Azithromycin 500mg tablets in a 3-tablet pack provide a complete short-course antibiotic treatment for common bacterial infections. This macrolide antibiotic offers convenient once-daily dosing with a full treatment course contained in just three tablets. The extended-release formulation maintains therapeutic tissue concentrations for 5 days after the last dose, making it ideal for respiratory, urogenital, and skin infections. Clinical studies show 85-95% efficacy rates for approved indications when taken as directed.
The 3-tablet regimen (1500mg total dose) is FDA-approved for: community-acquired pneumonia (5-day course), acute bacterial sinusitis, and uncomplicated skin infections. It's particularly effective against atypical pathogens like Chlamydia pneumoniae and Mycoplasma pneumoniae. Compared to longer antibiotic courses, this pack offers improved compliance (92% completion rate vs 60% for 10-day regimens). Recent guidelines recommend it as first-line for chlamydial urethritis/cervicitis (single 1g dose) and traveler's diarrhea prevention.
Standard adult dosing: Take one 500mg tablet daily for 3 consecutive days. For pneumonia: 500mg on Day 1, then 250mg daily for 4 more days (additional pack needed). Swallow whole with water - can be taken with or without food (though food reduces GI upset). Space antacids by 2 hours. No renal adjustment needed for this short course. Complete all tablets even if symptoms improve earlier. The pack provides exact treatment duration to prevent under/overuse.
Azithromycin binds to the 50S ribosomal subunit, inhibiting bacterial protein synthesis. The 500mg dose achieves tissue concentrations 10-100x higher than serum levels, with sustained action due to extensive tissue penetration and long half-life (68 hours). It covers Gram-positives (S. pneumoniae), some Gram-negatives (H. influenzae), and atypicals (Legionella, Mycoplasma). Resistance occurs via efflux pumps and ribosomal methylation (currently <10% in S. pneumoniae in most regions).
Generally well-tolerated; common effects include diarrhea (5%), nausea (3%), and abdominal pain (2%). Rare but serious risks: QT prolongation (0.1%), hepatotoxicity (0.01%), and Clostridioides difficile infection. Contraindications include known macrolide allergy and concurrent use with ergotamine or pimozide. Caution required in cardiac patients (monitor ECG if risk factors) and hepatic impairment (reduce dose if severe). Discontinue if jaundice or irregular heartbeat occurs.
Pregnancy: Category B (safe when needed). Pediatrics: Not for children <6 months (different formulations available). Elderly: No adjustment but monitor for QT effects. Hepatic impairment: Reduce dose in severe cirrhosis. HIV patients: Watch for opportunistic infections. Myasthenia gravis: May exacerbate weakness. No renal dose adjustment needed for the 3-day course.
The 500mg 3-tablet pack offers complete treatment in one package versus loose tablets. Compared to Z-Pak (6 tablets over 5 days), it provides simpler dosing with comparable efficacy. Versus erythromycin: better GI tolerance and once-daily dosing. Cost is comparable to other azithromycin formats but with improved compliance. The concentrated 500mg strength reduces pill burden versus 250mg tablets. Not interchangeable with single-dose 1g packs for STI treatment.
Store at 20-25°C (68-77°F) in original blister packaging. Protect from moisture and light - avoid bathroom storage. Tablets remain stable until expiration date (typically 2-3 years). Once removed from packaging, use immediately. Travelers should keep in original pack with desiccant. Never use tablets that are cracked or discolored.
Generic 3-tablet packs cost $5-$15 without insurance. Most plans cover with $0-$10 copay. Medicare Part D typically requires no prior authorization. The WHO Essential Medicines List includes azithromycin. Cost-effective for appropriate indications due to high compliance and low resistance rates compared to alternatives. Some insurers prefer this pack over loose tablets for approved diagnoses.
Take at same time daily for 3 days. Can take with food if stomach upset occurs. Report severe diarrhea, irregular heartbeat, or allergic reactions. Space antacids by 2 hours. Complete all tablets to prevent resistance. Not for viral infections. Women: May reduce oral contraceptive efficacy (use backup). Store properly and don't share medication.
Current studies investigate: shorter 1-2 day courses for select infections, novel combinations for resistant gonorrhea, and anti-inflammatory effects in COPD. Resistance monitoring shows <15% in S. pneumoniae but rising in N. gonorrhoeae (>50%). Research continues on optimal dosing for obese patients and new formulations with enhanced tissue targeting.
Increases levels of digoxin, colchicine, and warfarin (monitor INR). Avoid with QT-prolonging drugs. Antacids reduce absorption (space by 2 hours). Cyclosporine levels may increase. No significant food interactions. May enhance effects of oral hypoglycemics. Space iron/zinc supplements by 2 hours.
This 1500mg total dose (3x500mg tablets) treats: community-acquired pneumonia, streptococcal pharyngitis, uncomplicated skin infections, and acute bacterial sinusitis. It's also prescribed for chlamydia (single 1g dose) and COPD exacerbations.
• Standard regimen: 500mg once daily for 3 consecutive days
• Alternative: 1500mg as single one-time dose for STIs
• Take 1 hour before or 2 hours after food for best absorption
• Space antacids by 2+ hours if needed
• Complete all tablets even if symptoms improve earlier
The "Z-Pak" refers to the 3-5 day short-course therapy unique to azithromycin. Its long tissue half-life (68 hours) allows this abbreviated course while maintaining effective antibiotic levels for 5-7 days post-last dose.
Stop taking and contact your doctor for: severe diarrhea (may indicate C. diff), irregular heartbeat (QT prolongation risk), hearing changes, liver problems (yellow skin, dark urine), or severe skin reactions. These are rare but require prompt evaluation.
Limited alcohol is generally acceptable with azithromycin (unlike other antibiotics), but heavy drinking may increase nausea and liver stress. For liver patients or those taking other hepatotoxic drugs, complete avoidance is recommended.
Most patients notice symptom improvement within 48-72 hours. However, the medication continues working for days after the last dose. Don't stop early - bacterial eradication takes longer than symptom relief.