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.
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. Renal impairment (esp. GFR <10mL/min). Neonates: possible infantile hypertrophic pyloric stenosis. Pregnancy. Nursing mothers: monitor infants.
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, colchicine, cyclosporine, ergots, hexobarbital, phenytoin, warfarin.
Diarrhea, nausea, vomiting, abdominal pain, headache; hepatotoxicity, torsades de pointes (esp. elderly), C. difficile-associated diarrhea (evaluate if occurs); rare: allergic reactions (eg, angioedema, AGEP, Stevens-Johnson syndrome, toxic epidermal necrolysis, DRESS), lab abnormalities.