I am a newcomer to this antibiotic and am on week five of taking it but have noticed a pattern emerging.

Thursday - two pills - feel quite bouncy and good in the lung department.

Friday - one pill - still feeling good in the lung department.

Saturday - one pill - quite energetic and able to move around much better.

Sunday - absolutely shattered!

Monday - chest feels a little tighter but generally quite good.

Tuesday - no problems with chest and breathing excellent considering my rubbish lung function.

Wednesday - feel quite lethargic and as if I was about to start an exacerbation again.

My question is, am I alone in this pattern and how do other fellow azithromycin takers feel this is affecting them?

23 Replies

  • I am no doctor but have been on this for 2 years now and i must say your pattern of taking them is rather odd. I take one on a monday, wednesday and friday. I think they are a 'long lasting' prophylactic which means they work over a 72 hour period. So from Saturday until Thursday you are essentially going 96 hours before taking your next pill. The whole point about azithromycin is it acts over the long term. Like I say i am not a doctor but I do think you should go back to your GP and suggest that you feel shattered by the Wednesday. See what they say.


  • Thanks for replying Marie - the instructions on my box, state two the first day, then one, then one - so assumed it was over three consecutive days - that will be the first question to the GP - now I'm really glad I asked the question here! :)

  • I haven't read the following replies so forgive me if I'm on repeat......

    Bearing in mind I'm still wearing L Plates, from what I've understood from docs and past post Marie is right on the prophylactic dosage. I recall several people taking it permanently Sun Wed Fri.

    It's in my rescue pack and I take it as cure to infection: 3 consecutive days followed by 7 consecutive days without, then 3 on, 7 off, 3 on, 7 off Totalling 9 tabs in all.

    The 1st time I was presc it was 19 Dec last year (after 3 months of continuous chronic infection and different ABs) doc said to take it for 5 days running and it would stay in my system for 10 days getting me through to new year - which it did (by 4th Jan when they opened after Xmas I was first through the door ill again.

  • Oh deary me, well at least you were not too bad all over Christmas, so not all rotten. I think it must vary from GP to GP; I do know that on balance, I am better for taking than not so will now try the spaced out dose and see whether it makes any difference.

  • I believe Azithromycin can be used as a prophylactic or as a one off. I use it as you do Marie, taking one tablet on Monday, Wednesday and Friday. Only been on it for a few months though and it has certainly prevented me having so many Exacerbations. On saying this though, I had to start using my rescue medications a week past Friday.


  • Me too - I also opened my rescue pack last Monday! :-(

  • We probably were but I have been discharged from CIC - now solely under the Freeman. I will be interested in your update post though!

  • Marie, is this The Freeman at Newcastle?

  • Yes it is the very same one.

  • Only a few miles from where I live!


  • Its about 45 miles from where I live. But i only go twice a year now so i can handle it! ;-)

  • Just had a re-read of the notes about Azithromycin and this is what it states about dosage:

    The usual dose is 1500mg divided over either 3 or 5 days as follows:

    When taken over 3days, 500mg a day.

    When taken over 5days, 500mg on the first day and then 250mg on days 2 and through to 5.

    No mention at all of it being used as we take it Marie.

    I take 250mg when I do take it. Are you on the same dosage?


  • I take 250mg the same way as you Therese. Has worked incredibly well for me these past couple of years.

  • I was put on azithromycin by the onsultant yesterday, and will pick up the script when I see my GP on Friday. I will sort when to take it then. I do hope it does good - so fed up with infections.

  • Snap! I've just read that too, my dosage is 500mg the first day and then 250mg on the second and third. I am going to try it spaced over the week and see what happens since you guys are already doing that and doing well on it.

  • Been on Azrithromycin 250 three days a week almost two years. I have not had any infections since I began taking them. I still have to take steroids when I become very breathless and they help a lot. Don't know why!

  • Because steroids are anti-inflammatory and open up the airways so I was told. I am supposed to take them ongoing at 20mg per day but at the moment they are making me more breathless so have stopped.

  • I think it should be taken on three days spaced throughout the week.

    When the pharmacy puts '500mg on the first day then 250mg on the second and third' he/she assumes you have been told which days to take it.The GP hasn't put the days on your prescription.

    It has been written in a very confusing way - does '500mg the first day' mean only on the very first day of the course then 250mg on your chosen days thereafter or does it mean taking 500mg then 200mg x 2 times every week? I'm surprised your GP didn't tell you properly. Phone or go to your GP for clarification.

  • GP has given me four weeks' worth at a time, and the pharmacy have given me four boxes with four pills in each (having said that I've just opened one box and there are six pills inside - doh!!). GP didn't specify which days or how to space them, it was me assuming three days on the trot but having read the comments above, it makes much more sense to space them evenly out over the week! Phoned the GP and waiting for a callback to get the definitive answer.

  • hubby was only told to take 3 tablets a week - Monday, Wednesday and Friday - so we haven't noticed a great change apart from the fact that since starting these he has only had one bad exacerbation.

  • GP has phoned and confirmed the two tablets for the first day and one for the second and third and to space out the days, ie. start today, then Thursday then Saturday and see how that goes.

  • I've not been prescribed Azithromycine before so can't really advise, although I am wandering if you wore yourself out come Sunday, being shattered was the price for 3 days bouncy and energetic.


    I usually can do max 2 days energetic and shattered pm 2nd day and third day must be rest time, that is under normal circumstances, but not with a chest infection.

    Hope you are feeling better soon.

  • Actually I think you are probably right about paying the price for three days bouncing LOL. Going to change the days I take them now and space them out more evenly and see what effect that has - I think as is the way with many things, trial and error sorts it all out! Quite happy on this occasion to be a guinea pig. :)

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