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Same active ingredient — pay up to 57% less
These brands contain the same active ingredient (Azithromycin Dihydrate). Same strength and form. Confirm the switch with your doctor or pharmacist.
More from Thromax
Other strengths and forms by Novo Healthcare and Pharma Ltd.
Indications & Uses
Pharmacology
Azithromycin is stable in acid, so it can be taken by mouth without any protection from stomach acid. It is absorbed readily, and absorption is greater on an empty stomach. In adults, the time to peak concentration is 2.1 to 3.2 hours for oral dosage forms. Phagocytes hold azithromycin in high concentration, so it is actively carried to the site of infection. During active phagocytosis, large amounts are released. The concentration in tissues can be over 50 times higher than in plasma, and this is due to ion trapping and high lipid solubility.
The half-life of azithromycin allows a large single dose to be given and still keep bacteriostatic levels in the infected tissue for several days. After a single 500 mg dose, plasma concentrations fell in a polyphasic pattern, with a mean apparent plasma clearance of 630 mL/min and a terminal elimination half life of 68 hours. This long terminal half-life is thought to be due to extensive uptake of the drug into tissues and its later release. Biliary excretion, mostly of unchanged drug, is a major route of elimination. Over a week, approximately 6% of the dose appears as unchanged drug in urine.
Microbiology
Azithromycin works by binding to the 50S ribosomal subunit of susceptible microorganisms, which interferes with microbial protein synthesis. Nucleic acid synthesis is not affected. It has been shown to be active against most isolates of the following microorganisms, both in vitro and in clinical infections.
Aerobic and facultative gram-positive microorganisms: Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus pyogenes.
Aerobic and facultative gram-negative microorganisms: Haemophilus ducreyi, Haemophilus influenzae, Moraxella catarrhalis, Neisseria gonorrhoeae.
Other microorganisms: Chlamydia pneumoniae, Chlamydia trachomatis, Mycoplasma pneumoniae.
Betalactamase production should have no effect on azithromycin activity.
Aerobic and facultative gram-positive microorganisms: Streptococci (Groups C,F,G), Viridans group streptococci.
Aerobic and facultative gram-negative microorganisms: Bordetella pertussis, Legionella pneumophila.
Anaerobic microorganisms: Peptostreptococcus species, Prevotella bivia.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
For adults, the usual oral dose of azithromycin is 500 mg once daily for 3 days. Another schedule is 500 mg once on day 1, then 250 mg once daily on days 2 to 5 (4 days). For sexually transmitted diseases caused by Chlamydia trachomatis in adults, the dose is 1 gm given as a single dose. Alternatively, 500 mg once on day 1, followed by 250 mg once daily for the next 2 days, may also be given.
Children over 6 months get 10 mg/kg body weight once daily for 3 days. By weight, that works out as 200 mg (1 teaspoonful) for 3 days if the child weighs 15 to 25 kg, 300 mg (1½ teaspoonfuls) for 3 days if the weight is 26 to 35 kg, and 400 mg (2 teaspoonfuls) for 3 days if the weight is 36 to 45 kg. In typhoid fever, 500 mg (2½ teaspoonfuls) is given once daily for 7 to 10 days.
Azithromycin injection is for IV infusion only. For adults with community-acquired pneumonia due to the indicated organisms, the recommended dose is 500 mg as a single daily dose by the intravenous route for at least two days. After that, azithromycin is given by mouth as a single daily dose of 500 mg, taken as two 250-mg tablets, to complete a 7 to 10-day course. The doctor decides when to switch to the oral form, based on how the patient responds clinically.
For adults with pelvic inflammatory disease due to the indicated organisms, the recommended dose is 500 mg as a single daily dose by the intravenous route for one or two days. Intravenous treatment is then followed by oral azithromycin at a single daily dose of 250 mg to complete a 7-day course. Again, the timing of the switch to oral treatment is left to the doctor and depends on clinical response.
If anaerobic microorganisms are suspected of contributing to the infection, an antimicrobial agent with anaerobic activity should be given together with azithromycin. The safety and effectiveness of azithromycin injection in children or adolescents under 16 years have not been established.
