreased Hemoglobin
  • Increased Neutrophils
  • Thrombocythemia
  • Change In Neutrophil Count
  • Eosinophilia
  • Lymphocytopenia

• Hepatic:

  • Increased Serum ALT
  • Increased Serum AST
  • Increased Serum Bilirubin
  • Cholestatic Jaundice

• Local:

  • Pain At Injection Site
  • Local Inflammation

• Neuromuscular & Skeletal:

  • Increased Creatine Phosphokinase

• Renal:

  • Increased Serum Creatinine
  • Increased Blood Urea Nitrogen
  • Nephritis

• Respiratory:

  • Bronchospasm

• Miscellaneous:

  • Fever

Contraindication to Azithromycin Include:

• Azithromycin, erythromycin, other macrolide antibiotics, and any formulation component allergy reactions
• histories of cholestasis and hepatic impairment after earlier azithromycin treatment.

Warnings and Precautions

• Hypersensitivity reactions

  • Anaphylaxis, angioedema, Stevens-Johnson syndrome, toxic epidermal necrolysis, and drug reaction with eosinophilia and systemic symptoms (DRESS) are examples of allergic reactions that can occasionally be fatal.

• Modified cardiac conduction

  • Avoid Macrolides, especially erythromycin, in patients with QTc prolongation, ventricular arrhythmias, or torsades-de-pointes.
  • It should not be used in those with long QT intervals, congenital long QT syndrome, a history of torsades, bradyarrhythmias, or untreated hypomagnesemia or hypokalemia.

• Cardiac risk

  • Compared to amoxicillin or ciprofloxacin, azithromycin is linked to a greater risk of having a heart attack.

• Superinfection

  • Extended use of azithromycin for more than two months has been linked to fungal and bacterial superinfections, including Clostridium difficile.

• Gonorrhea, syphilis

  • Before initiating any treatment, it is important to perform appropriate culture and susceptibility testing.
  • This may be necessary because it can mask or delay symptoms such as syphilis or gonorrhea.

• Hepatic impairment

  • Preexisting liver disease, hepatic impairment, hepatic necrosis and hepatic failure should be avoided.
  • Patients with symptoms of liver disease such as nausea, vomiting and colic should stop taking medication immediately.

• Myasthenia gravis:

  • It can worsen myasthenia gravis symptoms.

• Renal impairment

  • Patients with kidney disease should be cautious with this drug, particularly if their GFR is less than 10ml/minute.

Monitoring Parameters:

• Monitor CBC with differential counts and Liver function tests.

How to administer Azithromycin?

• Intravenous administration:

  • It should not be injected as a bolus and should not be administered via the intramuscular route.
  • either over three hours (1 mg/ml infusion) or over one hour (2 mg/ml infusion). Not to be administered as an intravenous or intramuscular bolus.

• Oral administration:

  • Meals are not necessary for the immediate-release formulations to be taken.
  • Take the extended-release medications on an empty stomach (at least one hour before or two hours after a meal)

Mechanism of action of Azithromycin:

• It binds to the bacterial ribosomal 50s subunit and prevents mRNA translation.
• It interferes with the bacterial protein synthesis.

It is growing rapidly absorbed It is found in the gastrointestinal tract. It is widely distributed.

distributed In the tissues, including the skin, lungs and tonsils.

There is relatively little CSF penetration. Drug protein binding ranges from 7 to 51%. The liver then converts it into inactive molecules.

BioavailabilityThe extended-release formulation has a 28% to 43% concentration, while the immediate-release formulations have a 34% to 52% concentration.

Half-life elimination Zithromycin is effective in children for 54.5 hours, adults for 68-72 hours with the immediate-release formulation and 59 hours with the extended-release formulation.

Time to get there peak serum concentration It takes 2 - 3 hours to prepare the immediate-release formulation, while the extended-release formulation takes 3 - 5 hours.

