What is zithromax 250 mg tablets for

Ask your doctor if this drug is safe for you. One study in pregnant rats did show increased risk of fetal death and delays in development after birth.

Azithromycin does pass into the breast milk of lactating women. These side effects may include diarrhea, vomiting, and rash. All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:. Typical dosage is mg once per day for 3 days.

Your doctor may also prescribe mg taken as a single dose on day 1, followed by mg once per day on days 2 through 5. Your doctor may prescribe mg taken in a single dose on day 1, followed by mg once per day on days 2 through 5. Your doctor may prescribe mg in a single dose on day 1, followed by mg once per day on days 2 through 5. For treatment , typical dosage is mg once per day, taken with the drug ethambutol.

However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. Always speak with your doctor or pharmacist about dosages that are right for you. Azithromycin is typically used for short-term treatment. For azithromycin to work well, a certain amount needs to be in your body at all times. If you take too much: You could have dangerous levels of the drug in your body. This may cause liver damage or an irregular heart rhythm.

If your symptoms are severe, call or go to the nearest emergency room right away. What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

If you take too much azithromycin, you could have dangerous levels of the drug in your body. This may cause liver damage and irregular heart rhythm. A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Azithromycin belongs to a drug class called macrolide antibiotics. Data from a cohort study in adults have associated azithromycin with an increased risk of cardiovascular death. Analysis of the data found those persons receiving a 5-day course of azithromycin had a significantly greater risk of cardiovascular death than persons not treated with antibiotics HR: 2.

Clinical trials of oral and intravenous azithromycin and other reported clinical experience has not identified overall differences in safety and effectiveness between geriatric and younger adult subjects. Greater sensitivity of some older individuals cannot be ruled out. Health care providers are advised that geriatric patients may be more susceptible to drug-associated effects on the QT interval.

According to OBRA, use of antibiotics should be limited to confirmed or suspected bacterial infections. Antibiotics are non-selective and may result in the eradication of beneficial microorganisms while promoting the emergence of undesired ones, causing secondary infections such as oral thrush, colitis, or vaginitis.

Any antibiotic may cause diarrhea, nausea, vomiting, anorexia, and hypersensitivity reactions. Available data over several decades with systemic azithromycin use in pregnant women have not identified any drug-associated risks for major birth defects, miscarriage, or adverse maternal or fetal outcomes.

Developmental toxicity studies in animals showed no drug-induced fetal malformations at doses up to 4 times the adult human daily dose of mg based on body surface area; however, decreased viability and delayed development were observed in the offspring of pregnant rats given azithromycin at a dose equivalent to 4 times the adult human daily dose from day 6 of pregnancy through weaning. Specific findings for azithromycin use during the first trimester were precluded due to few events.

Macrolide use during the second and third trimesters showed no increased risk of any major malformation Macrolide use in any trimester was associated with an increased risk of genital malformations adjusted risk ratio 1.

Use azithromycin with caution and with proper monitoring in young infants and neonates; there have been reports of infantile hypertrophic pyloric stenosis IHPS occurring in young infants after azithromycin therapy. Because azithromycin is sometimes used for the treatment of conditions that are associated with significant mortality or morbidity e.

Inform parents and other caregivers to contact their physician if vomiting or irritability with feeding occurs. A male predominance was also observed, as all 8 infants who developed IHPS were boys. No infants aged 43 to 90 days at the time of azithromycin exposure developed IHPS; however, there have been 2 case reports of older infants developing IHPS 89 and 94 days old at diagnosis, respectively.

Azithromycin is present in human breast milk. Non-serious adverse reactions have been reported in breast-fed infants after maternal administration of azithromycin. Consider the developmental and health benefits of breast-feeding along with the mother's clinical need for azithromycin and any potential adverse effects on the breast-fed infant from azithromycin or the underlying maternal condition.

Monitor the breast-fed infant for diarrhea, vomiting, or rash. There are no available data on the effects of azithromycin on milk production. Azithromycin breast milk concentrations were measured in 20 women receiving a single 2 g oral dose during labor.

