AzaSite (Azithromycin): Uses, Side Effects, Dosage

By Sarah Malka, MD
Medically reviewed
November 17, 2021

If either you or your child has recently been diagnosed with bacterial conjunctivitis (also called pink eye), your health care provider may prescribe a medication called AzaSite (azithromycin ophthalmic) to treat the infection.

AzaSite is a prescription drug in a class of medications called macrolide antibiotics often used to kill the bacteria that causes certain eye infections.

Naturally, as with any new medication you’re prescribed, you may have some questions about it.

Before using AzaSite, it’s important to understand how to take the medication properly, what side effects may occur, and which precautions, if any, may be worth taking before starting the medication. 

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What is AzaSite?

In 2007, AzaSite became the first commercially available form of ophthalmic azithromycin approved by the Food and Drug Administration (FDA) to treat bacterial conjunctivitis

It’s a prescription drug in a class of medications called macrolide antibiotics used to kill the type of bacteria that causes bacterial conjunctivitis (also called pink eye) in adults and children over the age of one.

It comes as a topical solution used for ophthalmic use only (eye drops). 

AzaSite Uses

AzaSite is prescribed to treat bacterial conjunctivitis most commonly caused by the bacteria CDC coryneform group G, Haemophilus influenzae, Staphylococcus aureus, Streptococcus mitis group, and Streptococcus pneumoniae

Eye infections

Eye infections can be painful and bothersome, perhaps especially if you’re unsure about the exact cause of your symptoms. 

Pink eye, also known as conjunctivitis, is an infection in the thin outer membrane that covers a person’s eyeball.

There are three different types of pink eye: allergic conjunctivitis, bacterial conjunctivitis, and viral conjunctivitis.

Though they can share common symptoms, including redness and irritation, itchiness, and tearing or watering eyes, they are treated differently.

Bacterial conjunctivitis, which can be highly contagious, is the type of pink eye that is often treated with antibacterial eye drops, including AzaSite. 

How to Use AzaSite Eye Drops

As with any new medication, it’s important to follow the directions on the prescription label carefully.

If any of the directions are unclear, ask your provider or pharmacist about how to proceed.

AzaSite comes in topical form and is designed for ophthalmic use only.

The medication is generally applied twice daily for the first two days (8-12 hours apart) and then once daily for the next five days.

But if your provider recommends otherwise, be sure to follow their instructions.

Generally speaking, it’s a good idea to take antibiotic medication at about the same time each day.

Administration

When administering the drops, be sure to:

  1. Keep AzaSite in the refrigerator until you are ready to start using it. After opening, you can put it back in the refrigerator or leave it at room temperature.
  2. Wash your hands thoroughly before applying the eye drops.
  3. Even after washing your hands, don’t touch the tip of the dropper or let it touch your eye or any other surface.
  4. Before first use, hold the dropper upright and remove the cap to release any extra pressure inside the dropper.
  5. Then, put the cap on and shake the dropper as directed.
  6. Tilt your head back, look upward, and hold the lower lid of the affected eye to create a pouch.
  7. Hold the dropper directly over your eye to place one drop into the pouch.
  8. Look downward and close your eyes for up to 2 minutes to allow the medicine to absorb into the eye.
  9. To prevent excess solution from running out of your eyes, place one finger at the corner of your eye and apply gentle, easy pressure.
  10. If recommended by your provider, repeat the process on the other eye.
  11. Avoid wearing contact lenses while taking this medication.

Your symptoms may start to improve within a few days of starting treatment, but it’s still important to complete the course of medication as directed by your provider or pharmacist.

If you don’t complete the full course of treatment or skip several doses, the infection may not be fully treated and symptoms can resurface.

If your symptoms don’t improve after one week of starting AzaSite, reach out to your provider as soon as possible.

Dosage

Generally, AzaSite is prescribed for use two times a day (roughly 8-12 hours apart) in the affected eye for the first two days and then once a day for the following five days.

The solution is equivalent to 0.1% azithromycin (2.5 mL in a 5 mL bottle containing a total of 25mg of azithromycin).

What happens if I miss a dose?

Take the missed dose as soon as you remember it, unless you are close to the timing of the next dose.

In that case, skip the missed dose and continue the regular dosing schedule until you complete the antibiotics as directed.

Importantly, you should never take an extra dose to make up for a missed one.

AzaSite Side Effects

The most common adverse reaction reported in 1-2% of patients treated with the medication was eye irritation.

Additional side effects that occured in less than 1% of those studied in clinical trials were:

  • Burning, stinging, and irritation upon instillation
  • Contact dermatitis
  • Corneal erosion
  • Dry eye
  • Dysgeusia
  • Nasal congestion
  • Ocular discharge
  • Punctate keratitis
  • Sinusitis

Precautions for AzaSite

Before starting AzaSite, tell your provider about any medications, vitamins, supplements, or herbal products you’re currently taking and whether or not you’re pregnant.

It’s also important to disclose whether or not you’re allergic to azithromycin, any other antibiotics, or any of the ingredients in AzaSite.

People with a known hypersensitivity to azithromycin or erythromycin should let their provider know to discuss alternate treatment options.

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When to See a Doctor

Reach out to your provider if you’re experiencing any of the side effects of bacterial pink eye, including:

  • Redness or irritation
  • Itchiness
  • A burning sensation
  • A sandy or gritty feeling in one or both eyes
  • Tearing or watering eyes
  • Mucus or pus in one or both eyes
  • A watery or runny nose
  • Cough
  • Sore throat
  • Fever
  • Rash

If your provider confirms that you have bacterial conjunctivitis, ask if AzaSite is right for you.

How K Health Can Help

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Frequently Asked Questions

What is AzaSite used for?
AzaSite is used to treat bacterial conjunctivitis (pink eye).
Is AzaSite the same as azithromycin?
AzaSite is an ophthalmic form of azithromycin.
How do you use AzaSite for blepharitis?
Unfortunately, AzaSite is not typically used to treat blepharitis, or eyelid inflammation. Not all cases of blepharitis are bacterial, but if your provider recommends an antibiotic to treat your blepharitis, the first-line treatment is usually erythromycin.
What kind of drug is AzaSite?
AzaSite contains azithromycin, a macrolide antibiotic.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

Sarah Malka, MD

Dr. Sarah Malka is a board certified emergency medicine physician with K Health. She completed her residency at Harvard Medical School.