Sumamed 250 mg capsules and 500 mg tablets – azithromycin for bacterial infections

Sumamed is a macrolide antibiotic containing azithromycin (as the dihydrate). It is used to treat bacterial infections of the airways and skin, sexually transmitted infections caused by chlamydia and stomach infections caused by Helicobacter pylori, when the causative bacteria are sensitive to azithromycin.

In Serbia, Sumamed 250 mg capsules (pack of 6 capsules) and Sumamed 500 mg tablets (pack of 3 film-coated tablets) are registered. Because azithromycin stays in the tissues for a long time, treatment is short – for most infections only 3 days, with one dose a day.

Which infections is Sumamed used for and how should it be taken?

Basic information about the medicine

What is Sumamed used for?

According to the patient leaflet, Sumamed capsules and tablets are used for the following infections caused by bacteria sensitive to azithromycin:

• upper airways: inflammation of the throat and tonsils, sinuses and middle ear;
• lower airways: acute worsening of chronic bronchitis and community-acquired pneumonia;
• skin and soft tissue: moderate acne, erythema migrans (first stage of Lyme disease), erysipelas, impetigo and pyoderma;
• sexually transmitted diseases: uncomplicated inflammation of the urethra and cervix caused by Chlamydia trachomatis;
• stomach and duodenum: Helicobacter pylori infection, in combination with other medicines.

How is Sumamed taken and dosed?

The doses apply to adults, including the elderly, and children weighing more than 45 kg. The total doses are the same for both forms – only the number of capsules or tablets differs:

• Airway, skin and soft tissue infections (except erythema migrans): 500 mg once daily for 3 consecutive days (2 capsules of 250 mg or 1 tablet of 500 mg); 1500 mg in total.
• Moderate acne: 6 g in total – 500 mg once daily for 3 days, then 500 mg once a week for the next 9 weeks (at 7-day intervals).
• Erythema migrans: 3 g in total – 1 g on day 1 (4 capsules or 2 tablets at once), then 500 mg once daily from day 2 to day 5.
• Chlamydial infection (urethritis, cervicitis): a single dose of 1 g (4 capsules or 2 tablets).
• Helicobacter pylori: 1 g daily, in combination with other medicines as decided by the doctor.
• How to take: swallow the capsules whole with a little water at least 1 hour before or 2 hours after a meal; swallow the tablets whole with a little water, regardless of meals. Do not take more than one dose a day.

Special patient groups

• Children: the capsules and tablets may be used only in children weighing more than 45 kg who can swallow a capsule or tablet, at the adult dose; for lighter children other forms of azithromycin are available (e.g. suspensions).
• Elderly: the same dose range as adults.
• Impaired kidney function: no dose change in mild to moderate impairment (GFR 10–80 mL/min); caution is needed in severe impairment (GFR below 10 mL/min).
• Impaired liver function: no dose change in mild to moderate impairment; the doctor may monitor liver function or stop treatment.

Contraindications – when the medicine must not be used

• allergy to azithromycin, erythromycin, other macrolide or ketolide antibiotics or any of the excipients;
• an allergic reaction, rash or difficulty breathing after previously taking Sumamed or another macrolide antibiotic.

Precautions and warnings

• Tell your doctor if you have liver problems, severe kidney problems or heart disease, or if you take ergot derivatives (migraine medicines).
• Heart rhythm: macrolides can prolong the QT interval – caution in patients with QT prolongation and with antiarrhythmics, cisapride, terfenadine, pimozide, citalopram or fluoroquinolones (moxifloxacin, levofloxacin). If you feel palpitations, light-headedness or faint, contact your doctor immediately.
• Diarrhoea: if diarrhoea occurs during or after treatment, contact your doctor and do not take anti-diarrhoeal medicines without advice.
• Myasthenia gravis: the medicine may worsen muscle weakness.
• Fungal infections: redness and white patches with burning and itching in the mouth or genital area – contact your doctor.
• The capsules contain sulphur dioxide, which may rarely cause severe allergic reactions and bronchospasm.

Interactions with other medicines, food and drink

Tell your doctor if you take:

• warfarin or other coumarin anticoagulants;
• ciclosporin;
• digoxin;
• antacids (for heartburn and indigestion);
• terfenadine;
• ergot or ergotamine (migraine);
• colchicine;
• atorvastatin;
• methylprednisolone;
• rifabutin;
• zidovudine.

Take the capsules at least 1 hour before or 2 hours after a meal; the tablets can be taken regardless of food.

