Azikil Tablet, Powder For Suspension

Azikil is an azalide antibiotic, a subclass of macrolide antibiotic. It acts by binding to the 50s ribosomal subunit of susceptible microorganisms and thus interfering with microbial protein synthesis. Azikil has been shown to be active against most strains in the following microorganisms, both In vitro and in clinical infections:

Gram-positive microorganisms: Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus pyogenes.

Gram-negative microorganisms: Haemophilus ducreyi, Haemophilus influenzae, Moraxella catarrhalis, Neisseria gonorrhoeae, Escherichia coli.

Other microorganisms: Chlamydia pneumoniae, Chlamydia trachomatis, Mycoplasma pneumoniae, Bacteroides fragilis, Legionella pneumophila, oxoplasma gondii.

Uses

Azikil is used for infections caused by susceptible organisms in-

Upper respiratory tract infections including sinusitis, pharyngitis and tonsillitis

Lower respiratory tract infections including bronchitis, acute bacterial exacerbations of chronic obstructive pulmonary

disease (COPD)

Otitis media

Skin and soft tissue infections including cellulitis, pyoderma, erysipelas, wound infections

Diarrhea, Shigellosis

Sexually transmitted diseases, especially in the treatment of non-gonococcal urethritis and cervicitis due to Chlamydia trachomatis

Genital ulcer disease in men due to Haemophilus ducreyi (chancroid)

Mild or moderate typhoid due to multiple-antibacterial resistant organisms

Prophylaxis against a-hemolytic (viridans group) streptococcal bacterial endocarditis

Other infections including odontogenic infections, bartonella infections, toxoplasmosis, babesiosis

Azikil is also used to associated treatment for these conditions: Acute Bacterial Sinusitis (ABS), Acute Otitis Media, Acute bacterial exacerbation of COPD caused by Haemophilus Influenza Infections, Moraxella Catarrhalis Infection, Streptococcus Pneumoniae Infections, Bacterial Conjunctivitis, Bacterial Sinusitis, Cervicitis, Chancroid, Community Acquired Pneumonia (CAP), Genital Ulcer Disease (GUD), Pelvic Inflammatory Disease (PID), Pharyngitis, Streptococcal Pharyngitis, Streptococcal tonsillitis, Tonsillitis bacterial, Traveler's Diarrhea, Uncomplicated Skin and Skin Structure Infections, Urethritis

Trade Name Azikil
Generic Azithromycin
Other Names Azithromycin, Azithromycine, Azithromycinum, Azitromicina
Weight 200mg/5ml, 500mg
Type Tablet, Powder For Suspension
Formula C38H72N2O12
Weight Average: 748.9845
Monoisotopic: 748.508525778
Protein binding

The serum protein binding of azithromycin varies in humans, decreasing from 51% at 0.02 g/mL to 7% at 2 g/mL .

Therapeutic Class Macrolides
Manufacturer Maxo Chem Limited, One Pharma Ltd
Available Country India, Bangladesh
Last Updated: June 23, 2021 at 9:00 am

Dosage

Azikil dosage

Azikil tablet can be taken with or without food. Azikil suspension should be taken at least 1 hour before or 2 hours after meal.

 

Oral:

Adult:

For respiratory tract infections, otitis media and skin & soft tissue infections: 500 mg once daily for 3 days or an alternative to this as 500 mg once on day 1, followed by 250 mg once daily for next 4 days. For sexually transmitted diseases like genital ulcer, non-gonococcal urethritis and cervicitis due to Chlamydia trachomatis : a single 1 gm (1000 mg) dose. For the treatment of urethritis and cervicitis due to Neisseria gonorrhoeae : a single 2 gm (2000 mg) dose. In typhoid, 500 mg once daily for 7 days. In Cholera, a single 1 gm (1000 mg) dose. In Shigellosis, 500 mg once on day 1, followed by 250 mg once daily for next 4 days.

Azikil can be taken with or without food.

To reconstitute Azikil 15 ml powder for suspension: Add 10 ml or 2 tea spoonfuls of just boiled and cooled water to the content of the bottle and shake well to mix uniformly. 