Azithromycin was present in breast milk up to 4 weeks after dosing. Another study of 8 women receiving azithromycin IV before incision of cesarean section showed azithromycin was present in breast milk up to 48 hours later.

The adverse event rate was similar to that seen in babies in a control group whose mothers were treated with amoxicillin 8. Only 10 mothers in the study received azithromycin, 6 received clarithromycin, 2 received erythromycin, and the remainder were treated with roxythromycin.

Direct sunlight UV exposure should be minimized during therapy with systemic azithromycin. Photosensitivity has been reported as an adverse reaction to azithromycin.

Some intravenous formulations of azithromycin contain a total of 4. The sodium amounts should be considered in patients with requirements for sodium restriction or blunted natriuresis to salt loading i. Patients who wear contact lenses should avoid wearing them while being treated for an ocular infection with azithromycin ophthalmic solution. Exacerbation of symptoms of myasthenia gravis and new onset of myasthenic syndrome have been reported in patients receiving systemic azithromycin therapy.

While azithromycin may be used to treat certain sexually transmitted diseases STD , the drug may mask or delay the symptoms of incubating syphilis when given as part of an STD treatment regimen. Initiate appropriate therapy and perform follow-up testing as recommended based upon sexually transmitted disease diagnosis. Do not use azithromycin for long-term prophylaxis of bronchiolitis obliterans syndrome BOS in patients with cancers of the blood or lymph nodes i.

Aclidinium; Formoterol: Major Avoid coadministration of azithromycin with long-acting beta-agonists due to the increased risk of QT prolongation.

If use together is necessary, obtain an ECG at baseline to assess initial QT interval and determine frequency of subsequent ECG monitoring, avoid any non-essential QT prolonging drugs, and correct electrolyte imbalances.

QT prolongation and torsade de pointes TdP have been spontaneously reported during azithromycin postmarketing surveillance. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses, when associated with hypokalemia, or when used with other drugs known to prolong the QT interval.

This risk may be more clinically significant with long-acting beta-agonists as compared to short-acting beta-agonists. Albuterol: Major Avoid coadministration of azithromycin with short-acting beta-agonists due to the increased risk of QT prolongation. Alfuzosin: Major Avoid coadministration of azithromycin with alfuzosin due to the increased risk of QT prolongation. Alfuzosin may prolong the QT interval in a dose-dependent manner.

If antacids must be taken, stagger the administration of the antacid and azithromycin. Amiodarone: Major Avoid coadministration of amiodarone and azithromycin due to the increased risk of QT prolongation.

Due to the extremely long half-life of amiodarone, a drug interaction is possible for days to weeks after discontinuation of amiodarone. Reports of QT prolongation and torsade de pointes TdP have been spontaneously reported during azithromycin postmarketing surveillance.

QT prolongation was reported in a year old woman receiving azithromycin and amiodarone. The patient had a history of stable congestive heart failure and a posterior communicating artery aneurysm. Additional medications included furosemide, enalapril, and aspirin. Therapy with azithromycin was started at mg PO on day 1, followed by mg PO once daily for 4 days.

Sinus bradycardia with marked QT prolongation and increased QT dispersion were noted on day 3 of treatment. Amisulpride: Major Avoid coadministration of azithromycin with amisulpride due to the increased risk of QT prolongation. Amisulpride causes dose- and concentration- dependent QT prolongation. Amitriptyline: Major Avoid coadministration of azithromycin with tricyclic antidepressants TCAs due to the increased risk of QT prolongation. TCAs share pharmacologic properties similar to the Class IA antiarrhythmic agents and may prolong the QT interval, particularly in overdose or with higher-dose prescription therapy elevated serum concentrations.

Anagrelide: Major Avoid coadministration of azithromycin with anagrelide due to the increased risk of QT prolongation.

TdP and ventricular tachycardia have been reported with anagrelide. In addition, dose-related increases in mean QTc and heart rate were observed in healthy subjects. Apomorphine: Major Avoid coadministration of azithromycin with apomorphine due to the increased risk of QT prolongation.

