Zmax Dosage

Generic name: AZITHROMYCIN DIHYDRATE 2g in 60mL
Dosage form: powder, for oral suspension
Drug class: Macrolides

Medically reviewed by Drugs.com. Last updated on Feb 24, 2023.

Adults

Zmax should be taken as a single 2 g dose. Zmax provides a full course of antibacterial therapy in a single oral dose. It is recommended that Zmax be taken on an empty stomach (at least 1 hr before or 2 hr following a meal).

Pediatric Patients

For pediatric patients 6 months and older, Zmax should be taken as a single dose of 60 mg/kg (equivalent to 27 mg/lb) body weight. The Zmax dose in mL is equivalent to the child's weight in lb (1 mL/lb dose, see Table 1 below), for a body weight of less than 75 lb (34 kg). It is recommended that Zmax be taken on an empty stomach (at least 1 hr before or 2 hrs following a meal).

Pediatric patients weighing 75 lb (34 kg) or more should receive the adult dose (2 g).

Table 1. Zmax Pediatric Dosage Guidelines: 1-dose regimen
Dosing Calculated on 1 mL/lb, Dose 1 mL of Suspension for every 1 lb of Body Weight for Children <75 lb (34 kg)*
Weight		1 mL/lb Dose
Lb	Kg	Dose	Volume
Lb	Kg	(mg)	(mL)
* To ensure accurate dosing, a dosing spoon, medicine syringe, or cup is recommended.

10	5	270	10
15	7	405	15
20	9	540	20
25	11	675	25
30	14	810	30
35	16	945	35
40	18	1080	40
45	20	1215	45
50	23	1350	50
55	25	1485	55
60	27	1620	60
65	30	1755	65
70	32	1890	70
≥75	34	2000	Consume entire contents of bottle

Additional Treatment after Vomiting with Zmax

In the event that a patient vomits within 5 minutes of administration, the health care provider should consider additional antibiotic treatment since there would be minimal absorption of azithromycin. Since insufficient data exist on absorption of azithromycin if a patient vomits between 5 and 60 minutes following administration, alternative therapy should be considered. Neither a second dose of Zmax nor alternative treatment is warranted if vomiting occurs ≥60 minutes following administration, in patients with normal gastric emptying. In patients with delayed gastric emptying, alternative therapy should be considered.

Instructions for the Pharmacist

Constitute with 60 mL of water and replace cap. Shake bottle well before dispensing. Do not refrigerate. Constituted suspension should be consumed within 12 hr.

For pediatric dosing in patients weighing less than 75 lb (34 kg), use of a dosing device is recommended. The pharmacist should inform the patient's caregiver that any suspension remaining after dosing MUST be discarded.