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Zithromax [Azithromycin] / Bilirubin


Recently, the doctor of my CF outpatient department was very surprised about my Zithromax dosage. I take 500mg [milligram] three times a week (on Monday, Wednesday and Friday). He said, this dosage is too high, all other patients in the outpatient department would only take 250mg three times a week. But I know from other CF patients that 3x500mg is taken frequently. Then, the doctor said that he wanted to control the liver enzymes. GOT, GPT, etc. is fine, without anomalies. However, the bilirubin is 1,9 (instead of max 1,2).Now he wants me to take only half as much Zithromax than before, namely 3x250mg. But I don't see the point in reducing the dose of Zithromax to then end up catching more infections.Is the value of the bilirubin really so very critical (especially since all other values are okay)? And are there any objections regarding the former dose respectively?Thank you very much for your answer.

Unfortunately, I do not know much about you according to the particulars given, so that I can only answer in a general way: The dosage of Zithromax is generally speaking 3x250 mg per week for persons that weigh less than 40kgs and 3x500mg for those who weigh more than 40kgs. Although an isolated increase of bilirubin is possible, it is not very likely, though, if all other values are normal. It would be necessary to also check the alkaline phosphatase (ALKP) and to do an ultrasound of the liver for several reasons. Indeed, the bilirubin values should also be controlled again, because there are innocuous diseases , that cause a temporary slight increase of the value.

You should get together with your doctor in charge again and discuss this, then you will surely find a way that is acceptable for both of you. It is unfavourable if one cannot agree to something that the doctor recommends and therefore one does not follow the suggestions. You should comment this to your doctor.

With kind regards,
Prof. Dr. med. Joachim Bargon