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 Post subject: Zithromax capsules! Help!
 Post Posted: Wed Aug 30, 2017 11:25 am 
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Long story short, my boys were prescribed Zithromax to help with a myco flare up. They are 5 months old and all weigh between 380g and 440g.
The vet had prescribed 250mg zithromax capsules for me to mix with baby food. I have to split the capsules as follows:

1 quarter of a 250mg capsule split between 3 rats, twice daily.

So is this dose too high?? I have tried to understand the correct dosages and from what I've seen it looks like my boys are having too much?

Further on from that, I asked to just treat 2 of the boys, as they are the only ones unwell and he said the dosage would be the same as you cant split the capsule into more than 4?!

A very confused Mummy... :?


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 Post subject: Re: Zithromax capsules! Help!
 Post Posted: Wed Aug 30, 2017 6:28 pm 
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I don't know about the specific dosages required, but a crushed tablet or opened capsule can be divided into as many parts as you like really, so I don't get that either... does the vet think the rats take it in a solid piece?! :roll:

Also, I'm very much against giving antibiotics if they aren't required, so you're quite right to not want to give it to the third rat.

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 Post subject: Re: Zithromax capsules! Help!
 Post Posted: Wed Aug 30, 2017 7:44 pm 
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Location: Leicestershire, UK
RattieMummaSharna wrote:
Long story short, my boys were prescribed Zithromax to help with a myco flare up. They are 5 months old and all weigh between 380g and 440g.
The vet had prescribed 250mg zithromax capsules for me to mix with baby food. I have to split the capsules as follows:

1 quarter of a 250mg capsule split between 3 rats, twice daily.

So is this dose too high?? I have tried to understand the correct dosages and from what I've seen it looks like my boys are having too much?

Further on from that, I asked to just treat 2 of the boys, as they are the only ones unwell and he said the dosage would be the same as you cant split the capsule into more than 4?!

A very confused Mummy... :?

Maths time! (If numbers aren't your thing, skip the italics!)

According to the RMCA chart, you want 4-8mg/lb, once or twice a day. For the sake of finding a "maximum" dose, let's say 8mg/lb twice a day.

1lb = 453g, so 8mg per 453g, or 1.77mg per 100g. Assuming a 500g boy, that's 8.85mg twice a day.

1/4 of 250mg is 62.5mg, split between 3 rats is 20.83mg each, so even half of that looks like it'd be too high!

Treating 2 500g boys at the maximum specified dose would need a tiny bit of the tablet... Divide by 4, then divide by 4 again, and one of those portions would provide two 7.81mg doses (going back to the 4-8mg/lb ratio, that's the equivalent of 7mg).


Assuming my maths is right... To give you a round number to get a "real life" idea, dividing the tablet into 4, then into 4 again, will give you two "maximum" doses for a 440g boy, or two "middle ground" doses for a 660g boy (or two "minimum" doses for an 880g boy :shock: ). If you want me to adjust for your boys, let me know how much they weigh and I'll get on it! :D

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 Post subject: Re: Zithromax capsules! Help!
 Post Posted: Wed Aug 30, 2017 8:00 pm 
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The BSAVA 9th edition formulary's azithromycin (Zithromax) dosage for rats is 50mg/kg twice daily. Since the capsule contains 250mg of azithromycin, that's 1/5th of a tablet per kg of rat twice daily.

A 380g rat should get approximately 1/13th of a capsule twice daily, while a 440g rat should get approximately 1/11th of a capsule twice daily. To make life easier on yourself, instead of giving each rat a slightly different fraction of a capsule, you could just give 1/12th of a capsule to each regardless of their weight. And that's precisely what your vet has prescribed: 1 capsule is split into quarters, and each quarter is split between 3 rats, which results in 1/12th of a capsule per rat.

I continue to be perplexed at your vet's claim that you can't split a capsule into anything more than quarters, because that is exactly what they have asked you to do, if you're having to then split the quarter capsule dosage between 3 rats. You absolutely can split the dose as low as you like; however, the more you split, the harder it is to do so evenly. That's probably what your vet means: you can split a pile of powder into quarters and be reasonably confident that each of the 4 piles is roughly the same size as the others. Whereas I've split into 16ths and try as I might, there were definitely some big piles and some not so big piles. :P

Do the best you can, and you can also round down the number of piles a bit to cover for the fact that you'll end up with some smaller piles by accident (and you'll also lose a bit in the splitting process since you'll end up with powder sticking to things and not coming off). Say split into 10ths, or even 8ths. (8ths is easier.)

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 Post subject: Re: Zithromax capsules! Help!
 Post Posted: Wed Aug 30, 2017 8:09 pm 
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bazu wrote:
According to the RMCA chart, you want 4-8mg/lb, once or twice a day.

The RMCA say that 2 rats could live in a 20 gallon tank, so I'd trust the rest of their information about as far as I could throw the tank. :P (To be perfectly fair, they do warn about the ventilation problems with tanks, and advise the use of a wheel or daily out of tank time for exercise, but still.)

Even Carpenter's Exotic Animal Formulary suggests 15-30mg/kg once daily (interesting choice of dosing frequency) which is higher than the RMCA's chart, and Carpenter's dosages tend to run low in my experience. If it's between him and the BSAVA, I'll go with the BSAVA...

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Fondly remembering: Falere the contrary NLA36, Mirala the best and finest NLA36, Zephyr Opold the serene, and Rila the rodentist.
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 Post subject: Re: Zithromax capsules! Help!
 Post Posted: Wed Aug 30, 2017 9:37 pm 
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Location: Leicestershire, UK
[cub] wrote:
bazu wrote:
According to the RMCA chart, you want 4-8mg/lb, once or twice a day.

The RMCA say that 2 rats could live in a 20 gallon tank, so I'd trust the rest of their information about as far as I could throw the tank. :P (To be perfectly fair, they do warn about the ventilation problems with tanks, and advise the use of a wheel or daily out of tank time for exercise, but still.)

Even Carpenter's Exotic Animal Formulary suggests 15-30mg/kg once daily (interesting choice of dosing frequency) which is higher than the RMCA's chart, and Carpenter's dosages tend to run low in my experience. If it's between him and the BSAVA, I'll go with the BSAVA...

Ooooh, that's an interesting one then - a lot of their other doses seem to be about accurate (IIRC the baytril one is right where we'd want it), but if other sources suggest a much higher dose they could well be wrong!

I'll happily stand down on this occasion :lol:

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 Post subject: Re: Zithromax capsules! Help!
 Post Posted: Wed Aug 30, 2017 11:29 pm 
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Joined: Wed Aug 23, 2017 8:34 am
Posts: 7
Ahh thank you all for your responses! It's really helpful.
I shall continue to use the zithro but I will split the capsule so that I am dosing more appropriately!

Maths is NOT my strength so thank you for being so patient and explaining so well!

:D wish us luck!
Sharna x


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