Side effects - JASE Medical

How Long Do My Meds Last? A Look at Azithromycin

(They may last longer than you think)

Azithromycin is a type of macrolide antibiotic. It works by decreasing the production of protein and stopping bacterial growth. Other macrolide antibiotics include clarithromycin and erythromycin.

Because of the anti-inflammatory and antiviral properties of Azithromycin, this antibiotic was used extensively for mild to moderate symptoms of Covid during the pandemic; however, a study published by the American Family Physician showed no difference in symptoms or mortality when compared to a placebo in hospitalized patients(patients with severe symptoms).

Azithromycin is listed in the World Health Organization Model List of Medications for the newly released 2023 edition:

FIRST CHOICE (From WHO 2023 List)

  • Cholera
  • Enteric fever
  • Gonorrhea
  • Chlamydia trachomatis
  • Trachoma (a contagious bacterial infection of the eye in which there is inflamed granulation on the inner surface of the lids)
  • Yaws (a tropical infection of the skin, bones, and joints caused by the spirochete bacterium)

SECOND CHOICE

  • Acute invasive bacterial diarrhea
  • Dysentery
  • Gonorrhea

In addition, Azithromycin can be used to treat

  • Pneumonia and
  • Urinary tract infections

How long does Azithromycin remain potent?

The potency of antibiotics can be affected by factors such as temperature, light, moisture, and storage conditions. Inappropriate storage and transportation of antibiotics may lead to loss of potency earlier than the expiry date. Keep dry and at stable room temperature away from light.

Expiration dates reflect when the product is expected to remain stable or retain its identity, strength, quality, and purity when properly stored according to its labeled storage conditions.

According to the Shelf-Life Extension Program, a joint initiative of the FDA and Department of Defense that tested 122 drugs for potency after their expiration date revealed that erythromycin powder, a macrolide antibiotic in the same family as Azithromycin, retained its potency up to 83 months (over 7 years). Given that powder forms of antibiotics lose potency sooner than tablet form, this family of antibiotics may likely retain its potency past 7 years.

It is a general consensus that even though antibiotics are safe to take past their expiration date, they may lose potency.

How to take

Azithromycin is usually taken once a day.

Take capsules whole with a large glass of water and 1 hour before or 2 hours after meals.

Side effects

Common side effects include nausea, vomiting, diarrhea and an upset stomach.

An allergic reaction, such as anaphylaxis, QT prolongation, or a type of diarrhea caused by Clostridium difficile is possible.

What to avoid

Do not take Azithromycin if you have hypersensitivity or allergy to erythromycin or other macrolide antibiotics.

Do not take antacids that contain aluminum or magnesium within 2 hours before or after you take Azithromycin, as these can make it less effective. This includes Gaviscon, Maalox, Milk of Magnesia, Mylanta, Pepcid Complete, Rolaids, and others. These antacids can make Azithromycin less effective when taken at the same time.

Consult with your care provider before taking if you have:

  • Liver disease.
  • Kidney disease.
  • Myasthenia gravis.
  • A heart rhythm disorder.
  • Low levels of potassium in your blood.
  • Long QT syndrome (in you or a family member).

Seek medical attention if you experience:

  • Allergic reaction to Azithromycin: (hives, difficult breathing, swelling in your face or throat)
  • Severe skin reaction: (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling)

- Brooke Lounsbury, RN

Medical Content Writer

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Amoxicillin-Clavulanate Is it Still Good Past Expiration Date?

Amoxicillin-Clavulanate (also known under the brand name Augmentin) is a beta-lactam combination antibiotic. Amoxicillin is a penicillin antibiotic that fights bacteria in the body. Clavulanate potassium is a beta-lactamase inhibitor that helps prevent certain bacteria from becoming resistant to amoxicillin.

This combination antibiotic is used to treat bacterial infections such as bites, dental infections, pneumonia, ear infections, sinusitis, skin infections and in some cases, urinary tract infections.

When stored in a cool, dry and dark area away from sunlight and capped, amoxicillin-clavulanate can retain much of its potency past expiration date. In fact, there is no evidence that this antibiotic becomes toxic past its expiration date, however it may become less effective.

What is the difference between shelf life and expiration date?

