Azithromycin should be used with caution in patients with hepatic or renal impairment. Hepatic side effects have infrequently included transient elevations of liver function test [including aspartate aminotransferase (AST) and alanine transaminase (ALT)] and elevated bilirubin. Hepatitis and cholestatic jaundice, as well as rare cases of hepatic necrosis and hepatic failure (some resulting in death), have been reported during post-marketing experience. Although plasma concentrations may be increased in renal impairment, dosage adjustment is not usually required.
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