Can Zithromax Be Mixed with Water?
Yes, Zithromax (azithromycin) oral suspension can be mixed with water for administration to both pediatric and adult patients, and the tablets and sachet formulations can be taken with or without food, including water. 1
Oral Suspension Formulation
The pediatric oral suspension formulation is specifically designed to be reconstituted with water before administration, making it the preferred formulation for children who cannot swallow tablets. 2, 3
Azithromycin suspension maintains its bioavailability when taken with food or water, with studies demonstrating 113% relative bioavailability when the 500 mg suspension was administered with a standard high-fat breakfast compared to fasting conditions. 1
The oral suspension has superior palatability compared to other pediatric antibiotics, which enhances compliance in children—a critical factor given that azithromycin is commonly used for otitis media, pharyngitis, and respiratory infections in this population. 4
Tablet and Sachet Formulations
Azithromycin tablets (250 mg) and sachet (1000 mg) formulations can be taken with or without regard to meals, as food does not significantly decrease bioavailability of these newer formulations. 1
The mean relative bioavailability of azithromycin tablets when taken with food was 96%, and the 1000 mg sachet showed 112% relative bioavailability, confirming that water or food intake does not impair absorption. 1
Important Administration Considerations
Do not administer azithromycin simultaneously with aluminum- or magnesium-containing antacids, as these reduce drug absorption and should be separated by at least 2 hours. 2, 3, 5
The convenience of once-daily dosing without food restrictions enhances compliance, particularly important in pediatric populations where adherence to multi-dose regimens is challenging. 1, 4
Common Pitfall to Avoid
- Older azithromycin capsule formulations required administration without food, but this restriction does not apply to current tablet, suspension, or sachet formulations—ensure you are not following outdated labeling that applies only to the discontinued capsule form. 1