Side effects of Azithromycin - British Lung Foun...

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Side effects of Azithromycin

Clareyg profile image

Hi I’m new here. I had mutlifocal bilateral pneumonia over Christmas and spent the whole of January in hospital with 19 days of IV antibiotics.Found out in June after a HRCT when I didn’t seem to recover that I have bronchiectasis is both lobes of my left lung. I also have lifelong asthma. I’m 49 and very fit but really struggling to get the mucus production under control. The consultant wants me to start on Azithromycin 3 times a week for a long period of time because I work in an office where bugs go round and round and I keep getting infection after infection. My question is the listed side effects frighten me- do the benefits outweigh the side effects? I have them here to start but haven’t yet! The consultant tells me I am in denial about what’s happened. Comments welcomed! Thanks

32 Replies

Hi and welcome Clare? I'm on them now too plus a bucket full of prednisone but haven't noticed any adverse effects..maybe mention to GP?..regardsGer

Hi Clareyg,

Ihave lifelong bronchiectasis and took azith for five years. I had no side effects but came off it when it stopped working. It is a good drug and is given as a prophylactic to prevent bacteria growing.

In an office environment it is a good idea to use something like First Defense when there are colds etc around and keep washing your hands. Also have your vit D levels checked. Many folk with lung problems cannot absorb vit D from their food or the sun-like me. I take a high dose of vit D3 daily on prescription and it has really helped to keep the bugs ar bay.

Now that you know that you have bronch, the most important thing to do so that you stay well is to cough that mucus out every day - all of it. If you need help and advice on how to do that there are several of us on this site who will be happy to help you. It is all in your hands and once you have control of the management of your condition things will improve. I hope that helps a bit.

Clareyg profile image
Clareyg in reply to

Thank you very much for your reply. I’ve been taught autogenic drainage and abct (I can do this in the office if I really need to) so I’m managing to get the mucus out morning and night and we have hand sanitiser outside my office door and other places in the office to try to limit the spread of bugs. Im just not keen to take even more drugs than I already do especially as I have a sensitive stomach anyway so I’m nervous of the impact of more antibiotics as I’ve had pack after pack since coming out of hospital. I will take them and fingers crossed they don’t affect me as they didn’t for you or Ger. maybe I will try some probiotics as well!

in reply to Clareyg

Be careful with the pro biotics. They can prevent the antibiotics from working but not many people realise that. I’m afraid that with bronch, antibiotic therapy is a way of life. It is a matter of finding what works best for you and in what delivery system. Three doses a week long term is better in my eyes than frequent high dose two week courses. I nebulise ceftazidime as a prophylactic and take cipro if I go downhill, usually after a virus. I have been lucky, in 65 years of bronch I have only needed IV three times.

It looks as though you are very organised and set up to keep your life on track. Do let us know how you go on.

The side effects listed in the patients info leaflets are always scary Clareyg. They have to list every possible thing in case they get sued over one they haven't mentioned. I always do a swallow of apprehension when I read them but think about it - if the azith stops you getting more pneumonia, then isn't it worth a try? If you do get a nasty side effect then you can just stop taking it.

I have bronchiectasis diagnosed after double pneumonia 3 years ago. Ive been fine til this year and have had two lots of pneumonia, hospitalised each time with IV ABs. Im now taking aziththromycin and have had no side effects whatsoever. I feel very grateful for it.

You can't know if you don't try - if I were you I'd suck it and see. :)

Hello I’ve had these for over five years. Sometimes (not always) they can cause stomach problems for me unfortunately. But they’ve really helped with my lungs so worth it for me .

Iam also on these 3 times a week for 3 months because I have trouble getting mucas up and infections I have been on them for a month I have hade no side affects yet but I still can not expel mucas which I believe is the problem

in reply to Help_61

Hello Help_61

Yes I think you hit the nail on the head. Unless you get the mucus out of your lungs the poor azithromycin will be fighting a losing battle. As soon as it kills off most of the bugs, those that are left will have a party in the lovely warm puddles in your lungs and along come lots more bugs!

You need to find the best way of clearing your lungs and do it faithfully, every day, several times a day. I am sure that you know of the cycle of breathing that you can find on you tube and of various devices which help to loosen the mucus when you blow into them. I have an aerosure medic and wouldn’t be without itbut there are cheaper flutter devices. Keeping active, doing exercises, lying on your back or over the side of the bed whilst doing the breathing all help different people in different ways. I know that it is tedious, time consuming and tiring but absolutely cruciaI. I am sure that if you can achieve success with the clearance you will find azithromycin to be a very good drug.

