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| __NOTOC__ | | __NOTOC__ |
| {{Azithromycin}} | | {{Azithromycin (ophthalmic)}} |
| {{CMG}} | | {{CMG}}; {{AE}} {{SS}} |
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| ==Adverse Reactions== | | ==Adverse Reactions== |
| In clinical trials of intravenous azithromycin for community-acquired pneumonia, in which 2–5 I.V. doses were given, most of the reported side effects were mild to moderate in severity and were reversible upon discontinuation of the drug. The majority of patients in these trials had one or more co-morbid diseases and were receiving concomitant medications. Approximately 1.2% of the patients discontinued intravenous ZITHROMAX therapy, and a total of 2.4% discontinued azithromycin therapy by either the intravenous or oral route because of clinical or laboratory side effects.
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| In clinical trials conducted in patients with pelvic inflammatory disease, in which 1–2 I.V. doses were given, 2% of women who received monotherapy with azithromycin and 4% who received azithromycin plus metronidazole discontinued therapy due to clinical side effects.
| | Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in one clinical trial of a drug cannot be directly compared with the rates in the clinical trials of the same or another drug and may not reflect the rates observed in practice. |
| | | The data described below reflect exposure to AzaSite in 698 patients. The population was between 1 and 87 years old with clinical signs and symptoms of bacterial conjunctivitis. The most frequently reported ocular adverse reaction reported in patients receiving AzaSite was eye irritation. This reaction occurred in approximately 1-2% of patients. Other adverse reactions associated with the use of AzaSite were reported in less than 1% of patients and included ocular reactions (blurred vision, burning, stinging and irritation upon instillation, contact dermatitis, corneal erosion, dry eye, eye pain, itching, ocular discharge, punctate keratitis, visual acuity reduction) and non-ocular reactions (dysgeusia, facial swelling, hives, nasal congestion, periocular swelling, [[rash]], [[sinusitis]], [[urticaria]]).<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = |title = AZASITE (AZITHROMYCIN) SOLUTION [INSPIRE PHARMACEUTICALS, INC.] | url =http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=5dc0f75a-1e14-469f-af4f-c668a32f2328 |publisher = | date = | accessdate = }}</ref> |
| Clinical side effects leading to discontinuations from these studies were most commonly gastrointestinal (abdominal pain, nausea, vomiting, diarrhea), and rashes; laboratory side effects leading to discontinuation were increases in transaminase levels and/or alkaline phosphatase levels.
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| ===Clinical===
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| Overall, the most common side effects associated with treatment in adult patients who received I.V./P.O. ZITHROMAX in studies of community-acquired pneumonia were related to the gastrointestinal system with diarrhea/loose stools (4.3%), nausea (3.9%), abdominal pain (2.7%), and vomiting (1.4%) being the most frequently reported. Approximately 12% of patients experienced a side effect related to the intravenous infusion; most common were pain at the injection site (6.5%) and local inflammation (3.1%).
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| The most common side effects associated with treatment in adult women who received I.V./P.O. ZITHROMAX in studies of pelvic inflammatory disease were related to the gastrointestinal system. Diarrhea (8.5%) and nausea (6.6%) were most commonly reported, followed by vaginitis (2.8%), abdominal pain (1.9%), anorexia (1.9%), rash and pruritus (1.9%). When azithromycin was co-administered with metronidazole in these studies, a higher proportion of women experienced side effects of nausea (10.3%), abdominal pain (3.7%), vomiting (2.8%), application site reaction, stomatitis, dizziness, or dyspnea (all at 1.9%).
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| No other side effects occurred in patients on the multiple dose I.V./P.O. regimen of ZITHROMAX in these studies with a frequency greater than 1%.
