The common antibiotic that puts you at risk for a fatal heart rhythm

Raise your hand if your doctor has ever written you a prescription for a Z-pack?

I’m guessing you’re reaching for the sky right now. Z-packs are effective for a variety of common issues. That means, whether it was for pneumonia, pink eye, a sinus infection, strep throat or something else, most of us have taken them at least once.

What exactly is this mysterious Z-pack that cures us of our everyday bacterial ailments?

A Z-pack is just a cutsie name for the antibiotic azithromycin (aka Zithromax or Zmax). The typical Z-pack contains six azithromycin pills.

Now, there’s probably been a point sometime in your life where you took a Z-pack from your doctor without second guessing it. Maybe your throat was ablaze with strep bacteria. Or your eye matched the pink paint in your six-year-old daughter’s room. During those moments, a Z-pack feels like a life-saver. Unfortunately, this common antibiotic can also be a life-ender…

This may have flown under your radar (it flew under mine), but in 2013, the FDA issued a warning that azithromycin can cause abnormal — and potentially deadly — changes to your heart rhythm.

The scary truth about Z-packs

In 2013, the FDA issued an alarming warning about the antibiotic used in Z-packs…

They said that this common antibiotic can change your heart’s electrical activity, which could lead to a fatal heart rhythm. What clued them into the questionable safety of the sacred Z-pack?

Related: 7 things you need to know before taking antibiotics (slideshow)

A 2012 study published in the New England Journal of Medicine found that for every 1 million people taking azithromycin for five days (instead of another antibiotic for 10 days), 47 more people died from heart issues. That means more people died from taking azithromycin for a shorter period.

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Now, the heart risk associated with azithromycin is not sky high, but it’s still noteworthy. It got the FDA’s attention, after all… and that’s not always easy to do. Most of us, however, can take a Z-pack from time to time without harming our heart.

That said, certain people are more at risk for heart issues when taking a Z-pack. People who should probably steer clear of Z-packs include those with:

  • Long QT syndrome (a heart rhythm disorder)
  • Low blood levels of potassium or magnesium
  • A slower than normal heart rate
  • Abnormal heart rhythms or arrhythmias

Asking for alternatives

So, what should you do next time your doctor tries to write you a script for a Z-pack… especially if you fall into one of the categories mentioned above?

Well, hopefully, your doctor will already be aware of the heart risks associated with Z-packs and will prescribe you something else. If not, mention the risks to him or her and request something else.

An alternative that’s less risky from a heart-health perspective is amoxicillin. But watch out for levofloxacin (Levaquin)… that one is about as dangerous as azithromycin.

And, of course, make sure you’re taking antibiotics for an actual bacterial infection. A lot of people ask their doctors for a Z-pack when they have a cold (and their doctors comply!) But a Z-pack won’t do a dang thing for a viral infection like a cold. Plus, it may upset your stomach. And for an unlucky few, it may even harm your heart.

Sources:

  1. FDA warns azithromycin “Z-pack” antibiotics could lead to deadly heart rhythms for some — CBS News
  2. Azithromycin and the Risk of Cardiovascular DeathThe New England Journal of Medicine
  3. Zithromax Z-Pak — Drugs.com
  4. Can you take a Z pack for a cold? — Medical News Today
Jenny Smiechowski

By Jenny Smiechowski

Jenny Smiechowski is a Chicago-based freelance writer who specializes in health, nutrition and the environment. Her work has appeared in online and print publications like Chicagoland Gardening magazine, Organic Lifestyle Magazine, BetterLife Magazine, TheFix.com, Hybridcars.com and Seedstock.com.

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