It is excreted via the bile (via bile) as an unchanged drug

Azithromycin international brands:

• Ajustin
• Aratro
• Atizor
• ATM-200
• Aza-250
• Aza-500
• Azadose
• Azas
• Azath
• Azatril
• Azax
• Azbact
• Azce
• Azee
• Azeemycin
• Azenil
• Azent
• Azi-500
• Azibact
• Azibiot
• Azicine
• Azilide-250
• Azilide-500
• Azimac
• Azimacron
• Azimax
• Azimed
• Azin
• Azinobin
• Aziphar
• Aziraz
• Azirocin
• Azith
• Azithral
• Azithrin
• Azithro
• ACT Azithromycin
• AG-Azithromycin
• APO-Azithromycin
• APO-Azithromycin Z
• DOM-Azithromycin
• GD-Azithromycin
• GEN-Azithromycin
• JAMP-Azithromycin
• Mar-Azithromycin
• MYLAN-Azithromycin
• Novo-Azithromycin Pediatric
• PHL-Azithromycin
• PMS-Azithromycin
• PRO-Azithromycin
• RATIO-Azithromycin
• RIntravenousA-Azithromycin
• SANDOZ Azithromycin
• TEVA-Azithromycin
• Zithromax
• Zmax SR
• Azithrom
• Azitops
• Azitrex
• Azitrix
• Azitrocin
• Azitromax
• Azitrox
• Aziwok
• Azm
• Azo-500
• Azomycin
• Azomyne
• Azox
• Azro
• Azromax
• Aztrin
• Azyth
• Azytro
• Binozyt
• Clindal AZ
• Cronopen
• Decantin
• Enaz DS
• Floctil
• Glazi
• Imexa
• Inedol
• Jazit
• Koptin
• Macromax
• Macrozit
• Maxmor
• Mazit
• Meithromax
• Neazi
• OD Mac
• Odazyth
• Onzet
• Ormax
• Shepherd
• Thromaxin
• Tromix
• Ultreon
• Unizithrin
• Uzet
• Vinzam
• Weihong
• Wiltrozin
• Xithrone
• Zaha-250
• Zaret
• Zarom
• Zedbac
• Zedd
• Zemax
• Zenith
• Zeto
• Zetron
• Zicho
• Zimac
• Zimax
• Zimericina
• Zinfect
• Zistic
• Zithromac SR
• Zithromax
• Zithromax Intravenous
• Zithrotel
• Zithrox
• Zitrim
• Zitrocin
• Zitrolin
• Zitromax
• Zmax
• Zmax One Dose
• Zocin
• Zomax
• Zymed
• Zynomax
• Zyomycin
• Zythrocin

Azithromycin Brands in Pakistan

Azithromycin [Inj 500 Mg]
Acro	S.J. & G. Fazul Ellahie (Pvt) Ltd.
Mezomed	Mediate Pharmaceuticals (Pvt) Ltd
Nintramuscularoconil	Vision 2000 Plus
Zeecin	Wilshire Laboratories (Pvt) Ltd.
Zezot	Bosch Pharmaceuticals (Pvt) Ltd.
Zithrax	Biocare Pharmaceutical

Azithromycin [Inf 500 Mg]
Azintramuscularycin	Mediceena Pharma (Pvt) Ltd.