To reconstitute Azikil 30 ml powder for suspension: Add 20 ml or 4 tea spoonfuls of just boiled and cooled water to the content of the bottle and shake well to mix uniformly. 

To reconstitute Azikil 50 ml powder for suspension: Add 35 ml or 7 tea spoonfuls of just boiled and cooled water to the content of the bottle and shake well to mix uniformly.

Side Effects

Azikil is well tolerated with a low incidence of side efects. The side effects include nausea, vomiting, abdominal discomfort (pain/cramps), flatulence, diarrhea, headache, dizziness, and skin rashes and are reversible upon discontinuation of therapy. Reversible elevations in liver transaminases have been observed occasionally. Transient mild reductions in neutrophil counts have occasionally been observed in clinical trials, although causal relationship to Azikil has not been established.

Precaution

As with any antibiotic, observation for signs of super infection with non-susceptable organisms, including fungi, is recommended. Precaution should be taken in patients with more severe renal impairment.

Interaction

Antacids: Peak serum levels but not the total extent of absorption are reduced by aluminium and magnesium containing antacids in the stomach. Azikil should therefore be taken at least 1 hour before or 2 hours after taking these antacids. 

Ergot Derivatives: Because of the theoretical possibility of ergotism, concomitant administration of ergot derivatives and Azikil should be avoided. Digoxin & Cyclosporin: Macrolides have been known to increase the plasma concentration of Digoxin & Cyclosporin and so caution should be exercised while co-administration is necessary. 

Anti-Histamines: A potentially life threatening interaction between erythromycin and terfenadine or astemizole have been reported. Although such an interaction with Azikil is not established yet, it is wise to avoid concomitant use of Azikil and terfenadine or astemizole.

Food Interaction

  • Take on an empty stomach. Take at least 1 hour before or 2 hours after meals.

Volume of Distribution

After oral administration, azithromycin is widely distributed in tissues with an apparent steady-state volume of distribution of 31.1 L/kg . Significantly greater azithromycin concentrations have been measured in the tissues rather than in plasma or serum , . The lung, tonsils and prostate are organs have shown a particularly high rate of azithromycin uptake .

This drug is concentrated within macrophages and polymorphonucleocytes, allowing for effective activity against Chlamydia trachomatis . In addition, azithromycin is found to be concentrated in phagocytes and fibroblasts, shown by in vitro incubation techniques. In vivo studies demonstrate that concentration in phagocytes may contribute to azithromycin distribution to inflamed tissues .

Half Life

Terminal elimination half-life: 68 hours

Clearance

Mean apparent plasma cl=630 mL/min (following single 500 mg oral and i.v. dose)

Pregnancy & Breastfeeding use

Pregnancy: US FDA pregnancy category B. In the animal studies, no evidence of harm to the fetus due to Azikil was found. Because animal reproduction studies are not always predictive of human response, Azikil should be used during pregnancy only if clearly needed.

Lactation: It is not known whether Azikil is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Azikil is administered to nursing mother.

Contraindication

Azikil is contraindicated in patients hypersensitive to Azikil or any other macrolide antibiotic. Co-administration of ergot derivatives and Azikil is contraindicated. Azikil is contraindicated in patients with hepatic diseases.

Special Warning

Pediatric Use: Azikil oral dosage forms can be administered to pediatric patients from 6 months of age. Safety and effectiveness of azithromycin for injection in children or adolescents under 16 years have not been established.

Acute Overdose

There are no data available on overdose with Azikil. Typical symptoms of overdosage with macrolide antibiotics include hearing loss, severe nausea, vomiting and diarrhoea. Gastric lavage and general supportive measures are indicated.

Interaction with other Medicine

Peak serum levels but not the total extent of absorption were reduced by the presence of magnesium and aluminum-containing antacids. Azikil should be taken at least 1 hr before or 2 hrs after these antacids. In patients receiving ergot alkaloids, Azikil should be avoided concurrently because of the possibilty of ergotism result in from interaction of Azikil with the cytochrome P-450 system However, no cases of such interaction have been reported. Macrolides have been known to increase the plasma concentration of digoxin and cyclosporine. Therefore, if co-administration is necessary caution should be exercised and serum levels of digoxin and cyclosporine should be checked. There have been no pharmacokinetic drug interactions between Azikil and warfarin, theophylline, carbamazepine, methylprednisolone and cimetidine.

