Accession Number
DB00207  (APRD00397)
Small Molecule

Azithromycin is a semi-synthetic macrolide antibiotic of the azalide class. Like other macrolide antibiotics, azithromycin inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit of the bacterial 70S ribosome. Binding inhibits peptidyl transferase activity and interferes with amino acid translocation during the process of translation. Its effects may be bacteriostatic or bactericidal depending of the organism and the drug concentration. Its long half life, which enables once daily dosing and shorter administration durations, is a property distinct from other macrolides.

  • Azithromycin
  • Azithromycine
  • Azithromycinum
  • Azitromicina
External IDs
CP 62993 / CP-62,993 / CP-62993 / XZ 405 / XZ 450 / XZ-450
Product Ingredients
IngredientUNIICASInChI Key
Azithromycin dihydrate5FD1131I7S117772-70-0SRMPHJKQVUDLQE-KUJJYQHYSA-N
Azithromycin monohydrateJTE4MNN1MD121470-24-4HQUPLSLYZHKKQT-WVVFQGGUSA-N
Product Images
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Act AzithromycinTablet250 mgOralActavis Pharma Company2005-11-02Not applicableCanada
Act AzithromycinTablet600 mgOralActavis Pharma Company2005-11-02Not applicableCanada
AzaSITESolution / drops10 mg/1mLOphthalmicAkorn2014-05-14Not applicableUs
AzaSITESolution1 %OphthalmicInspire Pharmaceuticals, Inc.Not applicableNot applicableCanada
AzaSITESolution1 %OphthalmicInsite Vision IncorporatedNot applicableNot applicableCanada
AzaSiteSolution10 mg/1mLOphthalmicInspire Pharmaceuticals, Inc.2007-07-162015-08-31Us
AzithromycinPowder, for suspension100 mgOralPharmascience Inc2006-04-19Not applicableCanada
AzithromycinPowder, for suspension1 g/1OralRpk Pharmaceuticals, Inc.1999-02-12Not applicableUs
AzithromycinInjection2.5 g/23mLIntravenousTeva Parenteral Medicines, Inc.2006-12-192011-11-30Us
AzithromycinPowder, for suspension200 mgOralPharmascience Inc2006-04-19Not applicableCanada
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Apo-azithromycinTablet250 mgOralApotex Corporation2005-11-02Not applicableCanada
Apo-azithromycin ZTablet250 mgOralApotex Corporation2014-03-06Not applicableCanada
Ava-azithromycinPowder, for suspension100 mgOralAvanstra Inc2011-09-192014-08-21Canada
Ava-azithromycinPowder, for suspension200 mgOralAvanstra Inc2011-09-192014-08-21Canada
Ava-azithromycinTablet250 mgOralAvanstra Inc2011-09-192014-08-21Canada
AzithromycinTablet, film coated250 mg/1OralMylan Institutional2011-01-122012-02-29Us
AzithromycinTablet, film coated250 mg/1OralRxchange Co2014-11-13Not applicableUs
AzithromycinTablet, film coated500 mg/1OralAidarex Pharmaceuticals LLC2008-02-11Not applicableUs
AzithromycinTablet, film coated600 mg/1OralMylan Pharmaceuticals2010-05-282010-05-31Us
AzithromycinTablet, film coated250 mg/1OralAidarex Pharmaceuticals LLC2005-11-14Not applicableUs
International/Other Brands
Azenil / Azibiot / Azifast / Azigram / Azimakrol / Azin / Azithrocin / Azitromax / Azitromin / Aztrin / Hemomycin / Misultina / Penalox / Sumamed / Vinzam / Zifin / Zitrocin / Zitrotek
CAS number
Average: 748.9845
Monoisotopic: 748.508525778
Chemical Formula
InChI Key



For the treatment of patients with mild to moderate infections caused by susceptible strains of the designated microorganisms in the specific conditions: H. influenzae, M. catarrhalis, S. pneumoniae, C. pneumoniae, M. pneumoniae, S. pyogenes, S. aureus, S. agal

Associated Conditions

Azithromycin, a semisynthetic antibiotic belonging to the macrolide subgroup of azalides, is used to treat STDs due to chlamydia and gonorrhea, community-acquired pneumonia, pelvic inflammatory disease, pediatric otitis media and pharyngitis, and Mycobacterium avium complex (MAC) in patients with advanced HIV disease. Similar in structure to erythromycin. azithromycin reaches higher intracellular concentrations than erythromycin, increasing its efficacy and duration of action.

Mechanism of action

Azithromycin binds to the 50S subunit of the 70S bacterial ribosomes, and therefore inhibits RNA-dependent protein synthesis in bacterial cells.

Enteric bacteria and other eubacteria
A50S ribosomal protein L4
Escherichia coli O157:H7
A50S ribosomal protein L22
Escherichia coli O157:H7
UProtein-arginine deiminase type-4Not AvailableHumans

Bioavailability is 37% following oral administration. Absorption is not affected by food. Azithromycin is extensively distributed in tissues with tissue concentrations reaching up to 50 times greater than plasma concentrations. Drug becomes concentrated within macrophages and polymorphonucleocytes giving it good activity against Chlamydia trachomatis.

Volume of distribution
  • 31.1 L/kg
Protein binding

Serum protein binding is variable in the concentration range approximating human exposure, decreasing from 51% at 0.02 µg/mL to 7% at 2 µg/mL.


Hepatic. In vitro and in vivo studies to assess the metabolism of azithromycin have not been performed.

Route of elimination

Biliary excretion of azithromycin, predominantly as unchanged drug, is a major route of elimination.