Azithromycin [Susp 50 Mg/5ml]
Rasmic	Rasco Pharma

Azithromycin [Susp 100 Mg/5ml]
Megazith	Crest Pharmaceuticals

Azithromycin [Susp 125 Mg/5ml]
Reclocin	Zinta Pharmaceuticals Industries

Azithromycin [Susp 200 Mg/5ml]
Acasia	Nexpharm
Acro	S.J. & G. Fazul Ellahie (Pvt) Ltd.
Alide	Pharmix Laboratories (Printravenousate) Lintramuscularited.
Artiwin	Wns Field Pharmaceuticals
Athofix	The Schazoo Laboratories Ltd.
Axalina	Alina Combine Pharmaceuticals (Pvt) Ltd.
Azicure	Semos Pharmaceuticals (Pvt) Ltd.
Azidose	Shaheen Pharmaceuticals
Azilite	Webros Pharmaceuticals
Azintramuscularycin	Mediceena Pharma (Pvt) Ltd.
Azirolide	P.D.H. Pharmaceuticals (Pvt) Ltd.
Azirom	Macquins International
Aziromycin	Nawan Laboratories (Pvt) Ltd.
Azit	Raazee Theraputics (Pvt) Ltd.
Azita	Tg Pharma
Azitek Suspension	Hygeia Pharmaceuticals
Azithro	Goodman Laboratories
Azithrocin	Bex Pharma (Pvt) Ltd.
Azithrosaf	Saaaf Pharmaceuticals
Azintravenousid	Multinational Buisness Link
Azo	Ethical Laboratories (Pvt) Ltd.
Azobrain	Winbrain Research Laboratories
Azocam	Chas. A. Mendoza
Azocin	Trison Research Laboratories (Pvt) Ltd
Azogil	Glitz Pharma
Azolib	Stalwart Pharmaceuticals (Pvt) Ltd
Azom	Lotus Pharmaceuticals (Pvt) Ltd
Azomax	Novartis Pharma (Pak) Ltd
Azomax	Novartis Pharma (Pak) Ltd
Azomer	Miracle Pharmaceuticals(Pvt) Ltd
Azores	Saydon Pharmaceutical Industries (Pvt) Ltd.
Azorox	Caylex Pharmaceuticals (Pvt) Ltd.
Azotine	Nintramuscularrall Laboratories
Azoxin	Flow Pharmaceuticals (Pvt) Ltd.
Azpar	Zesion Pharmaceutical (Pvt) Ltd
Azrocin	Obsons Pharmaceuticals
Azrowin	Wns Field Pharmaceuticals
Bactizith	W.Woodward Pakistan (Pvt) Ltd.
Biozit	Leama Chemi Pharma (Pvt.) Ltd.
Chemzee	Ideal Pharmaceutical Industries
Exonex	Pharma Health Pakistan (Pvt) Ltd
Ezill	Dr. Raza Pharma (Printravenousate) Lintramuscularited
Ezonex	Mass Pharma (Printravenousate) Lintramuscularited
Fazi	Farm Aid Group Pak Ltd.
Fenzy	Noa Hemis Pharmaceuticals
Geozit	Geofman Pharmaceuticals
Hyzitek	Hygeia Pharmaceuticals
Kraze	Medicaids Pakistan (Pvt) Ltd.
Legzith	Legacy Pharmaceuticals
Maczin	Mcolson Research Laboratories
Mezomed	Mediate Pharmaceuticals (Pvt) Ltd
Mynex	Nexus Pharma (Pvt) Ltd
Od-3	Adamjee Pharmaceuticals (Pvt) Ltd.
Orzit	Seatle Pharma Pakistan (Pvt) Ltd.
Plazo	Platinum Pharmaceuticals (Pvt.) Ltd.
Ramoff	Valor Pharmaceuticals
Rasthro	Rasco Pharma
Resque	Standpharm Pakistan (Pvt) Ltd.
Romy	Fozan Pharmaceuticals Industriers (Pvt) Ltd
Romycin	Surge Laboratories (Pvt) Ltd.
Rothin	Rakaposhi Pharmaceutical (Pvt) Ltd.
Servaz	Kaizen Pharmaceuticals Pvt Ltd.
Spell	Tagma Pharma (Pvt) Ltd.
Syzcin	Sayyed Pharmaceuticals
Throb	Bio Labs (Pvt) Ltd.
Welromycin	Welwrd Pharmaceuticals
Xabest	Everest Pharmaceuticals
Z-Mac	Opal Laboratories (Pvt) Ltd.
Zatrocin	Pearl Pharmaceuticals
Zeecin	Wilshire Laboratories (Pvt) Ltd.
Zemark	Unintramuscularark Pharmaceuticals
Zetro	Getz Pharma Pakistan (Pvt) Ltd.
Zewin	Orta Labs. (Pvt) Ltd.
Zezot	Bosch Pharmaceuticals (Pvt) Ltd.
Zicure	Medicaids Pakistan (Pvt) Ltd.
Zirocin	Trigon Pharmaceuticals Pakistan (Pvt) Ltd.
Zitamax (Zithromax)	Pfizer Laboratories Ltd.
Zithin Suspension	Panacea Pharmaceuticals
Zithosintramuscular	Sintramuscularz Pharmaceuticals
Zithrofame	Lloyds Pharmaceuticals
Zithromed	Medicraft Pharmaceuticals (Pvt) Ltd.
Zithrovel	Well & Well Pharma (Pvt) Ltd
Zomax	Helix Pharma (Printravenousate) Lintramuscularited
Zomax	Helix Pharma (Printravenousate) Lintramuscularited
Zorix	Lahore Chemical & Pharmaceutical Works (Pvt) Ltd
Zygrel	Searle Pakistan (Pvt.) Ltd.
Zyson Suspension	British Pharmaceuticals Ltd

