Zynomax is well tolerated with a low incidence of side effects. The following undesirable effects have been reported: Blood and Lymphatic System Disorders: Transient episodes of mild neutropenia, thrombocytopenia.
Ear and Labyrinth Disorders: Hearing impairment (including hearing loss, deafness and/or tinnitus), vertigo.
Gastrointestinal Disorders: Nausea, vomiting/diarrhea (rarely resulting in dehydration), loose stools, abdominal discomfort (pain/cramps), and flatulence, dyspepsia, constipation, pseudomembranous colitis, pancreatitis, and rare reports of tongue discoloration, infantile hypertrophic pyloric stenosis.
Hepatobiliary Disorders: Abnormal liver function, hepatitis and cholestatic jaundice have been reported, as well as rare cases of hepatic necrosis and hepatic failure, which have rarely resulted in death. However, a causal relationship has not been established.
Skin and Subcutaneous Tissue Disorders: Allergic reactions including pruritus, rash, photosensitivity, edema, urticaria, and angioedema. Rarely, serious skin reactions including erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis and DRESS have been reported. Frequency not known: severe cutaneous adverse reactions (SCARs) including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms (DRESS) & acute generalised exanthematous pustulosis (AGEP).
General Disorders and Administration Site Conditions: Local pain and inflammation at the site of infusion, asthenia has been reported, although a causal relationship has not been established; fatigue, and malaise.
Infections and Infestations: Moniliasis and vaginitis.
Immune System Disorders: Anaphylaxis (rarely fatal)
Metabolism and Nutrition Disorders: Anorexia.
Psychiatric Disorders: Aggressive reaction, nervousness, agitation, and anxiety.
Nervous System Disorders: Dizziness, convulsions (as seen with other macrolides), headache, hyperactivity, hypoesthesia, paresthesia, somnolence, and syncope. There have been rare reports of taste/smell perversion and/or loss. However, a causal relationship has not been established.
Cardiac Disorders: Palpitations and arrhythmias including ventricular tachycardia (as seen with other macrolides) have been reported. There have been rare reports of QT prolongation and torsades de pointes. A causal relationship between Zynomax and these effects has not been established.
Vascular Disorders: Hypotension.
Musculoskeletal and Connective Tissue Disorders: Arthralgia.
Renal and Urinary Disorders: Interstitial nephritis and acute renal failure.