Half life

68 hours

  • apparent plasma cl=630 mL/min [following single 500 mg oral and i.v. doses]

Potentially serious side effects of angioedema and cholestatic jaundice were reported

Affected organisms
  • Enteric bacteria and other eubacteria
  • Corynebacterium diphtheriae
  • Treponema pallidum
  • Streptococcus pyogenes
  • Chlamydia pneumoniae
  • Chlamydia trachomatis
  • Chlamydophila psittaci
  • Mycoplasma pneumoniae
  • Neisseria gonorrhoeae
  • Legionella pneumophila
  • Bordetella pertussis
Azithromycin Action PathwayDrug action
Pharmacogenomic Effects/ADRs
Not Available


Drug Interactions
(R)-warfarinThe serum concentration of (R)-warfarin can be increased when it is combined with Azithromycin.
(S)-WarfarinThe serum concentration of (S)-Warfarin can be increased when it is combined with Azithromycin.
3,5-diiodothyropropionic acidThe metabolism of 3,5-diiodothyropropionic acid can be decreased when combined with Azithromycin.
4-hydroxycoumarinThe metabolism of 4-hydroxycoumarin can be decreased when combined with Azithromycin.
5-androstenedioneThe metabolism of 5-androstenedione can be decreased when combined with Azithromycin.
6-Deoxyerythronolide BThe metabolism of Azithromycin can be decreased when combined with 6-Deoxyerythronolide B.
6-O-benzylguanineThe metabolism of 6-O-benzylguanine can be decreased when combined with Azithromycin.
7-ethyl-10-hydroxycamptothecinThe metabolism of Azithromycin can be decreased when combined with 7-ethyl-10-hydroxycamptothecin.
9-aminocamptothecinThe metabolism of 9-aminocamptothecin can be decreased when combined with Azithromycin.
AbataceptThe metabolism of Azithromycin can be increased when combined with Abatacept.
Food Interactions
  • Do not take Aluminum or magnesium antacids or supplements while on this medication.
  • Take on empty stomach: 1 hour before or 2 hours after meals.


Synthesis Reference

William Heggie, Zita Maria De Mouro Vaz Azevedo Mendes, "Process for the preparation of azithromycin." U.S. Patent US6013778, issued November, 1994.

General References
  1. Noedl H, Krudsood S, Chalermratana K, Silachamroon U, Leowattana W, Tangpukdee N, Looareesuwan S, Miller RS, Fukuda M, Jongsakul K, Sriwichai S, Rowan J, Bhattacharyya H, Ohrt C, Knirsch C: Azithromycin combination therapy with artesunate or quinine for the treatment of uncomplicated Plasmodium falciparum malaria in adults: a randomized, phase 2 clinical trial in Thailand. Clin Infect Dis. 2006 Nov 15;43(10):1264-71. Epub 2006 Oct 12. [PubMed:17051490]
External Links
Human Metabolome Database
KEGG Compound
PubChem Compound
PubChem Substance
Therapeutic Targets Database
RxList Drug Page Drug Page
ATC Codes
J01RA07 — Azithromycin, fluconazole and secnidazoleS01AA26 — AzithromycinJ01FA10 — Azithromycin
AHFS Codes
  • 52:04.04 — Antibacterials
  • 08:12.12.92 — Other Macrolides
PDB Entries
1m1k / 1nwy / 1yhq / 4v7y / 5igi / 5igv / 5uxc / 5uxd
FDA label
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Clinical Trials