Azithromycin [Susp 250 Mg/5ml]
Azicin	Acme Laboratories Pakistan (Pvt) Ltd.
Azocure	Orta Labs. (Pvt) Ltd.
Azorox	Jawa Pharmaceuticals(Pvt) Ltd.

Azithromycin [Tabs 250 Mg]
Aptintramuscularac	Aptcure Printravenousate Lintramuscularited
Atizor	Macter International (Pvt) Ltd.
Austa-Z	Bloom Pharmaceuticals (Pvt) Ltd.
Azelide	Hygeia Pharmaceuticals
Azi-Once Tablet	Crest Pharmaceuticals
Azia	Medera Pharmaceuticals (Pvt) Ltd.
Azic	Nabiqasintramuscular Industries (Pvt) Ltd.
Azintramuscularal	Shazals Pharmaceuticals
Azintramuscularycin	Mediceena Pharma (Pvt) Ltd.
Aziomak	Makson Pharmaceuticals
Aziotic	Everest Pharmaceuticals
Azir	Innvotek Pharmaceuticals
Azirol	Harmann Pharmaceutical Laboratories (Pvt) Ltd.
Azirom	Macquins International
Azisia	Ambrosia Pharmaceuticals
Azitab	Cherwel Pharmaceuticals (Pvt) Ltd
Azitab	Cherwel Pharmaceuticals (Pvt) Ltd
Azitek Tablet	Hygeia Pharmaceuticals
Azithro	Goodman Laboratories
Azithrosaf	Saaaf Pharmaceuticals
Azintravenouser	Florence Farmaceuticals (Pvt) Ltd
Aziwin	Jinnah Pharmaceuticals
Azizox	Alliance Pharmaceuticals (Pvt) Ltd.
Azobit	Wns Field Pharmaceuticals
Azogil	Glitz Pharma
Azoheintramuscular	Pakheintramuscular Internanational Pharma
Azolintravenouse	Olintravenouse Laboratories
Azopik	Wise Pharmaceuticals (Pvt) Ltd
Azotek	Saffron Pharmaceutical Company
Azure	Fynk Pharmaceuticals
Biozith	Bio Labs (Pvt) Ltd.
Blitz	Biogen Pharma
Caramycin	Caraway Pharmaceuticals
Conbac	Convell Laboratories
Delide	Dermagen Pharma Pakistan (Pvt) Lintramuscularited
Ery-Pack	Lowitt Pharmaceuticals (Pvt) Ltd
Exthro	Indus Pharma (Pvt) Ltd.
Ezmin	Honig Pharmaceuticals Laboratories
Fenzy	Noa Hemis Pharmaceuticals
Geozit	Geofman Pharmaceuticals
Grazeth	Gray`S Pharmaceuticals
Hyzitek	Hygeia Pharmaceuticals
Hyzitek	Hygeia Pharmaceuticals
Irzazitho	Irza Pharma (Pvt) Ltd.
Kinra	Tabros Pharma
Maczin	Mcolson Research Laboratories
Maksin	Trison Research Laboratories (Pvt) Ltd
Megatab	Robins Pharmaceutical Industries
Mezith	Qintar Pharmacuticals
Mynex	Nexus Pharma (Pvt) Ltd
Myzi	Pharmacare Laboratories (Pvt) Ltd.
Myzitro	Miracle Pharmaceuticals(Pvt) Ltd
Ottocin	Ottoman Pharma
Plazo	Platinum Pharmaceuticals (Pvt.) Ltd.
Rasmic	Rasco Pharma
Rasmic	Rasco Pharma
Rasmic	Rasco Pharma
Rasmic Forte	Rasco Pharma
Rasthro	Rasco Pharma
Reclocin	Zinta Pharmaceuticals Industries
Servaz	Kaizen Pharmaceuticals Pvt Ltd.
Silina	Fassgen Pharmaceuticals
Spell	Tagma Pharma (Pvt) Ltd.
Thron	Linear Pharma
Winzith	Pharmevo (Pvt) Ltd.
Zatrox	Usawa Pharmaceuticals
Zee	Danas Pharmaceuticals (Pvt) Ltd
Zeecin	Wilshire Laboratories (Pvt) Ltd.
Zeerox	Spl Pharmaceuticals (Pvt) Ltd
Zefed	Fedro Pharmaceutical
Zepack	Pearl Pharmaceuticals
Zesty	Innvotek Pharmaceuticals
Zetro	Getz Pharma Pakistan (Pvt) Ltd.
Zintramuscular	Genome Pharmaceuticals (Pvt) Ltd
Zintramuscular	Genome Pharmaceuticals (Pvt) Ltd
Zithin Tablet	Wisdom Therapeutics
Zithrosafe	Helicon Pharmaceutek Pakistan (Pvt) Ltd.
Zithrovel	Well & Well Pharma (Pvt) Ltd
Zithrowan	Swan Pharmaceuticals(Pvt) Ltd
Zitrex	Genome Pharmaceuticals (Pvt) Ltd
Zitrex	Genome Pharmaceuticals (Pvt) Ltd
Zitro	Glitz Pharma
Zomysin	Alkemy Pharmaceutical Laboratories (Printravenousate) Ltd.
Zycin	Everest Pharmaceuticals