Side Effects
Azithromycin Dihydrate is well tolerated, and side-effects are uncommon. Most of the ones seen were mild to moderate in severity. The majority were gastrointestinal, with nausea, abdominal discomfort (pain or cramps), vomiting, flatulence, diarrhoea and loose stools being seen occasionally. Allergic reactions such as rash or photosensitivity have occurred, and there have also been rare reports of serious hypersensitivity reactions. Reversible rises in liver transaminases have been seen, at a frequency similar to that of the comparative macrolides and penicillins used in clinical trials. Cases of cholestatic jaundice have been observed rarely. Transient, mild reductions in neutrophil counts have occasionally been seen in clinical trials, although a causal relationship to azithromycin has not been established. Hearing impairment In investigational studies where higher doses were used for prolonged periods, reversible hearing impairment was seen in some patients.
Cautions & Contraindications
Warnings & Precautions
Rare but serious allergic reactions, including angioneurotic oedema and anaphylaxis, have been reported with erythromycin and other macrolides, and the same is true of azithromycin. In some people taking azithromycin, these reactions came back after the first episode. They needed a long period of observation and treatment.
Contraindications
Azithromycin Dihydrate must not be given to anyone who is hypersensitive to azithromycin or to any other macrolide antibiotic. It also must not be taken together with ergot derivatives. People with hepatic diseases should not use azithromycin either.
Pregnancy & Breastfeeding
Azithromycin Dihydrate falls under Pregnancy Category B. In animal reproduction studies, azithromycin showed no evidence of harm to the fetus. There are no adequate and well controlled studies in pregnant women, though. Animal studies don't always predict how humans will respond, so azithromycin should be used during pregnancy only if adequate alternatives are not available.
It is not known whether azithromycin is secreted in breast milk. For that reason, caution should be exercised when it is given to nursing women.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
Use in renal impairment: People with mild renal impairment (creatinine clearance >40 ml/min) don't need a dose adjustment. There are no data on azithromycin in patients with more severe renal impairment, so take care when using azithromycin in these patients.
Use in hepatic impairment: The liver is the main route by which azithromycin leaves the body, so it should not be used in patients with hepatic disease.
Effects on ability to drive and use machines: There is no evidence that azithromycin affects a patient's ability to drive or operate machinery.
Overdose
There's no data on overdosage with Azithromycin Dihydrate. With macrolide antibiotics, the usual symptoms of overdosage are hearing loss, severe nausea, vomiting and diarrhoea. Gastric lavage and general supportive measures are indicated.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Store Azithromycin Dihydrate in a dry place, away from light and heat. Keep it where children can't reach it.
Drug Interactions
Common questions about Thromax 500 mg
What is Thromax 500 mg Tablet?
Thromax 500 mg Tablet is a medicine that contains Azithromycin Dihydrate. It is made by Novo Healthcare and Pharma Ltd. It belongs to the Macrolides group of medicines.
What is Thromax used for?
Thromax is used for: Pneumonia, Bronchitis, Sinusitis, Pharyngitis, Tonsillitis, Bacterial Infection, Respiratory Tract Infection, Skin and Soft Tissue Infection, Otitis Media.
What are the side effects of Thromax?
Azithromycin Dihydrate is well tolerated, and side-effects are uncommon. Most of the ones seen were mild to moderate in severity.
Can I take Thromax during pregnancy or while breastfeeding?
Azithromycin Dihydrate falls under Pregnancy Category B. In animal reproduction studies, azithromycin showed no evidence of harm to the fetus. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Thromax?
There's no data on overdosage with Azithromycin Dihydrate. With macrolide antibiotics, the usual symptoms of overdosage are hearing loss, severe nausea, vomiting and diarrhoea. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Thromax?
Store Azithromycin Dihydrate in a dry place, away from light and heat. Keep it where children can't reach it.
Can I take other medicines with Thromax?
Some medicines can interact with Azithromycin Dihydrate, for example: Cyclosporine, Azithromycin, Theophylline, Digoxin. Tell your doctor or pharmacist about every medicine you take.
Is there a cheaper medicine with the same ingredient?
Azithrogen by Biogen Pharmaceuticals Ltd. has the same ingredient and strength for ৳15.00 per unit, compared with ৳35.00 for Thromax. Ask your doctor or pharmacist before switching.
Do I need a prescription for Thromax?
Thromax is a prescription (Rx) medicine. Take it as your doctor advises.