Clinical Trials
0Active Not RecruitingTreatmentChronic Obstructive Pulmonary Disease (COPD)1
0Not Yet RecruitingTreatmentAcne Vulgaris1
0Not Yet RecruitingTreatmentBMI >30 kg/m2 / Induction of Labor Affected Fetus / Newborn1
0RecruitingTreatmentRespiratory Syncytial Virus (RSV)1
1CompletedNot AvailableFasting1
1CompletedNot AvailableHealthy Volunteers7
1CompletedNot AvailableProphylaxis of Malaria1
1CompletedBasic ScienceInflammatory Reaction1
1CompletedBasic SciencePharmacokinetics1
1CompletedBasic SciencePrebiotics / Probiotics / Quorum Sensing / Sepsis1
1CompletedHealth Services ResearchPlasmodium Infections1
1CompletedPreventionHuman Immunodeficiency Virus (HIV) / Plasmodium Infections / Pregnant State1
1CompletedTreatmentBacterial Infections / Human Immunodeficiency Virus (HIV) Infections2
1CompletedTreatmentBacterial Infections / Ureaplasma1
1CompletedTreatmentDrug Drug Interaction (DDI)1
1CompletedTreatmentEye Infections, Bacterial5
1CompletedTreatmentHealthy Volunteers1
1CompletedTreatmentHuman Immunodeficiency Virus (HIV) Infections / Toxoplasmosis, Cerebral1
1CompletedTreatmentInfection NOS1
1RecruitingOtherPhysiological Response to Antibiotics1
1RecruitingTreatmentConjunctivitis, Bacterial1
1WithdrawnPreventionAcute Chest Syndrome / Sickle Cell Disorders1
1, 2Not Yet RecruitingTreatmentEbola Virus Disease1
1, 2RecruitingPreventionRandomized Controll Trial1
1, 2TerminatedPreventionBacteria Infection / Respiratory Tract Infections (RTI)1
1, 2WithdrawnOtherSickle Cell Disorders1
1, 2WithdrawnPreventionMalaria caused by Plasmodium falciparum1
1, 2WithdrawnTreatmentGraves Ophthalmopathy1
2Active Not RecruitingTreatmentChildhood Asthma With Acute Exacerbation1
2Active Not RecruitingTreatmentPeriodontitis, Chronic1
2Active Not RecruitingTreatmentUreaplasma Infections1
2CompletedNot AvailableSinusitis1
2CompletedBasic SciencePharmacokinetics1
2CompletedPreventionChronic Lung Disease of Prematurity1
2CompletedTreatmentAcute Otitis Media1
2CompletedTreatmentBacterial Infections / Human Immunodeficiency Virus (HIV) Infections / Pneumonia, Pneumocystis Carinii1
2CompletedTreatmentChlamydia Trachomatis Infection1
2CompletedTreatmentChlamydial Infections1
2CompletedTreatmentDisseminated Sclerosis1
2CompletedTreatmentEsophageal Motility Disorders1
2CompletedTreatmentFatty Liver / Insulin Resistance / Liver Dysfunction1
2CompletedTreatmentHuman Immunodeficiency Virus (HIV) Infections / Infection, Mycobacterium Avium-Intracellulare2
2CompletedTreatmentMalaria caused by Plasmodium falciparum1
2CompletedTreatmentObliterative Bronchiolitis1
2CompletedTreatmentObsessive Compulsive Disorder (OCD) / PANS / Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections1
2CompletedTreatmentPeriodontitis, Chronic1
2CompletedTreatmentPlasmodium Falciparum Malaria1
2CompletedTreatmentPosterior Blepharitis1
2CompletedTreatmentRsv Bronchiolitis1
2CompletedTreatmentUncomplicated Falciparum Malaria1
2CompletedTreatmentBacterial blepharitis3
2Not Yet RecruitingTreatmentChronic Asthma1
2Not Yet RecruitingTreatmentLymphatic Filariasis / Traumas / Yaws1
2RecruitingPreventionHuman Immunodeficiency Virus (HIV) / Pregnancy Malaria / Sexually Transmitted Infections (STIs)1
2RecruitingTreatmentAsthma Bronchial1
2RecruitingTreatmentChlamydophila Pneumoniae Infections / Coronary Heart Disease (CHD)1
2RecruitingTreatmentDiabetes Mellitus (DM) / Diabetes, Diabetes Mellitus Type 1 / Diet Modification / Endocrine System Diseases / Glucose Metabolism Disorders / Inflammatory Reaction / Insulin Dependent Diabetes / Metabolic Diseases / Type 1 Insulin-Dependent Diabetes Mellitus1
2RecruitingTreatmentPulmonary Tuberculosis (TB)1
2RecruitingTreatmentSarcoidosis; Antimycobacterial Therapy1
2TerminatedPreventionBronchiectasis / Chronic Bronchitis / Pulmonary Diseases1
2TerminatedPreventionChronic Obstructive Pulmonary Disease (COPD) / Tracheostomy care1
2TerminatedPreventionCryptogenic Organizing Pneumonia / Lung Diseases, Interstitial / Obliterative Bronchiolitis / Respiratory Tract Infections (RTI)1
2TerminatedPreventionPseudomonas Infections / Ventilator-Associated Pneumonia (VAP)1
2TerminatedTreatmentAsthma Bronchial / Chronic Obstructive Pulmonary Disease (COPD)1
2TerminatedTreatmentMalaria caused by Plasmodium falciparum1
2TerminatedTreatmentPharyngitis / Tonsillitis1
2TerminatedTreatmentPosterior Blepharoconjunctivitis1
2TerminatedTreatmentBacterial blepharitis1
2Unknown StatusTreatmentAcne1
2Unknown StatusTreatmentCystic Fibrosis (CF)1
2Unknown StatusTreatmentPediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections1
2Unknown StatusTreatmentPlasmodium Infections1
2WithdrawnTreatmentMeibomian Gland Dysfunction (MGD)1
2, 3CompletedScreeningLow Risk of Preterm Delivery1
2, 3CompletedTreatmentMalaria caused by Plasmodium falciparum2
2, 3CompletedTreatmentPlasmodium Falciparum Malaria1
2, 3Not Yet RecruitingTreatmentMycobacterium avium complex infection / Nontuberculous Mycobacterium Infection1
2, 3RecruitingPreventionCampylobacter Infections / Enteric Pathogens / Malnutrition; Protein / Stunting1
2, 3RecruitingTreatmentRespiratory Syncytial Virus, Bronchiolitis1
2, 3TerminatedTreatmentCommunity-Acquired Bacterial Pneumonia (CABP)1
2, 3TerminatedTreatmentLeishmaniasis, Cutaneous1
2, 3TerminatedTreatmentMalaria caused by Plasmodium falciparum1
2, 3WithdrawnTreatmentTrachoma1
3Active Not RecruitingPreventionMalignant Hematological Diseases1
3Active Not RecruitingTreatmentChronic Obstructive Pulmonary Disease (COPD)2
3Active Not RecruitingTreatmentNon Cystic Fibrosis Bronchiectasis in Children1
3Active Not RecruitingTreatmentYaws1
3CompletedPreventionAnemias / Malaria in Pregnancy / Sexually Transmitted Infections (STIs)1
3CompletedPreventionCardiovascular Disease (CVD) / Coronary Heart Disease (CHD) / Heart Diseases / Myocardial Infarction1
3CompletedPreventionNeonatal Infections1
3CompletedPreventionPlasmodium Infections / Respiratory Tract Infections (RTI)1
3CompletedTreatmentAbdominal Pain (AP) / Fevers / Severe or persistent diarrhea / Vomiting1
3CompletedTreatmentAsthma Bronchial3
3CompletedTreatmentAsthma Bronchial / Wheezing1
3CompletedTreatmentChlamydial Infections1
3CompletedTreatmentChronic Bronchitis1
3CompletedTreatmentChronic Bronchitis / Chronic Obstructive Pulmonary Disease (COPD) / Coughing1
3CompletedTreatmentCommunity Acquired Pneumonia (CAP)1
3CompletedTreatmentConjunctivitis, Bacterial3
3CompletedTreatmentCystic Fibrosis (CF)1
3CompletedTreatmentHuman Immunodeficiency Virus (HIV)1
3CompletedTreatmentHuman Immunodeficiency Virus (HIV) Infections / Infection, Mycobacterium Avium-Intracellulare1
3CompletedTreatmentHuman Immunodeficiency Virus (HIV) Infections / Infection, Mycobacterium Avium-Intracellulare / Mycoses1
3CompletedTreatmentNeglected Tropical Disease / Treponema Infection / Yaws1
3CompletedTreatmentOtitis Media (OM)1
3CompletedTreatmentPelvic Inflammatory Disease (PID)1
3CompletedTreatmentPharyngitis / Tonsillitis1
3CompletedTreatmentPlasmodium Falciparum Infection1
3CompletedTreatmentPlasmodium Infections2
3CompletedTreatmentReactive Arthritis / Reiter's Disease1
3CompletedTreatmentUncomplicated Urogenital Gonorrhea1
3CompletedTreatmentBacterial blepharitis2
3Not Yet RecruitingDiagnosticPneumonia / Respiratory Tract Infections (RTI) / Tuberculosis Infection1
3Not Yet RecruitingTreatmentLymphatic Filariases / Oesophagostomiasis / Scabies / Trachoma / Yaws1
3RecruitingPreventionBronchiectasis / Cystic Fibrosis (CF)1
3RecruitingPreventionNeonatal Sepsis1
3RecruitingTreatmentChronic Cough (CC)1
3RecruitingTreatmentChronic Lung Diseases / Human Immunodeficiency Virus (HIV) Infections1
3RecruitingTreatmentLung Infection / Mycobacterium avium complex infection1
3RecruitingTreatmentPreterm Premature Rupture of Membranes (PPROM)1
3RecruitingTreatmentUndifferentiated Febrile Illness1
