Indications for ZMAX:
Mild-to-moderate susceptible acute bacterial sinusitis in adults. Community-acquired pneumonia in adults and children ≥6mos old.
Adults and Children:
Take on an empty stomach. Sinusitis: 2g once. CAP: <6mos: not established. ≥6mos: <34kg: 60mg/kg (27mg/lb) once; ≥34kg: 2g once. If vomiting occurs within 1 hour post-dose or delayed gastric emptying, consider alternative therapy.
Macrolide or ketolide related allergy. History of cholestatic jaundice/hepatic dysfunction with prior use.
Renal impairment (esp. GFR <10mL/min). Discontinue if signs/symptoms of hepatitis occur. Myasthenia gravis. History of QT prolongation or proarrhythmic conditions. Allergic symptoms may recur after initial successful symptomatic treatment. Neonates: possible infantile hypertrophic pyloric stenosis. Pregnancy (Cat.B). Nursing mothers.
Possible QT prolongation with concomitant Class 1A (quinidine, procainamide) or Class III (dofetilide, amiodarone, sotalol) antiarrhythmics, or others known to prolong the QT interval; avoid. Potentiated by nelfinavir. Monitor digoxin, cyclosporine, ergots, hexobarbital, phenytoin, warfarin.
Diarrhea, nausea, vomiting, abdominal pain, headache; rare: allergy (eg, angioedema, AGEP, Stevens-Johnson syndrome, toxic epidermal necrolysis, DRESS), lab abnormalities; hepatotoxicity, torsades de pointes (esp. elderly), C. difficile-associated diarrhea (evaluate if occurs).