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The following safety information outlines important precautions and potential risks associated with the use of azithromycin (Zithromax). Please read carefully and consult your healthcare provider with any questions or concerns.

• Severe Allergic and Skin Reactions: Azithromycin (Zithromax) may cause severe allergic reactions, including life-threatening conditions such as facial swelling and anaphylaxis, signaled by throat closure. Alert your healthcare provider if you have a known allergy to antibiotics. Seek immediate medical attention if you experience symptoms like hives, skin rash, swelling of lips or tongue, or difficulty breathing. Rarely, azithromycin may lead to serious skin conditions such as Stevens-Johnson syndrome (SJS) and Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS). Discontinue use and seek medical help if you notice skin changes like rashes, blisters, redness, or peeling.

• Liver Damage: This medication can lead to severe liver issues, potentially resulting in liver failure. If you notice symptoms such as abdominal swelling, stomach pain, yellowing of the skin or eyes, unusual stools, nausea, vomiting, confusion, or dark urine, seek medical help immediately. Those with a history of liver problems are at higher risk.

• Heart Rhythm Problems (QT Prolongation): Azithromycin may affect heart rhythm, potentially causing life-threatening conditions like QT prolongation. This risk increases with factors such as abnormal electrolyte levels, heart rhythm disorders, or the use of other medications affecting heart rhythm (e.g., amiodarone). Contact emergency services if you experience symptoms like chest pounding, shortness of breath, chest pain, faintness, or lightheadedness. Individuals who are older, have low potassium or magnesium levels, kidney issues, or are on certain medications are at higher risk.

• Increased Risk of Heart-related Death: Some studies suggest a rare, short-term increased risk of heart-related death when taking azithromycin, especially within the first five days. Discuss the risks and benefits with your healthcare provider.

• Diarrhea from Clostridioides difficile Infection: Azithromycin may increase the risk of an infection from Clostridioides difficile, leading to severe diarrhea. Symptoms to watch for include rapid heart rate, foul-smelling diarrhea, fever, nausea, and frequent bowel movements. Seek immediate medical attention if these occur, as it may require testing and treatment for a C. diff infection.

• Worsening of Myasthenia Gravis: If you have myasthenia gravis, azithromycin may exacerbate symptoms like muscle weakness and breathing difficulties. Consult your healthcare provider about safer alternatives.

• Ineffectiveness against Syphilis: Azithromycin does not treat syphilis, and its use can complicate the diagnosis of this infection. If symptoms persist while treating a sexually transmitted infection, consult your healthcare provider for further testing.

Contraindications: Azithromycin (Zithromax) should not be used if you have a severe allergy to macrolide antibiotics or have experienced severe liver problems with prior use of this medication. Always consult your healthcare provider if these conditions apply to you.

When taking this medication, some individuals may experience mild side effects such as stomach upset, diarrhea, nausea, vomiting, or abdominal pain. These are common and typically not severe, but if they persist or worsen, it's advisable to consult your healthcare provider.

On occasion, more serious side effects can occur. These include hearing changes, such as decreased hearing or deafness, and eye issues like drooping eyelids or blurred vision. If you encounter difficulty speaking or swallowing, muscle weakness, or signs of liver problems—such as persistent nausea, unusual tiredness, severe abdominal pain, yellowing of the eyes or skin, or dark urine—seek medical advice promptly.

In very rare cases, this medication can lead to severe side effects that require immediate medical attention. These include a fast or irregular heartbeat, severe dizziness, or fainting. There is also a potential for a severe intestinal condition caused by C. difficile bacteria, which may manifest as persistent diarrhea, abdominal pain, or blood and mucus in the stool. Should these symptoms arise, avoid using anti-diarrhea or opioid products, and contact your doctor immediately.

Prolonged use of this medication may result in oral thrush or a new yeast infection. Be vigilant for signs such as white patches in the mouth or changes in vaginal discharge. Additionally, a serious allergic reaction is rare but possible, with symptoms like persistent fever, swelling of lymph nodes, rash, itching, swelling (particularly of the face, tongue, or throat), severe dizziness, or trouble breathing. If any of these occur, seek emergency medical help without delay.

Always be aware of potential side effects and contact your healthcare provider if you notice any new or concerning symptoms.