Azithromycin [Tabs 500 Mg]
Atizor	Macter International (Pvt) Ltd.
Azintramuscularic	Medera Pharmaceuticals (Pvt) Ltd.
Azithrosaf	Saaaf Pharmaceuticals
Azintravenouser	Florence Farmaceuticals (Pvt) Ltd
Azogil	Glitz Pharma
Azomax	Novartis Pharma (Pak) Ltd
Azomexin	Paramount Pharmaceuticals
Azopik	Wise Pharmaceuticals (Pvt) Ltd
Azotek	Saffron Pharmaceutical Company
Azure	Fynk Pharmaceuticals
Biozith	Bio Labs (Pvt) Ltd.
Ery-Pack	Lowitt Pharmaceuticals (Pvt) Ltd
Fenzy	Noa Hemis Pharmaceuticals
Grazeth	Gray`S Pharmaceuticals
Medi-Biotic	Medicon Pharmaceuticals Industries (Pvt) Ltd
Mynex	Nexus Pharma (Pvt) Ltd
Myzitro	Miracle Pharmaceuticals(Pvt) Ltd
Ottocin	Ottoman Pharma
Reclocin	Zinta Pharmaceuticals Industries
Servaz	Kaizen Pharmaceuticals Pvt Ltd.
Winzith	Pharmevo (Pvt) Ltd.
Zee	Danas Pharmaceuticals (Pvt) Ltd
Zeecin	Wilshire Laboratories (Pvt) Ltd.
Zefed	Fedro Pharmaceutical
Zetro	Getz Pharma Pakistan (Pvt) Ltd.
Zezot	Bosch Pharmaceuticals (Pvt) Ltd.
Zithrovel	Well & Well Pharma (Pvt) Ltd
Zithrowan	Swan Pharmaceuticals(Pvt) Ltd
Zitocin	Genera Pharmaceuticals
Zomax	Helix Pharma (Printravenousate) Lintramuscularited
Zycin	Everest Pharmaceuticals