3RecruitingTreatmentSevere or persistent diarrhea1
3TerminatedTreatmentAsymptomatic Parasitemia In Pregnancy1
3TerminatedTreatmentCervicitis / Vaginitis Bacterial1
3TerminatedTreatmentChronic Obstructive Pulmonary Disease (COPD)1
3TerminatedTreatmentOtitis Media, Purulent / Otitis Media, Suppurative1
3Unknown StatusNot AvailableChronic Obstructive Pulmonary Disease (COPD)1
3Unknown StatusTreatmentBronchiectasis / Inflammatory Reaction1
3WithdrawnPreventionChronic Lung Disease of Prematurity1
3WithdrawnPreventionPreterm Premature Ruptured Membranes1
3WithdrawnTreatmentCommunity Acquired Pneumonia (CAP)1
4Active Not RecruitingTreatmentChild's Development1
4CompletedNot AvailableHealthy Volunteers1
4CompletedNot AvailablePregnancy1
4CompletedNot AvailableRespiratory Tract Infections (RTI)1
4CompletedPreventionBronchiolitis Obliterans Syndrome (BOS) / Lymphocytic Bronchiolitis / Rejection, Transplant / Respiratory Tract Infections (RTI)1
4CompletedSupportive CareBacterial Infections / Cataract Extraction / Eye Infections1
4CompletedSupportive CareBacterial Infections / Eye Infections2
4CompletedTreatmentAcute Otitis Media1
4CompletedTreatmentAsthma Bronchial4
4CompletedTreatmentBacterial Vaginosis (BV)1
4CompletedTreatmentChildhood Mortality1
4CompletedTreatmentChlamydia Trachomatis / Human Immunodeficiency Virus (HIV) / Neisseria Gonorrhoeae Infection1
4CompletedTreatmentChlamydia Trachomatis / Trachoma1
4CompletedTreatmentChlamydial Infections / Trachoma1
4CompletedTreatmentChronic Rhinosinusitis / High-risk Patients1
4CompletedTreatmentCommunity Acquired Pneumonia (CAP)1
4CompletedTreatmentContact Lens Dry Eye1
4CompletedTreatmentCrohn's Disease (CD)1
4CompletedTreatmentCystic Fibrosis (CF)2
4CompletedTreatmentDisorders Related to Lung Transplantation1
4CompletedTreatmentDry Eye Syndrome (DES)1
4CompletedTreatmentHelicobacter Pylori / Indigestion / Peptic Ulcers1
4CompletedTreatmentImpetigo / Scabies / Yaws1
4CompletedTreatmentLymphocytic Bronchi(Oli)Tis Post-lung Transplantation1
4CompletedTreatmentUrinary Bladder, Overactive1
4CompletedTreatmentBacterial blepharitis5
4CompletedTreatmentSevere or persistent diarrhea1
4Enrolling by InvitationTreatmentChildhood Mortality1
4Enrolling by InvitationTreatmentCystic Fibrosis (CF)1
4Not Yet RecruitingBasic ScienceMicrobial Colonization1
4Not Yet RecruitingDiagnosticHelminth Infection1
4Not Yet RecruitingPreventionAntibiotic Resistance, Bacterial / Child Growth / Child Mortality / Diversity of Microbiome1
4Not Yet RecruitingPreventionChildhood Mortality2
4Not Yet RecruitingTreatmentAnal infection / Chlamydia Trachomatis Infection / Vaginal Infections1
4Not Yet RecruitingTreatmentTrachoma2
4Not Yet RecruitingTreatmentUncomplicated Severe Acute Malnutrition1
4RecruitingPreventionClinical Efficacy / Drug Kinetics / Infections, Plasmodia / Pregnancy1
4RecruitingPreventionFlu caused by Influenza1
4RecruitingPreventionPostpartum Endometritis / Postpartum Fever / Puerperal Sepsis1
4RecruitingTreatmentAnal chlamydia infection1
4RecruitingTreatmentChildhood Mortality1
4RecruitingTreatmentCo-Infection / Malnutrition / Plasmodium Infections / Pneumonia / Severe or persistent diarrhea / The Mortality Rate1
4RecruitingTreatmentCommunity Acquired Pneumonia (CAP)1
4RecruitingTreatmentCystic Fibrosis (CF)1
4RecruitingTreatmentDry Eye Syndromes / Meibomian Gland Dysfunction (MGD)1
4TerminatedNot AvailableHealthy Volunteers1
4TerminatedDiagnosticMaxillary Sinusitis1
4TerminatedTreatmentAsthma Bronchial1
4TerminatedTreatmentChronic Bronchitis / Pneumonia / Respiratory Tract Infections (RTI)1
4Unknown StatusTreatmentBartonella Infections / Cat scratch disease1
4Unknown StatusTreatmentCervicitis / Chlamydia Trachomatis / Genital Mycoplasma Infection / Urethritis1
4Unknown StatusTreatmentChronic Obstructive Pulmonary Disease (COPD)1
4Unknown StatusTreatmentLiver Cirrhosis1
4Unknown StatusTreatmentM. Abscessus / Mycobacterium avium complex infection1
4Unknown StatusTreatmentMycobacterium avium complex infection1
4Unknown StatusTreatmentSalmonella Typhi Infection1
4WithdrawnNot AvailableLymphatic Filariasis / Trachoma1
4WithdrawnTreatmentChronic Bronchitis / Pneumonia, Bacterial1
Not AvailableActive Not RecruitingOtherAnti-Bacterial Agents / Microbiota1
Not AvailableCompletedNot AvailableBronchiectasis1
Not AvailableCompletedNot AvailableChlamydial Infections1
Not AvailableCompletedNot AvailableChronic Obstructive Pulmonary Disease (COPD)1
Not AvailableCompletedNot AvailableCommunity Acquired Pneumonia (CAP) / Pelvic Inflammatory Disease (PID)1
Not AvailableCompletedNot AvailableCystic Fibrosis (CF)1
Not AvailableCompletedNot AvailableEndometritis1
Not AvailableCompletedNot AvailableHuman Immunodeficiency Virus (HIV) Infections1
Not AvailableCompletedNot AvailableLegionella Pneumophila Infections / Legionnaires' Disease1
Not AvailableCompletedBasic ScienceBronchiectasis1
Not AvailableCompletedBasic SciencePregnancy1
Not AvailableCompletedDiagnosticPost-gastrointestinal bypass surgery1
Not AvailableCompletedPreventionAbscesses / Endometritis / Surgical Site Infections / Wound Infections1
Not AvailableCompletedPreventionChronic Lung Diseases1
Not AvailableCompletedPreventionChronic Obstructive Pulmonary Disease (COPD)2
Not AvailableCompletedPreventionFirst Trimester Abortion1
Not AvailableCompletedPreventionPlasmodium Infections1
Not AvailableCompletedPreventionSinusitis1
Not AvailableCompletedTreatmentBacterial Diseases / Parasitic Diseases1
Not AvailableCompletedTreatmentBronchiectasis1
Not AvailableCompletedTreatmentConjunctivitis caused by chlamydia1
Not AvailableCompletedTreatmentCryptosporidiosis infection / Human Immunodeficiency Virus (HIV) Infections2
Not AvailableCompletedTreatmentCystic Fibrosis (CF)1
Not AvailableCompletedTreatmentHuman Immunodeficiency Virus (HIV) Infections / Infection, Mycobacterium Avium-Intracellulare7
Not AvailableCompletedTreatmentHuman Immunodeficiency Virus (HIV) Infections / Infection, Mycobacterium Avium-Intracellulare / Tuberculosis, Mycobacterium Infection1
Not AvailableCompletedTreatmentObliterative Bronchiolitis / Transplantation, Bone Marrow1
Not AvailableCompletedTreatmentPeriodontal Diseases / Periodontitis, Chronic1
Not AvailableCompletedTreatmentPeriodontitis1
Not AvailableCompletedTreatmentPneumonia, Mycoplasma1
Not AvailableCompletedTreatmentSnoring / Strep Throat1
Not AvailableNot Yet RecruitingNot AvailableCommunity Acquired Pneumonia (CAP)1
Not AvailableRecruitingNot AvailableBronchiolitis Obliterans Syndrome (BOS)1
Not AvailableRecruitingNot AvailableBronchitis / Sinusitis / Urinary Tract Infections (UTIs)1
Not AvailableRecruitingNot AvailableChildren; Infection / Newborn; Infection1
Not AvailableRecruitingDiagnosticLower Respiratory Tract Infection (LRTI)1
Not AvailableRecruitingOtherWhooping Cough1
Not AvailableRecruitingTreatmentAsthmatic Patients1
Not AvailableRecruitingTreatmentCoughing / Idiopathic Pulmonary Fibrosis (IPF)1
Not AvailableRecruitingTreatmentHaemolytic and Uremic Syndrome1
Not AvailableRecruitingTreatmentMalnutrition in Pregnancy / Nutrition Disorders / Pregnancy / Stunting1
Not AvailableRecruitingTreatmentPneumonia, Mycoplasma1
Not AvailableRecruitingTreatmentUndernutrition / Undernutrition, Lactation, Fortified Balanced Energy-protein Supplementation1
Not AvailableTerminatedNot AvailableBacterial blepharitis1
Not AvailableTerminatedTreatmentAcute Watery Diarrhea / Dysentery/Febrile Diarrhea1
Not AvailableTerminatedTreatmentCryptosporidiosis infection / Human Immunodeficiency Virus (HIV) Infections1
Not AvailableTerminatedTreatmentGraft Versus Host Disease (GVHD) / Obliterative Bronchiolitis1
Not AvailableTerminatedTreatmentRefractory Mycoplasma Pneumoniae Pneumonia1
Not AvailableUnknown StatusTreatmentAsthma Bronchial1
Not AvailableUnknown StatusTreatmentPneumonia1