Dose-related QTc prolongation is associated with therapeutic apomorphine exposure. Arformoterol: Major Avoid coadministration of azithromycin with long-acting beta-agonists due to the increased risk of QT prolongation. Aripiprazole: Major Avoid coadministration of azithromycin with aripiprazole due to the increased risk of QT prolongation.

QT prolongation has occurred during therapeutic use of aripiprazole and following overdose. Arsenic Trioxide: Major Avoid coadministration of azithromycin with arsenic trioxide due to the increased risk of QT prolongation.

TdP, QT interval prolongation, and complete atrioventricular block have been reported with arsenic trioxide use. Artemether; Lumefantrine: Major Avoid coadministration of azithromycin with artemether; lumefantrine due to the increased risk of QT prolongation. Artemether; lumefantrine is associated with prolongation of the QT interval. Asenapine: Major Avoid coadministration of azithromycin with asenapine due to the increased risk of QT prolongation.

Asenapine has been associated with QT prolongation. Aspirin, ASA; Pravastatin: Moderate Azithromycin has the potential to increase pravastatin exposure when used concomitantly.

Coadminister pravastatin and azithromycin cautiously due to a potential increased risk of myopathies. Atomoxetine: Major Avoid coadministration of azithromycin with atomoxetine due to the increased risk of QT prolongation.

QT prolongation has occurred during therapeutic use of atomoxetine and following overdose. Bedaquiline: Major Avoid coadministration of azithromycin with bedaquiline due to the increased risk of QT prolongation.

Discontinue bedaquiline if evidence of serious ventricular arrhythmia or QTcF interval greater than ms. Bedaquiline prolongs the QT interval. Belladonna Alkaloids; Ergotamine; Phenobarbital: Minor Carefully monitor patients when azithromycin and ergotamine are used concomitantly. Avoid concomitant use if possible, especially in patients with additional risk factors for TdP. Budesonide; Formoterol: Major Avoid coadministration of azithromycin with long-acting beta-agonists due to the increased risk of QT prolongation.

Budesonide; Glycopyrrolate; Formoterol: Major Avoid coadministration of azithromycin with long-acting beta-agonists due to the increased risk of QT prolongation. Buprenorphine: Major Avoid coadministration of azithromycin with buprenorphine due to the increased risk of QT prolongation. Buprenorphine has been associated with QT prolongation and has a possible risk of TdP. Buprenorphine; Naloxone: Major Avoid coadministration of azithromycin with buprenorphine due to the increased risk of QT prolongation.

Cabotegravir; Rilpivirine: Major Avoid coadministration of azithromycin with rilpivirine due to the increased risk of QT prolongation. Ceritinib: Major Avoid coadministration of azithromycin with ceritinib if possible due to the risk of QT prolongation.

An interruption of ceritinib therapy, dose reduction, or discontinuation of therapy may be necessary if QT prolongation occurs. Ceritinib causes concentration-dependent QT prolongation.

Chlordiazepoxide; Amitriptyline: Major Avoid coadministration of azithromycin with tricyclic antidepressants TCAs due to the increased risk of QT prolongation. Chloroquine: Major Avoid coadministration of chloroquine with azithromycin due to the increased risk of QT prolongation.

Chloroquine is associated with an increased risk of QT prolongation and torsade de pointes TdP ; the risk of QT prolongation is increased with higher chloroquine doses.

Chlorpromazine: Major Avoid coadministration of azithromycin with chlorpromazine due to the increased risk of QT prolongation. Chlorpromazine is associated with an established risk of QT prolongation and TdP. Cholera Vaccine: Major Avoid the live cholera vaccine in patients that have received azithromycin within 14 days prior to vaccination. Concurrent administration of the live cholera vaccine with antibiotics active against cholera, such as azithromycin, may diminish vaccine efficacy and result in suboptimal immune response.

A duration of fewer than 14 days between stopping antibiotics and vaccination might also be acceptable in some clinical settings if travel cannot be avoided before 14 days have elapsed after stopping antibiotics.

