Azithromycin: Uses, How It Works, Medicines
Also in: हिन्दी தமிழ் मराठी తెలుగు ಕನ್ನಡ বাংলা ગુજરાતી മലയാളം
Azithromycin is a macrolide antibiotic used to treat certain bacterial infections. These include infections of the chest, sinuses, throat, ears and skin, and some sexually transmitted infections such as chlamydia. It works only against bacteria, so it does not help colds, flu or other viral infections. In India it is a prescription medicine.
Also known as: Azithromycin dihydrate, Azithromycine, Azithromycin tablet, Azithromycin 500 mg, Azithromycin antibiotic
Pharmacist review in progress. This page is based on the sources listed below and is being checked by our registered pharmacist.
How does Azithromycin work?
Azithromycin binds to the larger (50S) part of the bacterial ribosome and stops bacteria from making the proteins they need to grow and multiply. It builds up in tissues such as the lungs, tonsils and skin and leaves the body slowly, so it is usually taken once a day and courses are often short.
How to take Azithromycin
Follow the label or your doctor's advice. Azithromycin is usually taken once a day, and courses are often short, such as 3 to 5 days, but the dose and the number of days depend on the infection. Take the full course your doctor prescribed.
Side effects of Azithromycin
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)
- New or worse muscle weakness, drooping eyelids 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 using 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
- 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 your doctor will decide whether it is the right antibiotic
- Breastfeeding: small amounts pass into breast milk. Watch the baby for diarrhoea, vomiting, rash or thrush, and tell your doctor if you notice them
- Dizziness: do not drive or use machines if azithromycin makes you dizzy
Medicines and things that interact with Azithromycin
Azithromycin has a few important interactions. Tell your doctor or pharmacist about every medicine you take, including herbal products.
- Antacids containing aluminium or magnesium: do not take them at the same time as azithromycin; keep a gap as the label or pharmacist advises
- Medicines that can affect heart rhythm, such as amiodarone, sotalol, citalopram, some antipsychotics, domperidone, hydroxychloroquine and moxifloxacin: a higher risk of an irregular heartbeat
- Warfarin and other blood thinners: their effect may increase, so your doctor may check your clotting more often
- Digoxin and colchicine: their levels in the blood may rise
- Ciclosporin and tacrolimus (medicines that suppress the immune system): levels may need checking
- Ergotamine or dihydroergotamine (migraine medicines): should not be taken with azithromycin
- Statins such as simvastatin and atorvastatin: tell your doctor about any unexplained muscle pain
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.
Regulatory status in India
Approved for sale in India. Azithromycin is a prescription antibiotic. Single-ingredient azithromycin is not on the CDSCO list of banned medicines. Several fixed-dose combinations that pair azithromycin with other ingredients are prohibited, for example azithromycin with cefixime, ofloxacin, levofloxacin or ambroxol (2018) and with adapalene (2024), so check the ingredient list on the pack.
Type of medicine
Azithromycin belongs to this type of medicine.
Medicines that contain Azithromycin
These medicines sold in India contain Azithromycin. They are listed A to Z, not ranked.
- Azithral 500 · 500 mg film-coated tablet
What is Azithromycin used for?
Medicines that contain Azithromycin are used for these conditions.
Common questions
How long does an azithromycin course last?
Courses are often short, commonly 3 to 5 days, and some infections are treated with a single larger dose. Because azithromycin leaves the body slowly, its effect continues for several days after the last dose. Your doctor decides the dose and length; take the full course as prescribed.
Should azithromycin be taken with food?
Advice differs: the US label says the tablets can be taken with or without food, while the NHS advises taking them 1 hour before or 2 hours after a meal. Follow the instructions on your pack or your doctor's advice, and keep antacids apart from the dose.
Is Azithral 500 the same as azithromycin?
Azithral 500 is a brand name. Its tablet contains azithromycin alone, 500 mg per tablet, so the medicine is azithromycin. Other brands also sell azithromycin in different strengths, and some may add other ingredients, so check the ingredient list and strength on the pack.
Does azithromycin work for a cold, flu or COVID-19?
No. Azithromycin works only against bacteria, so it does not treat colds, flu, COVID-19 or other viral infections. A doctor decides whether an infection is bacterial. Using antibiotics when they are not needed adds to antibiotic resistance.
Can I drink alcohol while taking azithromycin?
There is no known direct interaction between alcohol and azithromycin. Alcohol can add to dizziness or an upset stomach, which are possible side effects, and being unwell is a reason to take care. Ask your doctor or pharmacist if you are unsure.
Can I take azithromycin in pregnancy or while breastfeeding?
Azithromycin can be used in pregnancy and breastfeeding when an infection needs treatment, but only a doctor should decide this. Small amounts pass into breast milk, so tell your doctor if the baby has diarrhoea, vomiting, a rash or thrush.
What is the difference between azithromycin and amoxicillin?
Both are antibiotics for bacterial infections but belong to different families: azithromycin is a macrolide and amoxicillin is a penicillin. They act on bacteria differently and suit different infections. A doctor chooses between them, and penicillin allergy matters when choosing.
Should I stop azithromycin when I feel better?
Follow the course your doctor prescribed, for as many days as advised. Because azithromycin stays in the body for several days, a short course can still be a complete one. Do not keep leftover tablets for another illness; tell your doctor if you feel worse.
Sources
- ZITHROMAX (azithromycin) tablets and oral suspension: full prescribing information. Pfizer, US FDA-approved labeling
- Azithromycin. StatPearls, National Center for Biotechnology Information (NCBI), US National Library of Medicine
- Azithromycin: an antibiotic to treat bacterial infections. NHS (UK)
- How and when to take azithromycin. NHS (UK)
- National Formulary of India. Indian Pharmacopoeia Commission