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| Side effects that occurred with a frequency of 1% or less included the following:
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| '''Gastrointestinal''': [[dyspepsia]], [[flatulence]], [[mucositis]], [[oral moniliasis]], and [[gastritis]].<BR>
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| '''Nervous System''': [[headache]], [[somnolence]].<BR>
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| '''Allergic''': [[bronchospasm]].<BR>
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| '''Special Senses''': taste perversion.<BR>
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| ===Post-Marketing Experience===
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| Adverse events reported with azithromycin during the post-marketing period in adult and/or pediatric patients for which a causal relationship may not be established include:
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| '''Allergic''': [[Arthralgia]], [[edema]], [[urticaria]] and [[angioedema]].<BR>
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| '''Cardiovascular''': [[Arrhythmias]] including [[ventricular tachycardia]] and [[hypotension]]. There have been rare reports of QT prolongation and torsades de pointes.<BR>
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| '''Gastrointestinal''': [[Anorexia]], [[constipation]], [[dyspepsia]], [[flatulence]], [[vomiting]]/[[diarrhea]] rarely resulting in dehydration, [[pseudomembranous colitis]], [[pancreatitis]], [[oral candidiasis]], [[pyloric stenosis]], and rare reports of tongue discoloration.<BR>
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| '''General''': [[Asthenia]], [[paresthesia]], [[fatigue]], [[malaise]] and [[anaphylaxis]] (rarely fatal).<BR>
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| '''Genitourinary''': [[Interstitial nephritis]] and [[acute renal failure]] and [[vaginitis]].<BR>
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| '''Hematopoietic''': [[Thrombocytopenia]].<BR>
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| '''Liver/Biliary''': Adverse reactions related to [[hepatic dysfunction]] have been reported in postmarketing experience with azithromycin. (See WARNINGS, Hepatotoxicity.)<BR>
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| '''Nervous System''': [[Convulsions]], [[dizziness]]/[[vertigo]], [[headache]], [[somnolence]], [[hyperactivity]], [[nervousness]], [[agitation]] and [[syncope]].<BR>
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| '''Psychiatric''': Aggressive reaction and [[anxiety]].<BR>
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| '''Skin/Appendages''': [[Pruritus]], rarely serious skin reactions including, erythema multiforme, [[Stevens-Johnson syndrome]] and [[toxic epidermal necrolysis]].<BR>
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| '''Special Senses''': Hearing disturbances including [[hearing loss]], [[deafness]] and/or [[tinnitus]] and reports of taste/smell perversion and/or loss.<BR>
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| ===Laboratory Abnormalities=== | |
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| Significant abnormalities (irrespective of drug relationship) occurring during the clinical trials were reported as follows:
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| with an incidence of 4–6%, elevated ALT (SGPT), AST (SGOT), creatinine
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| with an incidence of 1–3%, elevated LDH, bilirubin
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| with an incidence of less than 1%, leukopenia, neutropenia, decreased platelet count, and elevated serum alkaline phosphatase
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| When follow-up was provided, changes in laboratory tests appeared to be reversible.
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| In multiple-dose clinical trials involving more than 750 patients treated with ZITHROMAX (I.V./P.O.), less than 2% of patients discontinued azithromycin therapy because of treatment-related liver enzyme abnormalities.<ref>{{Cite web | last = | first =|title = http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/050710s039,050711s036,050784s023lbl.pdf | url =http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/050710s039,050711s036,050784s023lbl.pdf | publisher = |date = | accessdate = }}</ref>
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| ==References== | | ==References== |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sheng Shi, M.D. [2]
Adverse Reactions
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in one clinical trial of a drug cannot be directly compared with the rates in the clinical trials of the same or another drug and may not reflect the rates observed in practice.
The data described below reflect exposure to AzaSite in 698 patients. The population was between 1 and 87 years old with clinical signs and symptoms of bacterial conjunctivitis. The most frequently reported ocular adverse reaction reported in patients receiving AzaSite was eye irritation. This reaction occurred in approximately 1-2% of patients. Other adverse reactions associated with the use of AzaSite were reported in less than 1% of patients and included ocular reactions (blurred vision, burning, stinging and irritation upon instillation, contact dermatitis, corneal erosion, dry eye, eye pain, itching, ocular discharge, punctate keratitis, visual acuity reduction) and non-ocular reactions (dysgeusia, facial swelling, hives, nasal congestion, periocular swelling, rash, sinusitis, urticaria).[1]
References
Adapted from the FDA Package Insert.