Ciprofloxacin: Major Avoid coadministration of azithromycin with ciprofloxacin due to the increased risk of QT prolongation. Rare cases of QT prolongation and TdP have been reported with ciprofloxacin during postmarketing surveillance. Cisapride: Contraindicated There have been case reports of QT prolongation and torsade de pointes TdP with the use of azithromycin in post-marketing reports. Azithromycin is contraindicated with other drugs that have been specifically established that have a causal association with QT prolongation and torsade de pointes, such as cisapride.

Citalopram: Major Avoid coadministration of azithromycin with citalopram due to the increased risk of QT prolongation. Citalopram causes dose-dependent QT interval prolongation. Clofazimine: Major Avoid coadministration of azithromycin with clofazimine due to the increased risk of QT prolongation. QT prolongation and TdP have been reported in patients receiving clofazimine in combination with QT prolonging medications. Clomipramine: Major Avoid coadministration of azithromycin with tricyclic antidepressants TCAs due to the increased risk of QT prolongation.

Clozapine: Major Avoid coadministration of azithromycin with clozapine due to the increased risk of QT prolongation. Treatment with clozapine has been associated with QT prolongation, TdP, cardiac arrest, and sudden death. Codeine; Phenylephrine; Promethazine: Major Avoid coadministration of azithromycin with promethazine due to the increased risk of QT prolongation.

Promethazine is associated with possible risk for QT prolongation. Codeine; Promethazine: Major Avoid coadministration of azithromycin with promethazine due to the increased risk of QT prolongation. Colchicine: Moderate Caution is warranted with the concomitant use of colchicine and azithromycin as increased colchicine concentrations may occur.

Monitor for colchicine toxicity. Colchicine accumulation may be greater in patients with renal or hepatic impairment. Coadministration with azithromycin resulted in an increase in colchicine Cmax of The clinical effect of these changes is not described.

Crizotinib: Major Avoid coadministration of crizotinib with azithromycin due to the risk of QT prolongation. An interruption of therapy, dose reduction, or discontinuation of therapy may be necessary for crizotinib if QT prolongation occurs. Crizotinib has been associated with concentration-dependent QT prolongation.

Prolongation of the QT interval and torsade de pointes TdP have been spontaneously reported during azithromycin postmarketing surveillance. Cyclosporine: Moderate Caution is warranted with the concomitant use of azithromycin and cyclosporine as increased cyclosporine concentrations may occur. Dose adjustment of cyclosporine may be necessary; monitor cyclosporine serum concentrations during use with azithromycin and after discontinuation of azithromycin.

Dasatinib: Major Avoid coadministration of azithromycin with dasatinib due to the increased risk of QT prolongation. In vitro studies have shown that dasatinib has the potential to prolong cardiac ventricular repolarization prolong QT interval. Degarelix: Major Avoid coadministration of azithromycin with degarelix due to the increased risk of QT prolongation. Androgen deprivation therapy i. Desflurane: Major Avoid coadministration of azithromycin with halogenated anesthetics due to the increased risk of QT prolongation.

Halogenated anesthetics can prolong the QT interval. Desipramine: Major Avoid coadministration of azithromycin with tricyclic antidepressants TCAs due to the increased risk of QT prolongation.

Desogestrel; Ethinyl Estradiol: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. It was previously thought that antibiotics may decrease the effectiveness of OCs containing estrogens due to stimulation of metabolism or a reduction in enterohepatic circulation via changes in GI flora.

One retrospective study reviewed the literature to determine the effects of oral antibiotics on the pharmacokinetics of contraceptive estrogens and progestins, and also examined clinical studies in which the incidence of pregnancy with OCs and antibiotics was reported. It was concluded that the antibiotics ampicillin, ciprofloxacin, clarithromycin, doxycycline, metronidazole, ofloxacin, roxithromycin, temafloxacin, and tetracycline did not alter plasma concentrations of OCs. Antituberculous drugs e.

