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The drug's active ingredient, z pack antibiotic minimax, can cause rare and serious side effects such as severe or life-threatening allergic reactions, irregular heartbeats, Clostridium difficile-associated diarrhea and liver damage. More common side effects include nausea, vomiting, diarrhea and abdominal pain.

z pack 250 mg is a well established drug of choice in the treatment of respiratory tract infection. However, in elderly patient as one of the patient-associated risk factors, azithromycin may develop a reversible acute kidney injury.