Shelf life is the time a product is exposed to storage conditions such as heat, light and humidity and how it affects the potency of a drug. Expiration dates reflect the time period during which the product is expected to remain stable, or retain its identity, strength, quality, and purity, when it is properly stored according to its labeled storage conditions. According to the Shelf Life Extension Program, a joint initiative of the FDA and Department of Defense that tested 122 drugs for potency after their expiration date, revealed that Ampicillin, which is in the same family as Amoxicillin-Clavulanate maintained its active ingredients with no deterioration in strength for up to 64 months. This represents an average extension time, with some lots testing even further out on the timeline. Given the stated expiration date of Ampicillin is around 2 years, this represents a significant increase in time that it is still active. From 64 months on (Over 5 years) potency may be slightly affected. Research is ongoing.

How to take Amoxicillin- Clavulanate

Tablets can be taken with or without food, but typically gastrointestinal side effects are lessened when taken with food. Avoid high fat foods as this can make it harder for your body to absorb the medication. Tablets may be crushed if difficulty swallowing pills. If taking an extended-release tablet, DO NOT CRUSH- Swallow whole.

Side Effects

  • Most common side effects include: gastrointestinal symptoms like diarrhea (may be caused by c. diff), nausea, and vomiting
  • Less common side effects include: abdominal pain, flatulence, low platelet count, liver injury, rash, and headaches

When To Avoid

  • Allergy or hypersensitivity to amoxicillin or clavulanic acid, or other beta-lactam antibiotics like penicillin or cephalosporins (like Keflex or cephalexin)
  • History of kidney or liver disease (or on dialysis)
  • Co-administration with probenecid and allopurinol
  • Avoid if suspicion or confirmed mononucleosis infection
  • Tell your care provider if you are pregnant or breastfeeding. This antibiotic can pass into breast milk and affect the infant.
  • Amoxicillin-Clavulanate can make birth control pills less effective. Ask your care provider about using a non-hormonal birth control (condom, diaphragm, cervical cap, or contraceptive sponge) to prevent pregnancy.

Seek medical attention if you experience:

  • Discontinue and seek emergency help if: signs of allergy (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).
  • Diarrhea that is bloody or watery
  • Swollen glands
  • Muscle aches
  • Yellowing of skin and/or eyes (jaundice)
  • Severe weakness
  • Unusual bruising

- Brooke Lounsbury, RN

Medical Content Writer

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How do Antibiotics Work? Part 4

The best way to take antibiotics is to never need them. But that isn’t always an option. However, there are some steps you can take to strengthen your immune system so that you and your loved ones can fight off illness. The recent outbreak of deaths from group A strep– which is usually treated with Amoxicillin, is currently in short supply. This highlights the fragility of our nations drug supply. Check this site for current drug shortages- if a medication you are taking is on the list contact your care provider to get your medications refilled, and if available ask for a years supply of your meds.

8 tips to strengthen your immune system

  1. Get good quality sleep

According to the Sleep foundation good quality sleep enhances both the innate and adaptive immune system responses. Non rapid eye movement, known as NREM is deep sleep slows the body’s processes allowing more energy to be directed at healing. Sleep is such an important topic that it really needs its own post.

  1. Cut back on sugar

Professor of immunobiology at Yale, Ruslan Medzhitov performed experiments on mice- after infecting the mice with the bacteria Listeria monocytogenes he fed one group fat and proteins. They lived. The group he fed simple carbohydrates died.  Conversely, when the mice were infected with an influenzas virus and fed fats and proteins, they were more likely to die compared to the mice fed simple carbohydrates. In other words, balance is the key. If unsure if you have a viral or bacterial infection it is best to just cut out excess sugar.

  1. Increase fresh fruits and vegetables

Up to 80% of our immune system is housed in lymphoid tissue in your intestines, It is called gut associated lymph tissue (GALT) By eating fiber rich foods the beneficial bacteria help the immune system do its job. In addition, a study found that eating a diverse diet high in fiber rich foods can help combat antibiotic resistance. There needs to be more research in this area of study, however initial results are promising.

In addition, several varieties of mushrooms are known to improve immune system function and are being studied for their cancer fighting properties.

  1. Drink plenty of water

Water helps flush toxins out of the body, both through elimination and mucus membranes.

The bloodstream is comprised mostly of water. To help the body fight infection keeping hydrated helps the white blood cells do their job- fight infections.

  1. Avoid alcohol and smoking–

Both can decrease immunity

  1. Keep your vitamin D levels up

Vitamin D is well known to help fight infections. Be sure that when you take vitamin D (which is really not a vitamin, it is a steroid hormone) be sure to add vitamin K2, also known as MK 7, This is important, because this helps avoid calcium buildup in your arteries.

  1. Reduce and manage stress

Stress raises our cortisol levels which in turn suppresses the immune response to pathogenic invaders.