Based on the study results, these authors recommended that back-up contraception may not be necessary if OCs are used reliably during oral antibiotic use. Another review concurred with these data, but noted that individual patients have been identified who experienced significant decreases in plasma concentrations of combined OC components and who appeared to ovulate; the agents most often associated with these changes were rifampin, tetracyclines, and penicillin derivatives.

These authors concluded that because females most at risk for OC failure or noncompliance may not be easily identified and the true incidence of such events may be under-reported, and given the serious consequence of unwanted pregnancy, that recommending an additional method of contraception during short-term antibiotic use may be justified.

During long-term antibiotic administration, the risk for drug interaction with OCs is less clear, but alternative or additional contraception may be advisable in selected circumstances.

Data regarding progestin-only contraceptives or for newer combined contraceptive deliveries e. Deutetrabenazine: Major Avoid coadministration of azithromycin with deutetrabenazine due to the increased risk of QT prolongation. Deutetrabenazine may prolong the QT interval, but the degree of QT prolongation is not clinically significant when deutetrabenazine is administered within the recommended dosage range.

Dextromethorphan; Quinidine: Major Avoid coadministration of azithromycin with quinidine due to the increased risk of QT prolongation. Quinidine administration is associated with QT prolongation and TdP. Dienogest; Estradiol valerate: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.

Digoxin: Moderate Monitor digoxin concentrations before and during concomitant use of azithromycin and reduce the digoxin dose if necessary.

Elevated digoxin concentrations have been observed when azithromycin has been coadministered with digoxin. Dihydroergotamine: Minor Carefully monitor patients when azithromycin and dihydroergotamine are used concomitantly. Disopyramide: Major Avoid coadministration of azithromycin with disopyramide due to the increased risk of QT prolongation. Disopyramide is associated with QT prolongation and TdP.

Dofetilide: Major Avoid coadministration of azithromycin with dofetilide due to the increased risk of QT prolongation. Dolasetron: Major Avoid coadministration of azithromycin with dolasetron due to the increased risk of QT prolongation.

Dolutegravir; Rilpivirine: Major Avoid coadministration of azithromycin with rilpivirine due to the increased risk of QT prolongation. Donepezil: Major Avoid coadministration of azithromycin with donepezil due to the increased risk of QT prolongation. Case reports indicate that QT prolongation and TdP can occur during donepezil therapy. Donepezil; Memantine: Major Avoid coadministration of azithromycin with donepezil due to the increased risk of QT prolongation.

Doxepin: Major Avoid coadministration of azithromycin with tricyclic antidepressants TCAs due to the increased risk of QT prolongation. Dronedarone: Contraindicated Coadministration of dronedarone and azithromycin is contraindicated due to the potential for QT prolongation and torsade de pointes TdP.

There have been case reports of QT prolongation and TdP with the use of azithromycin in post-marketing reports. Dronedarone administration is associated with a dose-related increase in the QTc interval. The increase in QTc is approximately 10 milliseconds at doses of mg twice daily the FDA-approved dose and up to 25 milliseconds at doses of mg twice daily. Although there are no studies examining the effects of dronedarone in patients receiving other QT prolonging drugs, coadministration of such drugs may result in additive QT prolongation.

Droperidol: Major Avoid coadministration of azithromycin with droperidol due to the increased risk of QT prolongation. Initiate droperidol at a low dose and increase the dose as needed to achieve the desired effect. Droperidol administration is associated with an established risk for QT prolongation and TdP. Some cases have occurred in patients with no known risk factors for QT prolongation and some cases have been fatal.

Drospirenone: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Drospirenone; Estetrol: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.

Drospirenone; Estradiol: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Drospirenone; Ethinyl Estradiol: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.

Drospirenone; Ethinyl Estradiol; Levomefolate: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Call your doctor for medical advice about side effects. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at Before taking azithromycin, tell your doctor or pharmacist if you are allergic to it; or to other antibiotics such as erythromycin, clarithromycin, telithromycin ; or if you have any other allergies.

This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. Before using this medication, tell your doctor or pharmacist your medical history, especially of:.

Azithromycin may cause a condition that affects the heart rhythm QT prolongation. The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation.