Clareyg - my OH took this drug three times a week for a few years with no side effects but it didn't work - he was still getting frequent infections, many due to pseudomonas. Now takes it every day and he has improved but the increased dose coincided with better clearance so that is doubtless a factor.

AFAIK the British Thoracic Society guidelines on the management of bronchiectasis is that long term antibiotics should be considered when there are more than three exacerbations (infections) in one year. Since recovering from pneumonia, have you had any further infections? How have you been? It sounds like you are struggling with your lung hygiene so maybe try one of the devices as well as your breathing exercises. Nebulized saline can help thin the mucous and make it easier to cough up. Clearance is really important as it will go some way to keeping you clear of infection.

Don't forget the influenza vaccination next month and ask about pneumovax, even though you have had pneumonia.

You have to make your own mind up about taking Azithromycin but I would say that with bilateral bronchiectasis and asthma as well, it would be worth trying. I was told by staff that it has an anti inflammatory effect. Infections are said to damage lung tissue further so this is something to be avoided if at all possible.

The only other thing I can think of is to discuss nebulized antibiotics such as Colomycin. It is a bit time consuming though, mostly due to the equipment needed.

I have bronchiecstasis too. I’ve been in Azithromycin three times a week since August 2017, plus 7.5mg pred and other drugs for RA and asthma. I was advised to stop in the Azithromycin in May because ‘people don’t get chest infections in the summer.’ Needless to say I got the mother of all chest infections at the end of May! I don’t have any side effects from the Azithromycin.

Yes, I would say so, I've been on Azithromycin for around 3 years now, Best ever Antibiotic, Keeps me from having Exacerbations. I have side affects But that is with Steroid based Meds, mainly Bruising and weight gain ( always on a Diet). I put my Trust in my Consultant, and my Transplant Team. I'm still here, I'm alive, Because of the Meds. Wishing you a Great Sunday. xxxxxx

Hi there, im in a similar position to u. I tried taking the antibiotics 3 times a week, they made my ears really funny, and i felt very unwell with them, i even fell asleep at the wheel, so stopped taking them.

I've taken them for almost 2 years and haven't experienced any side effects........unless loss of memory is one .😀

I have been on Azithromycin 3x a week (250mg) for over 10 years now. And I feel perfectly ok. I was diagnosed with COPD back in 2004 (?) and had exacerbations every few weeks for several months. Non stop antibiotics in those days was fairly new. But the minute I ws on it my infections stopped. I never read the side affects, I wait til I get something or feel off before I read what can go wrong. But life without the antibiotics is terrible for me as it becomes one long round of infection, slow recovery, next infection - one after the other. The only problem I have had in the last 10 years is when an elderly doctor took me off them and I promptly got a chest infection. And I have lived in South East Asia for three years without problems. I find exercise - 3x a week in the gym - also helps enormously.

Hi, I’ve been taking them for 6 years, 3 x a week with no side effects and they’ve reduced my infections as I work in an office environment too. It’s definitely worth giving them a try and good luck.

Hi I have copd asthma and bronchiectasis and have been on azithromycin for 3yrs also suffer with pneumonia in and out of the hospital and worked in a school so germs were rife. The azithromycin is great but also clearance of mucus is a key part to keeping infection at bay so get a device to cleat every day and you will feel so much better with that and the medication with lots of luck .

B0xermad profile image
B0xermad in reply to B0xermad

Clear mucus

I know it may seem a bit over the top but do you have your own office telephone and keyboard if you use a computer and office mug. Order in some anti bac wipes for he phone and keyboard and give them a good clean before you use them. Wash your own mug and keep it in your draw, sounds silly I know but you would be amazed what bugs collect on our office equipment. I have been n Azithromycin for 4 years now and apart from some tummy problems all is ok.



