Azithromycin 500 mg IV administration requires careful consideration of potential risks. Avoid use in patients with known hypersensitivity to azithromycin, erythromycin, or other macrolide antibiotics. A history of prolonged QT interval or cardiac arrhythmias represents a significant contraindication.
Proceed with caution in patients with:
- Liver dysfunction: Monitor liver function tests closely. Renal impairment: Dose adjustment may be necessary; consult renal dosing guidelines. Myasthenia gravis: Azithromycin can worsen symptoms.
Specific drug interactions exist. Concurrent use with certain medications, including:
- Pimozide: Increases risk of QT prolongation. Ergot alkaloids: May cause ergotism. Digoxin: Potential for increased digoxin levels. Warfarin: May potentiate anticoagulant effect.
Inform patients about potential adverse effects, including:
Gastrointestinal disturbances (nausea, vomiting, diarrhea). Cardiac arrhythmias (QT prolongation). Hepatotoxicity. Hypersensitivity reactions (rash, angioedema).
Regular monitoring of vital signs and laboratory values is recommended, particularly during prolonged therapy. Always consult current prescribing information for the most up-to-date guidance.