Storage Condition

Azikil IV infusion: When diluted according to the instructions, azithromycin for injection is stable for 24 hours at or below room temperature 30° C, or for 7 days if stored under refrigeration 5° C.

Azikil capsule, tablet and dry powder for suspension: should be stored at room temperature (below 30° C). Any unused portion of reconstituted Azikil suspension should be discarded after 5 days.

Azikil eye drops: Store unopened bottle under refrigeration at 2°C to 8°C. Once the bottle is opened, store at 2°C to 25°C for up to 14 days. Discard after the 14 days.

Azikil contains Azithromycin see full prescribing information from innovator Monograph

FAQ

What is Azikil used to treat?

Azikil is an antibiotic. It's widely used to treat chest infections such as pneumonia, infections of the nose and throat such as sinus infection (sinusitis), skin infections, Lyme disease, and some sexually transmitted infections.

Is Azikil a steroid or antibiotic?

Azikil is an antibiotic medication used for the treatment of a number of bacterial infections.

What is the side effect of Azikil?

Stomach upset, diarrhea/loose stools, nausea, vomiting, or abdominal pain may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

How quickly does Azikil work?

Azikil typically takes at least five days to fully work, but it can start to relieve your sore throat and other symptoms on the first day you take it. If your doctor prescribes a generic version of Azikil, your treatment may only last three days.

Who should not take Azikil?

The following conditions are contraindicated with this drug. Check with your physician if you have any of the following:

Conditions:

  • diarrhea from an infection with Clostridium difficile bacteria
  • low amount of magnesium in the blood
  • low amount of potassium in the blood
  • myasthenia gravis, a skeletal muscle disorder
  • hearing loss
  • torsades de pointes, a type of abnormal heart rhythm
  • slow heartbeat
  • prolonged QT interval on EKG
  • abnormal EKG with QT changes from birth
  • a narrowing of the opening between the stomach and the small intestine
  • liver problems
  • abnormal liver function tests
  • inflammation of the liver with stoppage of bile flow
  • a yellowing of the eyes or skin from buildup of bilirubin called jaundice

Does Azikil kill gut bacteria?

Like all broad-spectrum antibiotics, Azikil does not discriminate between pathogenic bacteria and healthy bacteria. Hence, when you take antibiotics to fight an infection, many of the bacteria in your gut are killed too (think of it as collateral damage).

Does Azikil make me tired?

Azikil oral tablet doesn't cause drowsiness, but it can cause other side effects.

How safe is Azikil?

The U.S. Food and Drug Administration (FDA) is warning the public that azithromycin (Zithromax or Zmax) can cause abnormal changes in the electrical activity of the heart that may lead to a potentially fatal irregular heart rhythm.  source

Can Azikil treat cold?

Azikil is used to treat a wide variety of bacterial infections. It is a macrolide-type antibiotic. It works by stopping the growth of bacteria. This medication will not work for viral infections (such as common cold, flu).

Can I take Azikil during pregnancy?

The safety of Azikil during pregnancy is yet to establish. Azikil is not recommendable in pregnancy. Ask your doctor before taking this medicine.

Can I take Azikil while breastfeeding?

Azikil partially passes into human breast milk. If you are taking Azikil then stop breastfeeding your baby. It is advised to discard the milk during treatment and until two days after discontinuation of treatment. You can restart breastfeeding thereafter.

Can I drive if I have consumed Azikil?

You may drive, but be sure you are not experiencing dizziness before you start driving.

How Does Azikil Work?

Azikil prevents the growth of bacteria by interfering with their protein synthesis. It binds to a specific part of the bacterial nucleus and inhibits the process required for bacterial growth. Thereby, bacteria are killed, or their growth is stalled depending on the organism and the medicine concentration.