Hi Clareyg

I am a long term user of these tablets / antibiotics like you I’m very prone to infections I have asthma and COPD, I find that they do good by me my consultant does do tests for bloods, heart, etc as part of the monitoring of these tablets, mind you I take my medication via nebuliser so I also use Sailine solution which helps with the mucus, when it’s really hard to bring up despite doing the breathing exercise I use honey, lemon and ginger, I boil up the ginger you only need a very small amount then I let it steep I do the same with the lemon wait for them both to cool down I then add a teaspoon or two of the honey sometimes I blend both the lemon and ginger as well it works for me, I do tend to prepare cut up the ginger or grate it then I freeze in batches same for lemon so I do have them at hand at all times for strength of flavour you just have to keep trying until you get it right for you,

Did you get sent off to get a cardio, chest X-ray and bloods done an got the results before you could start on the tablets that’s what was done with me, So long as you are being monitored whilst you are on the tablets you’ll be fine if you then notice side effects tell / discuss with your doctor as it could even be due to taking other meds clashing etc, the pharmacist or your doctor will tell you when it’s best time to use I’ve been on these tablets for some time now and they work for me plus I still get monitored good luck hope that I might have helped you in some way in making your decision xxxx

Clareyg. I too have had asthma since birth and have bronchiectasis also. I was described azthromycin 3 times a week, but must admit,, I haven't had any adverse effects. In the winter I was suffering a lot and was recommended this to help with amount of chest infections. I would give it a try. As for getting rid of mucus, see physio and ask for a flutter valve, it looks like a pipe with a ball bearing inside, you inhale using this and it helps shift mucus. I have been pleased with results. I have my Bronchiectasis in 3 lobes. Good luck and hope you feel a bit better soon.

Lizzie34 profile image
Lizzie34 in reply to Patchpoppy2

Good advice, I use the flutter, sometimes I don’t have success

Hi Clare

I have got bronchiestisis with asthma and COPD. I have been on azith for 5yrs after being on Trimithropin and flucs for many years. I haven't had any problems with the drug. I am also on pred when I need a stronger antibiotic ( Doxycycline).

I take Azithromycin, every day if you have been offered it 3x per day, you are being offered the 500mg dose, I take 250mg everyday, 1750 mg per week. I have been prescribed it by my chest consultant as a prophylactic, it is to maintain my lung health, it is the second time I have had this med, I took it from 2011 to 2015, I can honestly say never had any problems/side effects at all. I started back on Azithromycin last July and my lung health has improved, I am on the tail end of a 16 month continuous serious infection, been treated with some heavy duty antibiotics, which are all classed as unlicensed doses because I am resistant, to antibiotics and carry ESBL. It is a really good choice for long term use, as a prophylactic. Good luck with it all

sorry forgot to say if having problem with bringing up sputum, you can ask your consultant to prescribe, carbocisteine, I have used that for the last 12 years, I did my own research years ago and found it was a medication used by patients with cystic fibrosis to remove phlegm, so asked my consultant why couldn't i use it for the same purpose and he agreed, it was a good idea, I have hypersecretion, so it really helps to get it all moving also see a respiratory physiotherapist at moment every week for last 2 years, on and off for 15 years. I do Active Cycle of Breathing 2 x daily whilst nebulising (not at same time ) you can get referred to physio by gp

I've been on Azithromycin 500mg 3 times a week for quite a while and I think they do help prevent me from getting infections. I was advised to stop them for the summer months and start again in October. I haven't had any side effects at all.

Hi All thank you all so much for your helpful replies. I am starting them today so fingers crossed ! I let you know how I get on.

I have been on Azithromycin since 2015 daily for nine months of the year. I have only had one hospital admission each year since starting them. I now have a small hearing loss, I do not want to come off them altogether so have agreed to only go on them for six months of year i.e. Sept- March. They have not affected me in any other way except for reducing the number of infections.

With the information you gave, I believe that you should start Azithromycin right away. They are a great second line antibiotic, an even better anti inflammatory and best of all can break through the defence s of most infections so allowing antibiotics that had seized to work to start their good work again. I wish you all the best.

Hello Clareyg I’m going to tell you something that maybe a lot of people won’t agree with but this is what I do and it works for me!.. I never ever read the leaflets or side effects because an hour after I take one tablet I’d have every side effect that was mentioned, and I mean everyone of them.. so, my husband reads through it .. I take the tablets.. It works for me not everyone ..

I don't take this medication but I do the same as you Candyred, with whatever medications I am taking I don't read the leaflet. I know some people don't agree, but for me it's what works. I know if I read the side effects I'd be experiencing all of them. Also I figure, if I have to take a certain medication, then I have to take it, and I'd just rather not know what it could cause.

Phew and thank you HungryHufflepuff.. So glad we are on the same wave length 😊

Hi Clare, I have been taking them for nearly a year now and my chest is much better. I used to get one infection after another but I am keeping really well at the moment. I usually get ill when I take tablets but I've been fine on these. Good luck with them. You can always stop if you don't like them.

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