Before using azithromycin, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions:. Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. Talk to your doctor about using azithromycin safely. Azithromycin may cause live bacterial vaccines such as typhoid vaccine to not work as well. Before having surgery, tell your doctor or dentist about all the products you use including prescription drugs, nonprescription drugs, and herbal products.

Older adults may be more sensitive to the side effects of this drug, especially QT prolongation see above. During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions.

Do not start, stop, or change the dosage of any medicines without your doctor's approval. Many drugs besides azithromycin may affect the heart rhythm QT prolongation , including amiodarone, chloroquine, disopyramide, dofetilide, dronedarone, hydroxychloroquine, ibutilide, pimozide, procainamide, quinidine, sotalol, among others.

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call Otherwise, call a poison control center right away. US residents can call their local poison control center at Page last reviewed: 6 December Next review due: 6 December Azithromycin On this page About azithromycin Key facts Who can and cannot take azithromycin How and when to take it Side effects How to cope with side effects Pregnancy and breastfeeding Cautions with other medicines Common questions.

About azithromycin Azithromycin is an antibiotic. Help us improve our website Can you answer a quick question about your visit today? Azithromycin is usually taken once a day. Try to take it at the same time each day.

If you have tablets or liquid, you can take them with or without food. For most infections you should feel better within a few days, but you should still finish your full course of medicine.

The most common side effects of azithromycin are feeling or being sick, diarrhoea, headaches, or changes to your sense of taste. Azithromycin is also called by the brand name Zithromax. Azithromycin can be taken by adults and children. To make sure azithromycin is safe for you, tell your doctor if you have: had an allergic reaction to azithromycin or any other medicines in the past liver or kidney problems heart problems, including irregular heartbeats arrhythmia had diarrhoea when you have taken antibiotics before myasthenia gravis - azithromycin can worsen the symptoms of this muscle-weakening illness diabetes - azithromycin liquid contains sugar.

Important Carry on taking this medicine until the course is completed, even if you feel better. How to take it If your doctor has prescribed azithromycin capsules, you should take them at least 1 hour before food or 2 hours after eating.

Swallow tablets and capsules whole with a glass of water. What if I forget to take it? What if I take too much? Common side effects These common side effects of azithromycin happen in more than 1 in people. Keep taking the medicine, but talk to your doctor or pharmacist if these side effects bother you or don't go away: feeling sick nausea diarrhoea or being sick vomiting losing your appetite headaches feeling dizzy or tired changes to your sense of taste Serious side effects Serious side effects are rare and happen in less than 1 in 1, people.

Call a doctor straight away if you get: chest pains or a faster or irregular heartbeat yellow skin or the whites of your eyes turn yellow, or pale poo with dark pee - these can be signs of liver or gallbladder problems ringing in your ears tinnitus , temporary hearing loss, or you feel unsteady on your feet vertigo severe pain in your stomach or back - these can be warning signs of inflammation of the pancreas pancreatitis diarrhoea perhaps with muscle cramps that contains blood or mucus - if you have severe diarrhoea without blood or mucus for more than 4 days you should also speak to a doctor Serious allergic reaction In rare cases it's possible to have a serious allergic reaction anaphylaxis to azithromycin.

Information: You can report any suspected side effect using the Yellow Card safety scheme. Visit Yellow Card for further information. What to do about: feeling sick nausea - stick to simple meals and do not eat rich or spicy food while you're taking this medicine. Take small, frquent sips if you're being sick. Signs of dehydration include peeing less than usual or having strong-smelling pee. Do not take any other medicines to treat diarrhoea or vomiting without speaking to a pharmacist or doctor.

If it helps, eat smaller meals more often than usual. Snack when you're hungry. Have nutritious snacks that are high in calories and protein, such as dried fruit and nuts. Ask your pharmacist to recommend a painkiller if you need one. Talk to your doctor if the headaches last longer than a week or are severe. If you begin to feel dizzy, lie down so you don't faint, then sit until you feel better.

Do not drive or use tools or machines if you feel dizzy or tired.