  1. Exercise to boost immunity

Research shows that 20–40 minutes of moderate-intensity exercise per day is adequate to provide a positive boost to the immune system. Exercise helps circulate the infection fighting cells in the body.

If you still need an antibiotic Jase has you covered

The 5 antibiotics in the Jase case can cover a wide range of bacterial illnesses. If in doubt contact Jase provider for guidance, part of the outstanding service Jase offers is unlimited follow up for questions about antibiotic use.

 Let’s take a look at some of the infections Jase antibiotics cover:

  • Amoxicillin-clavulanate 875 mg tablets (28 tablets)

When amoxicillin is not available due to current shortages this antibiotic can be substituted. Other uses include group A strep, sinusitis, pneumonia, ear infections, bronchitis, urinary tract infections, and infections of the skin

  • Azithromycin 250 mg tablets (6 tablets)

Bacterial pneumonia, ear and sinus infections, skin infections, Travelers diarrhea, urinary tract infection

  • Ciprofloxacin 500 mg tablets (28 tablets)

Bioterrorism infections from anthrax, Tularemia or plague exposure

Travelers diarrhea

  • Doxycycline 100 mg capsules (120 capsules)

Bioterrorism infections from anthrax, Tularemia, or plague exposure

Skin infection, tetanus, bites (animal or human)

  • Metronidazole 500 mg tablets (30 tablets)

bacterial vaginosis, diarrhea (caused by giardia and clostridioides difficile), giardiasis, tetanus, and trichomoniasis

 

- Brooke Lounsbury

Medical Content Writer

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Everyone should be empowered to care for themselves and their loved ones during the unexpected.
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How do Antibiotics Work? Part 3

In part 1 we reviewed how antibiotics work, part 2 what biofilms are and their role in antibiotic resistance. In part 3 we will review:

  • When antibiotics are needed and when they aren’t appropriate
  • Distinguish between an allergic reaction to an antibiotic and the symptoms the infection is treating

When antibiotics are needed and when they aren’t appropriate

Antibiotic stewardship is one of the most pressing health issues of our time. As pathogens mutate and evade antibiotic therapy, we are forced to use more potent antibiotics. The use of antibiotics when not necessary is leading to devastating consequences. Antibiotic resistance, AKA antimicrobial resistance happens when germs like bacteria or fungi no longer respond to the drugs designed to kill them. According to the CDC: “About 47 million antibiotic courses are prescribed for infections that don’t need antibiotics, like colds and the flu, in U.S. doctors’ offices and emergency departments each year. That’s about 28% of all antibiotics prescribed in these settings.”

In the U.S., more than 2.8 million antimicrobial-resistant infections occur each year. A list of the antimicrobial resistant infections are listed on the CDC website. Some are familiar to the general population such as MRSA- Methicillin resistant Staphylococcus aureus, and VRE- Vancomycin resistant Enterococci. Some not so familiar-Drug resistant Candida and Carbapenem-resistant Acinetobacter for example. A full list of CDCs watchlist can be found here.

Antibiotics are indicated when:

A bacteria or fungal infection has taken over the body, either systemically (in the body) or topically-skin and tissues. Entry points can be a break in the skin, respiratory inhalation, eyes. Ears, mouth, urogenital route, or ingestion. They are not needed in all cases, sometimes our body can fight off the infection. If you own a Jase case check with your care provider when in question. They are not appropriate for viral illnesses such as colds, flu, covid, etc. Sometimes a viral infection will lower the body’s immune defenses allowing an opportunistic bacterial or fungal infection to take over as in the case of a viral pneumonia to bacterial pneumonia. At that point an antibiotic may be needed.

Distinguish between an allergic reaction to an antibiotic and the symptoms the infection is treating

Penicillin, the most commonly reported antibiotic allergy is less common than believed to be.

This is a great you tube video on penicillin allergies

According to the CDC: Although 10% of the population in the U.S. reports a penicillin allergy, less than 1% of the population is truly penicillin allergic.

The difference between a side effect and allergy

Side effects to antibiotics

  • Nausea, vomiting
  • Diarrhea
  • Mild rash
  • Photosensitivity
  • Vaginal yeast infection
  • Thrush

Allergic reaction to antibiotics- Seek medical care immediately

  • Severe rash/hives
  • Peeling skin
  • Anaphylactic reactions such as:
  • Respiratory distress/wheezing
  • Throat closing/tightness

- Brooke Lounsbury

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.
Order Today

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Keeping you informed and safe.

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