Azithral 500: Uses, How It Works, Side Effects

What is Azithral 500 used for?

Azithral 500 is used to treat bacterial infections caused by germs that azithromycin acts on. A doctor decides whether an infection is bacterial and whether azithromycin is the right choice.

• Chest infections caused by bacteria, such as community-acquired pneumonia and bacterial flare-ups of chronic bronchitis
• Bacterial sinus infections (sinusitis)
• Bacterial throat and tonsil infections, mainly when the usual first-choice antibiotics cannot be used
• Bacterial middle-ear infections (in children, usually as a liquid with a weight-based dose)
• Uncomplicated skin infections
• Some sexually transmitted infections, such as chlamydia infection of the urethra or cervix

How does Azithral 500 work?

Azithromycin attaches to the bacterial ribosome, the part of the cell that builds proteins, at its larger (50S) part. Without new proteins, the bacteria cannot grow or multiply, and the body's immune system clears the infection. It has no effect on viruses, which is why it does not help colds or flu.

What happens in your body after you take it

1. You swallow the tablet

   The tablet dissolves and azithromycin is absorbed from the gut. Only about a third of the dose (about 38%) reaches the blood. This is expected, and the dose allows for it.

2. It reaches the blood

   Blood levels peak about 2 to 3 hours after a dose. A fatty meal makes the peak a little higher but does not change the total amount absorbed.

3. It moves into the tissues

   Azithromycin quickly leaves the blood and builds up inside cells and tissues such as the lungs, tonsils, skin and cervix, where levels become much higher than in the blood. White blood cells also take it up, which helps carry it to infected areas.

4. It stops the bacteria

   Inside the bacteria, azithromycin binds to the ribosomes and blocks the making of new proteins. The bacteria stop growing and multiplying, and the immune system clears them.

5. It leaves slowly

   Azithromycin is released slowly from the tissues, so about half of it is still in the body nearly 3 days (about 68 hours) after a dose. This is why it is taken only once a day and why short courses are often enough.

6. The body clears it

   Most of the medicine leaves unchanged through the bile into the stool. Only a small part, about 6% of a dose, is passed in the urine over about a week.

How to take Azithral 500

Take Azithral 500 exactly as your doctor prescribes or as printed on the pack. The dose and the number of days depend on the infection being treated.

• It is usually taken once a day, at about the same time each day. Courses are often short, such as 3 days, but your doctor decides how long.
• Some labels say it can be taken with or without food; others advise 1 hour before or 2 hours after a meal. Follow the pack or your doctor's advice.
• Swallow the tablet whole with a glass of water.
• Do not take antacids for indigestion at the same time. A common gap is at least 1 hour before or 2 hours after the antacid.
• Take the full course your doctor prescribes, even if you feel better sooner. Stopping early can let the infection come back and helps bacteria become resistant.
• If you miss a dose, take it when you remember, unless it is nearly time for the next dose. Do not take two doses together.
• Tell your doctor if you are not feeling better after 3 days, or if you feel worse at any time.
• Do not keep leftover tablets for another illness or share them. Each infection needs a doctor's diagnosis.
• Children's doses are based on body weight and usually use the liquid form. This 500 mg tablet is not for young children unless a doctor prescribes it.

Azithral 500 dosage: how to take it

Side effects of Azithral 500

Most people take azithromycin without serious problems. Stomach upset is the most common side effect, and serious reactions are rare.

Uncommon or mild

• Diarrhoea
• Feeling sick (nausea) or being sick (vomiting)
• Stomach pain
• Loss of appetite
• Headache
• Feeling dizzy or tired
• Changes in taste

Azithral 500 side effects: common and serious

Who should be careful

Azithromycin is not suitable for everyone. Tell your doctor about your health conditions and other medicines before taking it.

• It treats bacterial infections only. It does not work for colds, flu, most coughs or other viral infections, and taking it when it is not needed adds to antibiotic resistance
• Past allergic reaction to azithromycin or other macrolide antibiotics such as erythromycin or clarithromycin
• Heart rhythm problems, a known long QT interval, a slow heart rate, heart failure, or low potassium or magnesium: azithromycin can rarely cause a dangerous irregular heartbeat, and older people may be more at risk
• Liver disease, or past liver problems after taking azithromycin
• Severe kidney disease
• Myasthenia gravis: azithromycin can make muscle weakness worse
• Past diarrhoea while taking antibiotics
• Pregnancy: azithromycin can be used when an infection needs treatment, but another antibiotic may suit some infections better, so your doctor will decide
• Breastfeeding: small amounts pass into breast milk. Watch the baby for diarrhoea, vomiting, rash or thrush, and tell your doctor if you notice them
• Thrush (a yeast infection of the mouth or vagina) can develop during or after a course of antibiotics; ask a pharmacist or doctor if it does
• Dizziness: do not drive or use machines if azithromycin makes you dizzy

Medicines and things that interact with Azithral 500

Some medicines can change how azithromycin works or add to its effect on heart rhythm. Tell your doctor or pharmacist about everything you take, including herbal remedies and supplements.

• Antacids containing aluminium or magnesium: do not take them at the same time as azithromycin
• Medicines that can affect heart rhythm, such as amiodarone, sotalol, citalopram, some antipsychotics, domperidone, hydroxychloroquine, chloroquine and some other antibiotics such as moxifloxacin: a higher risk of an irregular heartbeat
• Warfarin and other blood thinners such as dabigatran and edoxaban: their effect may increase, so your doctor may check your clotting more often
• Digoxin and colchicine: their levels in the blood may rise
• Ciclosporin and tacrolimus (medicines that suppress the immune system): levels may need checking
• Ergotamine or dihydroergotamine (migraine medicines): should not be taken with azithromycin
• Statins such as simvastatin and atorvastatin: tell your doctor about any unexplained muscle pain
• Nelfinavir (an HIV medicine): raises azithromycin levels, so your doctor may watch for liver and hearing side effects
• Herbal remedies and supplements: there is not enough information to say they are safe together, so tell your doctor or pharmacist

If someone takes too much

Storage

Store below 30°C in a dry place, protected from light and moisture, in the original strip, and out of the reach of children. Do not use after the expiry date.

Regulatory status in India

Approved for sale in India. Single-ingredient azithromycin is not on the CDSCO list of banned medicines. Several fixed-dose combinations that pair azithromycin with other ingredients are prohibited, for example azithromycin with cefixime, with ofloxacin, with levofloxacin or with ambroxol (September 2018), and azithromycin with adapalene (August 2024). Azithral 500 contains azithromycin only.

Other brands with the same medicine

Other brands with the same active ingredient include Azee 500 and Zathrin 500. Generic azithromycin 500 mg tablets are also available, including at Pradhan Mantri Bhartiya Janaushadhi Kendras. They all contain azithromycin and work the same way. Check the label for the strength, and do not switch brands or strengths without asking your doctor or pharmacist.

Other strengths and forms

Azithral 500 is the 500 mg tablet. Other Azithral products have different strengths or forms, so check the strength printed on the pack of the one you have.

Common questions