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  • Teva parenteral medicines inc
  • Pfizer inc
  • Inspire pharmaceuticals inc
  • Mylan pharmaceuticals inc
  • Teva pharmaceuticals usa inc
  • Wockhardt ltd
  • Advanced Pharmaceutical Services Inc.
  • Aidarex Pharmacuticals LLC
  • Amerisource Health Services Corp.
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  • APP Pharmaceuticals
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  • A-S Medication Solutions LLC
  • Baxter International Inc.
  • Cardinal Health
  • Catalent Pharma Solutions
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  • Direct Dispensing Inc.
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  • Diversified Healthcare Services Inc.
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  • H.J. Harkins Co. Inc.
  • Hospira Inc.
  • Innoviant Pharmacy Inc.
  • Inspire Pharmaceuticals
  • Kaiser Foundation Hospital
  • Lake Erie Medical and Surgical Supply
  • Liberty Pharmaceuticals
  • Major Pharmaceuticals
  • Medisca Inc.
  • Murfreesboro Pharmaceutical Nursing Supply
  • Mylan
  • Nucare Pharmaceuticals Inc.
  • Palmetto Pharmaceuticals Inc.
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Dosage forms
TabletOral250 mg
TabletOral600 mg
SolutionOphthalmic1 %
SolutionOphthalmic10 mg/1mL
Solution / dropsOphthalmic10 mg/1mL
For suspensionOral100 mg/5mL
For suspensionOral200 mg/5mL
InjectionIntravenous2.5 g/23mL
InjectionIntravenous500 mg/10mL
InjectionIntravenous500 mg/4.8mL
Injection, powder, lyophilized, for solutionIntravenous100 mg/1mL
Injection, powder, lyophilized, for solutionIntravenous500 mg/5mL
Injection, powder, lyophilized, for solutionIntravenous500 mg/1
Powder, for solutionOral200 mg
Powder, for suspensionOral1 g/1
Powder, for suspensionOral100 mg/5mL
Powder, for suspensionOral1200 mg/30mL
Powder, for suspensionOral200 mg/5mL
Powder, for suspensionOral200 mg
Powder, for suspensionOral900 mg/22.5mL
Tablet, film coatedOral250 mg/1
Tablet, film coatedOral500 mg/1
Tablet, film coatedOral600 mg/1
Injection, powder, lyophilized, for solutionIntravenous500 mg/10mL
TabletOral250 mg/1
TabletOral500 mg/1
TabletOral600 mg/1
TabletOral500 mg
Powder, for suspensionOral100 mg
CapsuleOral250 mg
Powder, for solutionIntravenous500 mg
Powder, for suspensionOral2 g/60mL
Granule, for suspension, extended releaseOral2 g
Unit descriptionCostUnit
Zithromax 3 1 gm Packets Box118.26USD box
Azithromycin 2.5 gm bulk vial75.6USD each
Zmax adult-ped 2 g/60 ml susp70.39USD each
Zithromax Tri-Pak 3 500 mg tablet Disp Pack69.67USD disp
Zithromax Z-Pak 6 250 mg tablet Disp Pack68.62USD disp
Zmax 2 g/60 ml susp sr67.04USD each
Zmax pediatric 2 g/60 ml susp67.04USD each
Zithromax 200 mg/5ml Suspension 30ml Bottle52.0USD bottle
Zithromax 100 mg/5ml Suspension 15ml Bottle51.6USD bottle
Zithromax 200 mg/5ml Suspension 15ml Bottle50.46USD bottle
Zithromax 200 mg/5ml Suspension 22.5ml Bottle50.46USD bottle
Azithromycin 3 500 mg tablet Disp Pack48.52USD disp
Azithromycin 6 250 mg tablet Disp Pack48.52USD disp
Azasite 1% eye drops42.85USD ml
Zithromax i.v. 500 mg vial34.39USD vial
Azithromycin 200 mg/5ml Suspension 15ml Bottle34.25USD bottle
Zithromax 600 mg tablet27.22USD tablet
Zithromax 500 mg tablet22.68USD tablet
Zithromax tri-pak 500 mg tablet22.24USD tablet
Azithromycin 600 mg tablet19.04USD tablet
Azithromycin 500 mg tablet15.87USD tablet
Trimox 125 mg/5ml Suspension 100ml Bottle11.99USD bottle
Trimox 125 mg/5ml Suspension 150ml Bottle11.99USD bottle
Trimox 250 mg/5ml Suspension 80ml Bottle11.99USD bottle
Zithromax 250 mg z-pak tablet11.12USD tablet
Azithromycin i.v. 500 mg vial11.09USD each
Azithromycin powder10.89USD g
Zithromax 250 mg tablet9.41USD tablet
Azithromycin 250 mg tablet6.33USD tablet
Apo-Azithromycin 250 mg Tablet3.11USD tablet
Co Azithromycin 250 mg Tablet3.11USD tablet
Mylan-Azithromycin 250 mg Tablet3.11USD tablet
Novo-Azithromycin 250 mg Tablet3.11USD tablet
Phl-Azithromycin 250 mg Tablet3.11USD tablet
Pms-Azithromycin 250 mg Tablet3.11USD tablet
Ratio-Azithromycin 250 mg Tablet3.11USD tablet
Sandoz Azithromycin 250 mg Tablet3.11USD tablet
Zithromax 40 mg/ml Suspension1.7USD ml
Zithromax 20 mg/ml Suspension1.2USD ml
Novo-Azithromycin 40 mg/ml Suspension0.95USD ml
Pms-Azithromycin 40 mg/ml Suspension0.95USD ml
Sandoz Azithromycin 40 mg/ml Suspension0.95USD ml
Novo-Azithromycin 20 mg/ml Suspension0.67USD ml
Pms-Azithromycin 20 mg/ml Suspension0.67USD ml
Sandoz Azithromycin 20 mg/ml Suspension0.67USD ml
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Patent NumberPediatric ExtensionApprovedExpires (estimated)