Pregnancy and breast-feeding

If you are pregnant, think you may be pregnant, are planning a pregnancy or are breast-feeding, do not take the medicine before talking to your doctor. Sumamed may be used during pregnancy and breast-feeding only if necessary.

Driving and using machines

Side effects such as dizziness, marked drowsiness, convulsions, hallucinations or loss of consciousness are possible and may affect the ability to drive and use machines.

Possible side effects

• Very common (more than 1 in 10): diarrhoea.
• Common (up to 1 in 10): headache, vomiting, abdominal pain, nausea, changes in white blood cell counts and some laboratory results.
• Uncommon (up to 1 in 100): fungal infections (mouth, vagina), inflammation of the throat, stomach and sinuses, loss of appetite, nervousness, insomnia, dizziness, drowsiness, taste disturbance, palpitations, constipation, wind, bloating, dry mouth, rash, itching, hives, muscle and joint pain, tiredness, raised liver enzymes.
• Rare (up to 1 in 1,000): agitation, liver function disorder, jaundice, sensitivity to light, rash with pustules.
• Not known: pseudomembranous colitis, low platelets, anaemia, anaphylaxis, hallucinations, loss of consciousness, convulsions, loss of smell and taste, hearing impairment and ringing in the ears, heart rhythm disorders, inflammation of the pancreas, liver damage, acute kidney injury.

Overdose, missed dose and stopping treatment

• Overdose: tell your doctor immediately. (Temporary) hearing loss, severe nausea, vomiting and diarrhoea may occur.
• Missed dose: take it as soon as you remember and the next one at the usual time. Do not take two doses at once or more than one dose a day.
• Stopping: take the medicine until the end of the prescribed course – stopping too early may cause the infection to return and bacterial resistance.

Related information

Antibiotics work only against bacteria, not viruses – so they are not used for a common cold or flu without a doctor’s recommendation.

To support the gut flora during and after antibiotic treatment, see also the category Products with probiotics – products in this category do not replace the medicine prescribed for you.

Composition, pack and manufacturer

• Capsules: 250 mg azithromycin (dihydrate); excipients – microcrystalline cellulose, sodium lauryl sulfate, magnesium stearate; shell – gelatin, titanium dioxide (E171), indigo carmine (E132), sulphur dioxide. Blister of 6 capsules.
• Tablets: 500 mg azithromycin (dihydrate); core – anhydrous calcium hydrogen phosphate, hypromellose, maize starch and pregelatinised starch, microcrystalline cellulose, sodium lauryl sulfate, magnesium stearate; film – hypromellose, indigo carmine (E132), titanium dioxide (E171), polysorbate 80, talc. Blister of 3 film-coated tablets.
• Marketing authorisation holder: Actavis d.o.o. Belgrade, Đorđa Stanojevića 12. Manufacturer: Pliva Hrvatska d.o.o., Prilaz baruna Filipovića 25, Zagreb, Croatia.
• Licence numbers: capsules 515-01-01843-19-001 and tablets 515-01-01844-19-001, both of 26 March 2020.

Storage

• No special storage conditions.
• Shelf life: 3 years.
• Keep out of the sight and reach of children; return unused medicine to a pharmacy that collects unused medicines.

Frequently asked questions

Why is Sumamed taken for only 3 days?

Azithromycin stays in the tissues for a long time, so for airway and skin infections 500 mg daily for 3 days gives a total dose of 1500 mg. Different schedules are prescribed for acne, Lyme disease and chlamydia.

Is Sumamed taken before or after meals?

The 250 mg capsules are taken at least 1 hour before or 2 hours after a meal, and the 500 mg tablets regardless of meals.

Can I take Sumamed if I am allergic to erythromycin?

No. Allergy to erythromycin or other macrolide and ketolide antibiotics is a contraindication.

What if I get diarrhoea during treatment?

Diarrhoea is a very common side effect. Drink enough fluids and do not take anti-diarrhoeal medicines without advice; if the diarrhoea is severe, prolonged or bloody, contact your doctor immediately.

Sources

• ALIMS – Patient information leaflet Sumamed 250 mg capsules (PIL)
• ALIMS – Summary of product characteristics Sumamed 250 mg capsules (SmPC)
• ALIMS – Patient information leaflet Sumamed 500 mg tablets (PIL)
• ALIMS – Summary of product characteristics Sumamed 500 mg tablets (SmPC)

Sources checked on: 25 October 2026.