ZITHROMAX POWDER FOR ORAL SUSPENSION 200 mg/5 ml

PFIZER PRIVATE LIMITED

PFIZER PRIVATE LIMITED

Therapeutic

Prescription Only

POWDER, FOR SUSPENSION

**4.2 Posology and method of administration** Oral azithromycin should be administered as a single daily dose. The period of dosing with regard to infection is given below. Azithromycin tablets and powder for oral suspension can be taken with or without food. **In adults** For the treatment of sexually transmitted diseases caused by _Chlamydia trachomatis_, _Haemophilus ducreyi_, or susceptible _Neisseria gonorrhoeae_, the dose is 1000 mg as a single oral dose. For prophylaxis against MAC infections in patients infected with the HIV, the dose is 1200 mg once per week. For the treatment of adult patients with CAP due to the indicated organisms, the recommended dose of IV azithromycin is 500 mg as a single daily dose by the IV route for at least 2 days. IV therapy should be followed by oral azithromycin at a single daily dose of 500 mg to complete a 7- to 10-day course of therapy. The timing of the conversion to oral therapy should be done at the discretion of the physician and in accordance with clinical response. For the treatment of adult patients with PID due to the indicated organisms, the recommended dose of IV azithromycin is 500 mg as a single daily dose by the IV route for 1 or 2 days. IV therapy should be followed by oral azithromycin at a single daily dose of 250 mg to complete a 7-day course of therapy. The timing of the conversion to oral therapy should be done at the discretion of the physician and in accordance with clinical response. If anaerobic microorganisms are suspected of contributing to the infection, an antimicrobial anaerobic agent may be administered in combination with azithromycin. For all other indications in which the oral formulation is administered, the total dosage of 1500 mg should be given as 500 mg daily for 3 days. As an alternative, the same total dose can be given over 5 days with 500 mg given on Day 1, then 250 mg daily on Days 2 to 5. Intravenous Administration: After reconstitution and dilution, the recommended route of administration for IV azithromycin is by IV infusion only. **Do not administer as an IV bolus or an intramuscular injection (** see **section 4.4** and **section 6.6** – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_ **).** The infusate concentration and rate of infusion for azithromycin IV should be either 1 mg/ml over 3 hours or 2 mg/ml over 1 hour. An IV dose of 500 mg azithromycin should be infused for a minimum duration of 1 hour. **In children** The maximum recommended total dose for any treatment is 1500 mg for children. The total dose of 30 mg/kg should be given as a single daily dose of 10 mg/kg daily for 3 days, or given over 5 days with a single daily dose of 10 mg/kg on Day 1, then 5 mg/kg on Days 2–5. For children weighing less than 15 kg, azithromycin suspension should be measured as closely as possible. For children weighing 15 kg or more, azithromycin suspension should be administered according to the guide provided below:  Azithromycin tablets should only be administered to children weighing more than 45 kg. The safety and efficacy of IV azithromycin for the treatment of infections in children have not been established. Safety and efficacy for the prevention of MAC in children have not been established. Based on pediatric pharmacokinetic data, a dose of 20 mg/kg would be similar to the adult dose of 1200 mg but with a higher Cmax. **Special populations** In the Elderly: The same dosage as in adult patients is used in the elderly. Elderly patients may be more susceptible to the development of torsades de pointes arrhythmia than younger patients (see **section 4.4** – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_). In Patients with Renal Impairment: No dose adjustment is necessary in patients with GFR 10–80 ml/min. Caution should be exercised when azithromycin is administered to patients with GFR <10 ml/min (see **section 4.4** and **section 5.2** – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_). In Patients with Hepatic Impairment: The same dosage as in patients with normal hepatic function may be used in patients with mild to moderate hepatic impairment (see **section 4.4** – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_).