Oral Zynomax should be administered as a single daily dose. The period of dosing with regard to infection is given as follows. Zynomax can be taken with or without food.
In Adults: For the treatment of sexually transmitted disease caused by Chlamydia trachomatis, or non-multiresistant Neisseria gonorrhea, the dose is 1000 mg as a single oral dose.
For all other indications in which the oral formulation is administered, the total dosage of 1500 mg should be given as 500 mg daily for 3 days. As an alternative, the same total dose can be given 5 days with 500 mg given on day 1, then 250 mg daily on days 2 to 5.
In Children: The maximum recommended total dose for any treatment is 1500 mg for children.
In general, the total dose in children is 30 mg/kg. Treatment for pediatric streptococcal pharyngitis should be dosed at a different regimen (see as follows).
The total dose 30 mg/kg should be given as single daily dose of 10 mg/kg daily for 3 days, or given over 5 days with a single daily dose of 10 mg/kg on day 1, then 5 mg/kg on days 2-5.
As an alternative to the previously mentioned dosing, treatment for children with acute otitis media can be given as a single dose of 30 mg/kg.
For pediatric streptococcal pharyngitis, Zynomax given as a single dose of 10mg/kg or 20mg/kg for 3 days has been shown to be effective; however, a daily dose of 500 mg must not be exceeded. In clinical trials comparing these two dosage regimens, similar clinical efficacy was observed but greater bacteriologic eradication was evident at the 20 mg/kg per day dose. However, penicillin is the usual drug of choice in the treatment of Streptococcus pyogenes pharyngitis, including prophylaxis of rheumatic fever.
For children weighing less than 15 kg, Zynomax should be measured as closely as possible. For children weighing 15 kg or more, Zynomax should be administered according to the guide provided as follows: (See table.)
Click on icon to see table/diagram/image
Tab: Zynomax tablets should only be administered to children weighing more than 45kg.
Powd for oral susp: Safety and efficacy for prevention or treatment of MAC in children have not been established. Based on pediatric pharmacokinetic data, a dose of 20 mg/kg would be similar to the adult dose of 1200 mg but with a higher Cmax.
Elderly: The same dosage as in adult patients is used in the elderly.
Patients with Renal Impairment: No dose adjustment is necessary in patients with mild to moderate renal impairment (GFR 10 - 80 ml/min). Caution should be exercised when Zynomax is administered to patients with severe renal impairment (GFR < 10 ml/min).
Patients with Hepatic Impairment: The same dosage as in patients with normal hepatic function may used in patients with mild to moderate hepatic impairment.