Azithromycin [Caps 250 Mg]
Acasia	Nexpharm
Acro	S.J. & G. Fazul Ellahie (Pvt) Ltd.
Akzith	Akson Pharmaceuticals (Pvt) Ltd.
Alide	Pharmix Laboratories (Printravenousate) Lintramuscularited.
Arcin	Linear Pharma
Athofix	The Schazoo Laboratories Ltd.
Azelide	Hygeia Pharmaceuticals
Azera	Medera Pharmaceuticals (Pvt) Ltd.
Azi-Once Capsule	Rotex Medica Pakistan (Pvt) Ltd
Azibect	Bryon Pharmaceuticals (Pvt) Ltd.
Azibect	Bryon Pharmaceuticals (Pvt) Ltd.
Azicin	Acme Laboratories Pakistan (Pvt) Ltd.
Azicure	Semos Pharmaceuticals (Pvt) Ltd.
Azidose	Shaheen Pharmaceuticals
Azigood	Goodman Laboratories
Azilite	Webros Pharmaceuticals
Azirolide	P.D.H. Pharmaceuticals (Pvt) Ltd.
Aziromycin	Nawan Laboratories (Pvt) Ltd.
Azit	Raazee Theraputics (Pvt) Ltd.
Azithadvan	Advanced Pharmaceuticals
Azithrocid	Unintravenousersal Enterprises
Azithrocin	Bex Pharma (Pvt) Ltd.
Azithromycin	Unipharma (Pvt) Ltd.
Azithrosaf	Saaaf Pharmaceuticals
Azithsun	Hisun Pharmaceuticals
Azitral	Nova Med Pharmaceuticals
Azix	Prays Pharmaceuticals
Azizen	Medizan Labs (Pvt) Ltd
Azo	Ethical Laboratories (Pvt) Ltd.
Azocure	Orta Labs. (Pvt) Ltd.
Azofas	Fassgen Pharmaceuticals
Azogen	Rogen Pharmaceuticals
Azolib	Stalwart Pharmaceuticals (Pvt) Ltd
Azom	Lotus Pharmaceuticals (Pvt) Ltd
Azomax	Novartis Pharma (Pak) Ltd
Azomed	Medera Pharmaceuticals (Pvt) Ltd.
Azomer	Miracle Pharmaceuticals(Pvt) Ltd
Azomin	Eg Pharmaceuticals
Azomite	Ambrosia Pharmaceuticals
Azomite	Ambrosia Pharmaceuticals
Azomycin	Pulse Pharmaceuticals
Azores	Saydon Pharmaceutical Industries (Pvt) Ltd.
Azorox	Caylex Pharmaceuticals (Pvt) Ltd.
Azotag	Biorex Pharmaceuticals
Azotine	Nintramuscularrall Laboratories
Azowin	Wise Pharmaceuticals (Pvt) Ltd
Azoxin	Flow Pharmaceuticals (Pvt) Ltd.
Azpar	Zesion Pharmaceutical (Pvt) Ltd
Azrocin	Obsons Pharmaceuticals
Azrowin	Wns Field Pharmaceuticals
Aztrix	Medisure Laboratories Pakistan (Pvt.) Ltd.
Azza	Genome Pharmaceuticals (Pvt) Ltd
Bactizith	W.Woodward Pakistan (Pvt) Ltd.
Carown	Crown Pharmaceuticals
Cinzit	Shrooq Pharmaceuticals
Clozip	Medisynth Pharmaceuticals
E-Thro	Olintravenouse Pharmaceuticals
Enzoxen	English Pharmaceuticals Industries
Ezill	Dr. Raza Pharma (Printravenousate) Lintramuscularited
Ezintramuscularax	Medipak Lintramuscularited
Ezonex	Mass Pharma (Printravenousate) Lintramuscularited
Ezonex	Mass Pharma (Printravenousate) Lintramuscularited
Fazi	Farm Aid Group Pak Ltd.
Geozit	Geofman Pharmaceuticals
Hazid	Gray`S Pharmaceuticals
Hith	Kanel Pharmaceuticals
Hyzith	Axis Pharmaceuticals
Irzazitho	Irza Pharma (Pvt) Ltd.
Kraze	Medicaids Pakistan (Pvt) Ltd.
Macro-Z	Z-Jans Pharmaceutical (Pvt) Ltd.
Macrobac	Continental Chemical Company (Pvt) Ltd.
Macrocap	Aries Pharmaceuticals (Pvt) Ltd
Macromax	Mega Pharmaceuticals (Pvt) Ltd
Macromyd	Global Pharmaceuticals
Macromyd	Global Pharmaceuticals
Macropore	Alson Pharmaceuticals
Macrozith	Rock Pharmaceuticals
Maxibest	Max Pharmaceuticals
Mylide	Envoy Pharma
Od-3	Adamjee Pharmaceuticals (Pvt) Ltd.
Ram-Off	Valor Pharmaceuticals
Rayaz	Ray Pharma (Pvt) Ltd
Resque	Standpharm Pakistan (Pvt) Ltd.
Rezoxin	Reko Pharmacal (Pvt) Ltd.
Romy	Fozan Pharmaceuticals Industriers (Pvt) Ltd
Romycin	Surge Laboratories (Pvt) Ltd.
Rothin	Rakaposhi Pharmaceutical (Pvt) Ltd.
Sintramuscularzith	Sintramuscularz Pharmaceuticals
Syzcin	Sayyed Pharmaceuticals
Throb	Bio Labs (Pvt) Ltd.
Throb	Bio Labs (Pvt) Ltd.
Wazocin	Warafana Pharmaceuticals
Xabest	Everest Pharmaceuticals
Xiaxi	Evergreen Pharmaceuticals Pvt Lintramuscularited
Z-Mac	Opal Laboratories (Pvt) Ltd.
Zatrocin	Pearl Pharmaceuticals
Zemark	Unintramuscularark Pharmaceuticals
Zetro	Getz Pharma Pakistan (Pvt) Ltd.
Zewin	Orta Labs. (Pvt) Ltd.
Zezot	Bosch Pharmaceuticals (Pvt) Ltd.
Zicure	Medicaids Pakistan (Pvt) Ltd.
Ziromac	Zain Pharmaceutical
Ziromax	Polyfine Chempharma (Pvt) Ltd.
Zitamax (Zithromax)	Pfizer Laboratories Ltd.
Zith	Silver Oak Corporation.
Zithro	Unexo Labs (Pvt) Ltd.
Zithrofast	Medifine Laboratories
Zithromed	Medicraft Pharmaceuticals (Pvt) Ltd.
Zithrosan	Sante (Pvt) Lintramuscularited
Zithrovel	Well & Well Pharma (Pvt) Ltd
Ziton	Shawan Pharmaceuticals
Zomax	Helix Pharma (Printravenousate) Lintramuscularited
Zorix	Lahore Chemical & Pharmaceutical Works (Pvt) Ltd
Zotter	Highnoon Laboratories Ltd.
Zygrel	Searle Pakistan (Pvt.) Ltd.