Experimental Properties
melting point (°C)114 °CPhysProp
water solubilityslightNot Available
logP4.02MCFARLAND,JW ET AL. (1997)
pKa8.74 (at 25 °C)MCFARLAND,JW ET AL. (1997)
Predicted Properties
Water Solubility0.514 mg/mLALOGPS
pKa (Strongest Acidic)12.43ChemAxon
pKa (Strongest Basic)9.57ChemAxon
Physiological Charge2ChemAxon
Hydrogen Acceptor Count13ChemAxon
Hydrogen Donor Count5ChemAxon
Polar Surface Area180.08 Å2ChemAxon
Rotatable Bond Count7ChemAxon
Refractivity194.11 m3·mol-1ChemAxon
Polarizability83.11 Å3ChemAxon
Number of Rings3ChemAxon
Rule of FiveNoChemAxon
Ghose FilterNoChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleYesChemAxon
Predicted ADMET features
Human Intestinal Absorption-0.5518
Blood Brain Barrier-0.9739
Caco-2 permeable-0.7578
P-glycoprotein substrateSubstrate0.8765
P-glycoprotein inhibitor IInhibitor0.8513
P-glycoprotein inhibitor IINon-inhibitor0.8893
Renal organic cation transporterNon-inhibitor0.8753
CYP450 2C9 substrateNon-substrate0.8373
CYP450 2D6 substrateNon-substrate0.9116
CYP450 3A4 substrateSubstrate0.6403
CYP450 1A2 substrateNon-inhibitor0.9295
CYP450 2C9 inhibitorNon-inhibitor0.9021
CYP450 2D6 inhibitorNon-inhibitor0.8904
CYP450 2C19 inhibitorNon-inhibitor0.9023
CYP450 3A4 inhibitorNon-inhibitor0.9533
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.9751
Ames testNon AMES toxic0.9133
BiodegradationNot ready biodegradable0.9673
Rat acute toxicity2.5423 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.9929
hERG inhibition (predictor II)Non-inhibitor0.8555
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)


