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Azithral 500 side effects: common and serious

Also in: हिन्दी தமிழ் मराठी తెలుగు ಕನ್ನಡ বাংলা ગુજરાતી മലയാളം

Also known as: Azithral, Azithral 500 mg, Azithral 500 tablet

Most people take azithromycin without serious problems. Stomach upset is the most common side effect, and serious reactions are rare.

Azithral 500: Uses, How It Works, Side Effects

Active ingredient
Azithromycin 500 mg
Type of medicine
Macrolide antibiotics
Used for
Bacterial skin infections, Respiratory tract infections
Starts working in
Many infections start to improve within a few days
Effect lasts
Stays in the body for several days; usually once a day
With or without food
Follow the pack or your doctor; advice differs between labels
Alcohol
No known direct interaction; avoid it if you feel dizzy
Pregnancy
Ask your doctor
Habit-forming
No
Made by
Alembic Pharmaceuticals Ltd

Pharmacist review in progress. This page is based on the sources listed below and is being checked by our registered pharmacist.

On this page
  1. Side effects of Azithral 500
  2. Who should be careful
  3. If someone takes too much
  4. Common questions

Side effects of Azithral 500

Most people take azithromycin without serious problems. Stomach upset is the most common side effect, and serious reactions are rare.

Uncommon or mild

  • Diarrhoea
  • Feeling sick (nausea) or being sick (vomiting)
  • Stomach pain
  • Loss of appetite
  • Headache
  • Feeling dizzy or tired
  • Changes in taste

Rare but serious: get medical help

  • Signs of a severe allergic reaction: swelling of the face, lips or throat, difficulty breathing, or collapse. Call 112 or go to hospital straight away
  • A serious skin reaction: a widespread rash with blisters or peeling skin, sores in the mouth, or a rash with fever and swollen glands
  • A fast, pounding or irregular heartbeat, or fainting, which can be a sign of a heart rhythm problem
  • Yellowing of the skin or eyes, dark urine, pale stools or severe tiredness, which can be signs of liver problems
  • Severe or watery diarrhoea that does not stop, or diarrhoea with blood or mucus, which can be a sign of a gut infection called C. difficile. This can start up to 2 months after the course
  • Ringing in the ears, hearing loss or a spinning feeling (vertigo)
  • Severe stomach pain that spreads to the back, which can be a sign of an inflamed pancreas
  • Passing much more or much less urine than usual, or blood in the urine
  • New or worse muscle weakness, drooping eyelids, double vision, or difficulty swallowing or breathing in people with myasthenia gravis
  • In babies a few weeks old: forceful vomiting or irritability when feeding. Contact a doctor straight away

Who should be careful

Azithromycin is not suitable for everyone. Tell your doctor about your health conditions and other medicines before taking it.

  • It treats bacterial infections only. It does not work for colds, flu, most coughs or other viral infections, and taking it when it is not needed adds to antibiotic resistance
  • Past allergic reaction to azithromycin or other macrolide antibiotics such as erythromycin or clarithromycin
  • Heart rhythm problems, a known long QT interval, a slow heart rate, heart failure, or low potassium or magnesium: azithromycin can rarely cause a dangerous irregular heartbeat, and older people may be more at risk
  • Liver disease, or past liver problems after taking azithromycin
  • Severe kidney disease
  • Myasthenia gravis: azithromycin can make muscle weakness worse
  • Past diarrhoea while taking antibiotics
  • Pregnancy: azithromycin can be used when an infection needs treatment, but another antibiotic may suit some infections better, so your doctor will decide
  • Breastfeeding: small amounts pass into breast milk. Watch the baby for diarrhoea, vomiting, rash or thrush, and tell your doctor if you notice them
  • Thrush (a yeast infection of the mouth or vagina) can develop during or after a course of antibiotics; ask a pharmacist or doctor if it does
  • Dizziness: do not drive or use machines if azithromycin makes you dizzy

If someone takes too much

Taking too much azithromycin mainly causes stronger side effects, such as nausea, vomiting and diarrhoea, and there is no specific antidote. One extra dose taken by mistake is unlikely to cause serious harm. If someone has taken much more than prescribed, or feels unwell, call 112 or go to the nearest hospital and take the medicine pack with you.

Common questions

Can azithromycin affect the heart?

Rarely, azithromycin can change the heart's rhythm (QT prolongation), which can be dangerous. The risk is higher in older people, people with heart rhythm problems or low potassium or magnesium, and people taking other medicines that affect heart rhythm. Tell your doctor about these before taking it, and get help for a fast or irregular heartbeat or fainting.

Can I take Azithral 500 in pregnancy or while breastfeeding?

Azithromycin can be used in pregnancy when an infection needs treatment, but another antibiotic may suit some infections better, so your doctor decides. Small amounts pass into breast milk; watch the baby for diarrhoea, vomiting, rash or thrush. Do not start or stop it without your doctor's advice.

Does Azithral 500 stop birth control pills from working?

Azithromycin does not stop contraceptive pills from working. But if you vomit or have severe diarrhoea, or diarrhoea lasting more than 24 hours, the pill may not be absorbed properly and may not protect you from pregnancy. Check the pill leaflet for what to do.

Sources

  1. ZITHROMAX (azithromycin) tablets and oral suspension: full prescribing information. Pfizer, US FDA-approved labeling
  2. Azithromycin. StatPearls, National Center for Biotechnology Information (NCBI), US National Library of Medicine
  3. Azithromycin: an antibiotic to treat bacterial infections. NHS (UK)
  4. How and when to take azithromycin. NHS (UK)
  5. Side effects of azithromycin. NHS (UK)
  6. Who can and cannot take azithromycin. NHS (UK)
  7. Taking azithromycin with other medicines and herbal supplements. NHS (UK)
  8. Pregnancy, breastfeeding and fertility while taking azithromycin. NHS (UK)
  9. Common questions about azithromycin. NHS (UK)
  10. Antibiotics. NHS (UK)
  11. Drugs prohibited under section 26A of the Drugs & Cosmetics Act 1940: status as on 22.11.2021. Central Drugs Standard Control Organisation (CDSCO)
  12. Fixed Dose Combinations (including list of 156 prohibited FDCs dated 02.08.2024). Central Drugs Standard Control Organisation (CDSCO)
  13. National Formulary of India. Indian Pharmacopoeia Commission
  14. Pradhan Mantri Bhartiya Janaushadhi Pariyojana. Pharmaceuticals & Medical Devices Bureau of India