Azithromycin [Caps 500 Mg]
Acro	S.J. & G. Fazul Ellahie (Pvt) Ltd.
Azicure	Semos Pharmaceuticals (Pvt) Ltd.
Azilite	Webros Pharmaceuticals
Azithadvan	Advanced Pharmaceuticals
Azithromycin	Unipharma (Pvt) Ltd.
Azocam	Chas. A. Mendoza
Azogen	Rogen Pharmaceuticals
Azomed	Medera Pharmaceuticals (Pvt) Ltd.
Azomer	Miracle Pharmaceuticals(Pvt) Ltd
Azotine	Nintramuscularrall Laboratories
Azotine	Nintramuscularrall Laboratories
Azoxin	Flow Pharmaceuticals (Pvt) Ltd.
Azrowin	Wns Field Pharmaceuticals
Bactizith	W.Woodward Pakistan (Pvt) Ltd.
Cararox	Caraway Pharmaceuticals
D-Kortes	Zephyr Pharmatec (Pvt) Ltd.
E-Thro	Olintravenouse Pharmaceuticals
Hazid	Gray`S Pharmaceuticals
Macrozith	Rock Pharmaceuticals
Megazith	Crest Pharmaceuticals
Od-3	Adamjee Pharmaceuticals (Pvt) Ltd.
Ram-Off	Valor Pharmaceuticals
Romy	Fozan Pharmaceuticals Industriers (Pvt) Ltd
Syzcin	Sayyed Pharmaceuticals
Zithromed	Medicraft Pharmaceuticals (Pvt) Ltd.
Zonacin	Akhai Pharmaceuticals.
Zygrel	Searle Pakistan (Pvt.) Ltd.