Mass Spec (NIST)
Not Available
SpectrumSpectrum TypeSplash Key
Predicted GC-MS Spectrum - GC-MSPredicted GC-MSNot Available
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available
LC-MS/MS Spectrum - LC-ESI-qTof , PositiveLC-MS/MSNot Available
LC-MS/MS Spectrum - LC-ESI-qTof , PositiveLC-MS/MSNot Available
LC-MS/MS Spectrum - LC-ESI-qTof , PositiveLC-MS/MSNot Available
MS/MS Spectrum - , positiveLC-MS/MSsplash10-004l-0309050000-5e1be028a242f0d384eb
MS/MS Spectrum - , positiveLC-MS/MSsplash10-0f6t-0300030900-1a7ea512a0aa566e59ed
MS/MS Spectrum - , positiveLC-MS/MSsplash10-066r-4911100000-f759f24274aebce8e08c
MS/MS Spectrum - , positiveLC-MS/MSsplash10-052f-3912280200-df9a72a4769570064ef9


This compound belongs to the class of organic compounds known as aminoglycosides. These are molecules or a portion of a molecule composed of amino-modified sugars.
Organic compounds
Super Class
Organic oxygen compounds
Organooxygen compounds
Sub Class
Carbohydrates and carbohydrate conjugates
Direct Parent
Alternative Parents
Macrolides and analogues / O-glycosyl compounds / Oxanes / Monosaccharides / Tertiary alcohols / Trialkylamines / Secondary alcohols / 1,2-aminoalcohols / Amino acids and derivatives / Carboxylic acid esters
show 11 more
Aminoglycoside core / Macrolide / Glycosyl compound / O-glycosyl compound / Monosaccharide / Oxane / Tertiary alcohol / 1,2-aminoalcohol / Amino acid or derivatives / Carboxylic acid ester
show 22 more
Molecular Framework
Aliphatic heteromonocyclic compounds
External Descriptors
macrolide antibiotic (CHEBI:2955)


