Those taking Zithromax may experience some of the most common side-effects, namely diarrhoea, nausea, abdominal pain, and vomiting which are thought to occur in around 5% of those treated with this azithromycin. An unfortunate few may have more severe reactions to the medication such as liver abnormalities, allergic reactions, and anxiety or nervousness.The gastrointestinal effects may be so debilitating in some patients that they need to cut their dose of Zithromycin or switch to a different Lyme disease antibiotic.
The flare-up of some Lyme disease symptoms may be considered a ‘herxing’ reaction as the Borrelia spirochaetes die off during treatment. Patients should not simply assume a Jarisch-Herxheimer reaction to Zithromax however as this does not always occur and, indeed, is not necessary as some believe to effect a complete cure of Lyme disease. Any adverse reaction to medication should be reported to the prescribing doctor in order for appropriate investigation to occur not only for the individual patient but for other patients who may be prescribed the medication in the future. A symptom flare-up may be due to another infection, of an IV line for example, or an unrelated infection such as pneumonia which could become life-threatening.
In some cases the initial side-effects of Zithromax may subside after a few days, although some patients may wish to discuss ways of reducing the likelihood of such side-effects through adjunct medications such as zofran, or phenergan. Protein-pump inhibitors to control acid reflux (heartburn) may also be prescribed in lieu of aluminium- or magnesium-based antacids during treatment with Zithromax. A minority of patients may experience the complication of Zithromax lowering potassium levels, which can be extremely dangerous in terms of heart function. Patients may be given potassium supplements during their treatment with Zithromax or may be switched to a different Lyme disease antibiotic.
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