When I get sick, I assume an antibiotic will solve my problems. I’m slightly allergic to amoxicillin. Zithromax, Z-Pak (Z-Pac, I’ve seen both), Zmax, or any similar antibiotic to treat bacterial infections is my drug of choice for ear infections, strep throat, pneumonia, traveler’s diarrhea, or other intestinal infections.
There are risks with any drug. You have been told that time and time again. But if you are like me, you just want to feel better and you have a history with antibiotics of doing just that.
A new study underscores that maybe we should slow our roll in racing to get Zithromax. Because the study suggests that the potential side effects are more than just theoretical and can increase the risk of heart problems and death. This gets my attention. Because I’d rather be sick than dead.
Z-Pac
Cardiovascualar Risk with Z-PAC
New England Journal of Medicine Study
A landmark study published in the New England Journal of Medicine in 2012 brought these concerns to the forefront. The study found a small but statistically significant increase in cardiovascular deaths among patients taking azithromycin compared to those taking other antibiotics or no antibiotics. Specifically, the study reported that for every million courses of azithromycin, there were an estimated 47 additional cardiovascular deaths. This finding was particularly alarming given the widespread use of azithromycin and its perception as a safe antibiotic option.
Although the precise mechanisms by which azithromycin increases cardiovascular risk are not entirely understood, it is believed to be related to its effect on the heart’s electrical activity. Azithromycin’s ability to interfere with cardiac ion channels may be a contributing factor, leading to disruptions in the heart’s normal rhythm. The risk is further amplified in patients with genetic predispositions to arrhythmias or those with existing cardiac conditions.
These findings underscore the importance of cautious use of azithromycin, particularly in patients with underlying heart conditions or those on concurrent QT-prolonging medications. Healthcare providers are advised to thoroughly assess the cardiovascular risk factors of patients before prescribing azithromycin. In cases where alternative antibiotics are available and appropriate, they may be preferred to mitigate potential risks. Additionally, monitoring ECGs and electrolyte levels in at-risk patients can be prudent when azithromycin use is necessary.
In conclusion, while azithromycin remains a valuable tool in the treatment of bacterial infections, awareness of its potential cardiovascular risks is crucial. Both healthcare providers and patients should engage in informed discussions about the benefits and risks associated with its use, ensuring that azithromycin is prescribed judiciously and safely.
2023 Study
The study “Relationship Between Azithromycin and Cardiovascular Outcomes in Unvaccinated Patients With COVID-19 and Preexisting Cardiovascular Disease,” published in the Journal of the American Heart Association, investigated the cardiovascular risks associated with azithromycin in COVID-19 patients. Using data from the ISACS-COVID-19 registry, it included 793 patients treated with azithromycin and 2141 receiving standard care. The primary outcomes were 30-day mortality and acute heart failure (AHF).
Key findings revealed that among patients with preexisting cardiovascular disease (CVD), Z-Pac use was significantly associated with an increased risk of AHF (risk ratio [RR], 1.48) but not with an increased risk of death (RR, 0.94). Conversely, in patients without prior CVD, azithromycin was associated with a reduced risk of death (RR, 0.57) and no significant increase in acute heart failure. These findings suggest that while azithromycin may pose cardiovascular risks for patients with preexisting cardiovascular disease, it might offer some mortality benefit for those without prior cardiovascular conditions. What that tells us is that this is not always a simple decision and it needs to be make with your doctor. Getting eduated online is not enough.
FDA Safety Communication
The FDA issued a Zithromax drug safety communication, warning that the drug can disrupt the electrical activity of the heart. Federal drug regulators also warned that the side effects of Zithromax can cause serious and potentially life-threatening abnormal heart activity. Multiple medical journals have published reports warning of the potential Zithromax heart risks.
These reports found that patients were 2.5 times more likely to die due to heart-related problems on a five-day Zithromax treatment when they compared it to treatment with other antibiotics or no antibiotic therapy. Despite these reports, the drug has continued to be widely distributed across the country. As I’m sure it should be. Again, it is all about cost/benefit and talking to your doctor about whether the risks are worth it for you. This is true with Z-Pak but it is also true with any other drug or treatment.
Frequently Asked Questions About Z-Pac Safety
Does Z-Pak make your heart beat faster?
Some patients will have an increased heart rate while taking Z-Pak. There are reports of some patients having heart rates that go as high as 200 beats per minute. For most of us, it just means a faster heart rate. (I could not find a study that shows how much faster on average it is.)
Does Z-Pac have serious side effects?
Z-Pac is like any drug. They all carry risks. In this case, there are five big risks that jump off the page:
- Abnormal heart rhythm
- Diarrhea
- Liver Problems
- Myasthenia gravis worsening
- Renal complications
That is not a laundry list and you really want to talk to your doctor about your opinions. The key is to weigh the risks and benefits. Long-term use will typically increase the risks of the drug.
Is Z-Pac bad for your heart?
It certainly can be. There may be a 2.5-fold increase in heart-related death for patients within five days of beginning Z-Pac compared to amoxicillin. The risk is even greater for people who have a history of heart problems.
Can Z-Pac treat COVID-19?
I’m writing this on February 10, 20220. There is no scientific evidence that azithromycin can treat the coronavirus. Some suspect that it may be helpful as a part of a cocktail treatment. But who knows?
Is your law firm handling Z-Pak heart attack lawsuits?
The azithromycin heart attack cases our firm reviews involve medical malpractice claims that the prescribing doctor knew or should have known of the patient’s prior heart condition. If you think you may have a claim, you can get a case evaluation online. Our lawyers can tell you without even speaking with you whether you may have a viable claim.