1. 23S rRNA
Enteric bacteria and other eubacteria
Pharmacological action
  1. Ng LK, Martin I, Liu G, Bryden L: Mutation in 23S rRNA associated with macrolide resistance in Neisseria gonorrhoeae. Antimicrob Agents Chemother. 2002 Sep;46(9):3020-5. [PubMed:12183262]
  2. Jalava J, Vaara M, Huovinen P: Mutation at the position 2058 of the 23S rRNA as a cause of macrolide resistance in Streptococcus pyogenes. Ann Clin Microbiol Antimicrob. 2004 May 6;3:5. [PubMed:15128458]
  3. Pereyre S, Renaudin H, Charron A, Bebear C, Bebear CM: Emergence of a 23S rRNA mutation in Mycoplasma hominis associated with a loss of the intrinsic resistance to erythromycin and azithromycin. J Antimicrob Chemother. 2006 Apr;57(4):753-6. Epub 2006 Feb 7. [PubMed:16464889]
Escherichia coli O157:H7
Pharmacological action
General Function
Structural constituent of ribosome
Specific Function
One of the primary rRNA binding proteins, this protein initially binds near the 5'-end of the 23S rRNA. It is important during the early stages of 50S assembly. It makes multiple contacts with diff...
Gene Name
Uniprot ID
Uniprot Name
50S ribosomal protein L4
Molecular Weight
22086.36 Da
  1. Halling SM, Jensen AE: Intrinsic and selected resistance to antibiotics binding the ribosome: analyses of Brucella 23S rrn, L4, L22, EF-Tu1, EF-Tu2, efflux and phylogenetic implications. BMC Microbiol. 2006 Oct 2;6:84. [PubMed:17014718]
  2. Tu D, Blaha G, Moore PB, Steitz TA: Structures of MLSBK antibiotics bound to mutated large ribosomal subunits provide a structural explanation for resistance. Cell. 2005 Apr 22;121(2):257-70. [PubMed:15851032]
  3. Schlunzen F, Harms JM, Franceschi F, Hansen HA, Bartels H, Zarivach R, Yonath A: Structural basis for the antibiotic activity of ketolides and azalides. Structure. 2003 Mar;11(3):329-38. [PubMed:12623020]
  4. Petropoulos AD, Kouvela EC, Starosta AL, Wilson DN, Dinos GP, Kalpaxis DL: Time-resolved binding of azithromycin to Escherichia coli ribosomes. J Mol Biol. 2009 Jan 30;385(4):1179-92. doi: 10.1016/j.jmb.2008.11.042. Epub 2008 Nov 27. [PubMed:19071138]
  5. Champney WS, Miller M: Inhibition of 50S ribosomal subunit assembly in Haemophilus influenzae cells by azithromycin and erythromycin. Curr Microbiol. 2002 Jun;44(6):418-24. [PubMed:12000992]
Escherichia coli O157:H7
Pharmacological action
General Function
Structural constituent of ribosome
Specific Function
This protein binds specifically to 23S rRNA; its binding is stimulated by other ribosomal proteins, e.g. L4, L17, and L20. It is important during the early stages of 50S assembly. It makes multiple...
Gene Name
Uniprot ID
Uniprot Name
50S ribosomal protein L22
Molecular Weight
12226.165 Da
  1. Halling SM, Jensen AE: Intrinsic and selected resistance to antibiotics binding the ribosome: analyses of Brucella 23S rrn, L4, L22, EF-Tu1, EF-Tu2, efflux and phylogenetic implications. BMC Microbiol. 2006 Oct 2;6:84. [PubMed:17014718]
  2. Tu D, Blaha G, Moore PB, Steitz TA: Structures of MLSBK antibiotics bound to mutated large ribosomal subunits provide a structural explanation for resistance. Cell. 2005 Apr 22;121(2):257-70. [PubMed:15851032]
  3. Schlunzen F, Harms JM, Franceschi F, Hansen HA, Bartels H, Zarivach R, Yonath A: Structural basis for the antibiotic activity of ketolides and azalides. Structure. 2003 Mar;11(3):329-38. [PubMed:12623020]
  4. Petropoulos AD, Kouvela EC, Starosta AL, Wilson DN, Dinos GP, Kalpaxis DL: Time-resolved binding of azithromycin to Escherichia coli ribosomes. J Mol Biol. 2009 Jan 30;385(4):1179-92. doi: 10.1016/j.jmb.2008.11.042. Epub 2008 Nov 27. [PubMed:19071138]
  5. Champney WS, Miller M: Inhibition of 50S ribosomal subunit assembly in Haemophilus influenzae cells by azithromycin and erythromycin. Curr Microbiol. 2002 Jun;44(6):418-24. [PubMed:12000992]
Pharmacological action
General Function
Protein-arginine deiminase activity
Specific Function
Catalyzes the citrullination/deimination of arginine residues of proteins such as histones, thereby playing a key role in histone code and regulation of stem cell maintenance. Citrullinates histone...
Gene Name
Uniprot ID
Uniprot Name
Protein-arginine deiminase type-4
Molecular Weight
74078.65 Da
  1. Knuckley B, Luo Y, Thompson PR: Profiling Protein Arginine Deiminase 4 (PAD4): a novel screen to identify PAD4 inhibitors. Bioorg Med Chem. 2008 Jan 15;16(2):739-45. Epub 2007 Oct 13. [PubMed:17964793]


1. Cytochrome P450 3A4
Pharmacological action
General Function
Vitamin d3 25-hydroxylase activity
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation react...
Gene Name
Uniprot ID
Uniprot Name
Cytochrome P450 3A4
Molecular Weight
57342.67 Da
  1. Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. doi: 10.1093/nar/gkp970. Epub 2009 Nov 24. [PubMed:19934256]
Pharmacological action
General Function
Steroid hydroxylase activity
Specific Function
Exhibits a high coumarin 7-hydroxylase activity. Can act in the hydroxylation of the anti-cancer drugs cyclophosphamide and ifosphamide. Competent in the metabolic activation of aflatoxin B1. Const...
Gene Name
Uniprot ID
Uniprot Name
Cytochrome P450 2A6
Molecular Weight
56501.005 Da
  1. Xia XY, Peng RX, Yu JP, Wang H, Wang J: In vitro metabolic characteristics of cytochrome P-450 2A6 in Chinese liver microsomes. Acta Pharmacol Sin. 2002 May;23(5):471-6. [PubMed:11978200]


Pharmacological action
General Function
Xenobiotic-transporting atpase activity
Specific Function
Energy-dependent efflux pump responsible for decreased drug accumulation in multidrug-resistant cells.
Gene Name
Uniprot ID
Uniprot Name
Multidrug resistance protein 1
Molecular Weight
141477.255 Da
  1. Wang E, Lew K, Barecki M, Casciano CN, Clement RP, Johnson WW: Quantitative distinctions of active site molecular recognition by P-glycoprotein and cytochrome P450 3A4. Chem Res Toxicol. 2001 Dec;14(12):1596-603. [PubMed:11743742]
  2. Asakura E, Nakayama H, Sugie M, Zhao YL, Nadai M, Kitaichi K, Shimizu A, Miyoshi M, Takagi K, Takagi K, Hasegawa T: Azithromycin reverses anticancer drug resistance and modifies hepatobiliary excretion of doxorubicin in rats. Eur J Pharmacol. 2004 Jan 26;484(2-3):333-9. [PubMed:14744620]

Drug created on June 13, 2005 07:24 / Updated on January 22, 2019 20:57