Suspensions azithromycin

Charge in a suitable stainless steel double-cone blender, sucrose, sodium phosphate, xanthan gum, sodium cyclamate, sodium saccharin, gly-camil, and starch pregelatinized. 

Mill the mixture in step 2 using a hammer mill (hammer forward) equipped with a 2-mm screen at high speed. 

Charge into a double-cone mixer the mixture from step 3 and add azithromycin and flavors. Mix for 15 minutes. 

Fill 11.01 g per bottle. The bottle must be reconstituted with 10 mL of the diluent (see step below) to obtain 16.5 mL of suspension with concentration of 200 mg/5 mL. 

Prepare the diluent by first dissolving items 14 and 15 in item 13 at 69° to 70°C, then mix with item 12 and item 16. 

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Treadway G, Reisman A. Tolerability of 3-day, once-daily azithromycin suspension versus standard treatments for community-acquired paediatric infectious diseases. Int J Antimicrob Agents 2001 18(5) 427-31. 

Still, J. G. (1993). Azithromycin suspension vs. penicillin V suspension in treatment of children with streptococcal pharyngitis [abstract PII-101]. Clin. Pharmacol. Ther. S3, 195. 

Still, J. G. (1994). Treatment of streptococcal pharyngitis in children with five days of azithromycin suspension. In Program of the 34th Interscience Conference on Antimicrobial Agents and Chemotherapy, Abstr. No. M67. American Society for Microbiology, Washington, DC. 

Macrolides The nurse gives claridiromycin without r ard to meals. Claridiromycin may be taken widi milk, if desired. Azidiromycin tablets may be given without regard to meals. However, azithromycin suspension is given 1 hour or more before a meal or 2 hours or more after a meal. Dirithromycin is given widi food or within 1 hour of eating. Erythromycin is given on an emply stomach (1 hour before or 2 hours after meals) and with 180 to 240 inL of water. 

A review by the manufacturers briefly mentions that food reduced the absorption of azithromycin by about half It is suggested therefore that azithromycin capsules should not be given at the same time as food, but should be taken at least 1 hour before or 2 hours after a meal. - However, the US prescribing information states that a high-fat meal increased the maximum levels of azithromycin tablets by 23%, and had no effect on the AUC. Similarly, food increased the maximum levels of azithromycin pension by 56%, without altering the AUC. Azithromycin suspension and tablets may therefore be taken without regard to food. 

Clarithromycin 15 mg/kg per day in 2 doses (adult 250 mg twice daily) Diarrhea, vomiting, rash, abnormal taste, abdominal pain SJ Many drug interactions (inhibits cytochrome P-450 3A4) suspension cannot be refrigerated and has metallic taste same microbiologic issues as azithromycin... 

AZITHROMYCIN Az Vr romyc n tablets and oral suspension (except Zmax) can be taken with or without food however, increased tolerability has been observed when tablets are taken with food. It is recommended that Zmax be taken on an empty stomach (at least 1 hours before or 2 hours following a meal). Single-dose 1 g packets are not for pediatric use. 

Acute otitis media The recommended dose of azithromycin oral suspension is 30 mg/kg given as a single dose or 10 mg/kg once daily for 3... 

Light-brown suspension showing no sedimentation during 24 hours and good redispersibility. The bitter taste of Azithromycin is almost completely masked. 

The tolerabihty of azithromycin oral suspension, 10 mg/ kg od for 3 days, has been assessed in children in a review of 16 multicenter studies (7). Of 2425 patients, 1213 received azithromycin and 1212 received other drugs. The incidence of treatment-related adverse events was significantly lower in those who took azithromycin, while withdrawal rates were similar. There were significantly fewer gastrointestinal events with azithromycin and their duration was significantly shorter. 

In an azithromycin dry syrup micronized crospovidone not only stabilizes the suspension physically but also maskes the bitter taste of the drug substance [615]. The formulation given in Table 145 was also developed on a laboratory scale and demonstrates the use of micronized crospovidone in an antiacid dry syrup from which a suspension is prepared as the administration form. 

Food appears to halve azithromycin absorption from the capsule formulation, but does not alter the AUC of tablets or suspension. 

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