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

Lifesaving Medications

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

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

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Keeping you informed and safe.

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