Azithromycin for bronchiectasis - British Lung Foun...

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Azithromycin for bronchiectasis

Phill1 profile image

Have Just been prescribed Azithromycin 500mg 3 x per week for my bronchiectasis..

Any advice on when in the day to take it?..

with without food?

Have read one of side effects could be stomach upset… that may wear off after first week or 2 ?

Any other advice appreciated …


61 Replies

Hi Phil I take mine first thing in the morning 1 hour before food. This works well for me. I have no side affects or problems with it but am only on 250mg 3 times a week.

Phill1 profile image
Phill1 in reply to Patsy164

Thanks for that PatsyWish he’d prescribed 250 mgs for me.. only a 5ft 8 st 5 lb female.. seems a high dose to me 🙄

I take 250mgs Mon Wed and Sat, after food as I have a dodgy sensitive stomach. Read the leaflet well and keep it with your meds for future reference. On my third winter of Azith and its helped so very much in avoiding infections.

I would doubke check on that 500mgs you mention in your post, seems a high dose to use as prophylactic. It's usually 250mgs . P

Phill1 profile image
Phill1 in reply to peege

Comforting to hear these posts.. Prescribed by Respiratory consultant so hopefully will be ok..

peege profile image
peege in reply to Phill1

I would still check Phill, 500 is a high dose. Perhaps your gp or a pharmacist would advise - or even a quick email or call to the helpline? Is your lung disease severe?

They do make mistakes, my 10 month old g'daughter was prescribed an adult dose of Azithromycin, luckily my daughter called me when the bottle was near empty, we never found out if it was prescription error or pharmacist labeling.

Beconator profile image
Beconator in reply to peege

I take 500mg per day 3x a week. It can be prescribed that way. I have to take Azithromycin with food else I get crippling stomach pains as mine is a high dose. I was prescribed this dosage by my respiratory consultant.

Hi,I’ve been on Axithromycin for 3 years.Some sources say take before food,some after food.

I’ve decided that it suits me best if I take it with or after food.

Phill1 profile image
Phill1 in reply to Oshgosh

Thanks.. sounds like the majority recommend with/ after food 👍

Hi Phil, hope this works for you though I agree with the others that 250mg is more usual, in fact Ive never heard of taking 500mg a week. If I were you I would ask your GP/consultant why he has put you on 500mg.

Just take with food - during, before or soon after.

Phill1 profile image
Phill1 in reply to O2Trees

Will do…thanks

O2Trees profile image
O2Trees in reply to Phill1

Well having seen LP's reply, thankfully you have a GP who knows what he is doing!

Littlepom profile image
Littlepom in reply to O2Trees

Hi 02 trees. This is where one of the differences between the treatment of bronch and that of copd comes in. Bronch patients need a higher dose ( and in the case of short term oral abs) a longer course because our bacterial susceptibility is higher than in copd. Many GPs and general respiratory consultants do not read the guidelines and so may treat bronch as copd.

O2Trees profile image
O2Trees in reply to Littlepom

Ah, interesting LP. I have 250 and it seems to work but so far my bronch, secondary to copd, doesnt seem to produce much mucus, for which Im very grateful. Useful to have this information though.

Littlepom profile image
Littlepom in reply to O2Trees

Yes sounds very sensible to me. Treating you with copd dose because your bronch isn’t the dominant problem and of course, 250mg will be giving your bronch an element of protection against infection and inflammation. Lovely.

500mg is the right dose for bronch. I took it for 5 years before it stopped working for me. I took it with food and it was fine.

Phill1 profile image
Phill1 in reply to Littlepom

Thanks btw.. good to hear that others are on that dose as well ..

Will start off with the 500mg, see how it goes as it was Prescribed by Respiratory consultant.. fingers crossed 🤞

Littlepom profile image
Littlepom in reply to Phill1

Consultants who read the bronch guidelines will prescribe that dose. Some people do ok on the lower dose but the larger dose is more effective at keeping down inflammation in bronch and against some bacteria. Unfortunately it is not effective against pseudomonas which is one of the reasons I stopped taking it. Also I developed AF and dilated cardiomyopathy and couldn't take it with digoxin. I hope that you do well on it. Lots of people do.

Eeeek…the reason I was put on the Az, I thought, was because of my pseudomonas…I haven’t had that many exacerbations..2/3 per year 😬

Did the AZ cause the AF / cardiomyopathy???

Littlepom profile image
Littlepom in reply to Phill1

Cipro is the only oral ab which is affective against pseudo. Azith helps because it keeps down inflammation and infections from other bugs which can prevent pseudo from having a party. During the 5 yrs I took it I had to take about 3 courses of cipro each year in addition when the pseudo overcame it. We are all very different and bronchs are very different to those with copd so it is best to see how you go yourselfNobody can figure out why I got AF and why my left ventricle started to fail. It took me 2 yrs to persuade my doctors that my additional breathlessness was different to bronch.

Phill1 profile image
Phill1 in reply to Littlepom

Thanks Littlepom.. all a bit of a learning curveI did have a course of cipro which settled down my last exacerbation but was disappointed to find that a follow up sample still grew pseudomonas. I assume it’s just going to be lurking around. Have just taken another sample in with my appointment..🤞

Littlepom profile image
Littlepom in reply to Phill1

Once it is in there, you are right, pseudo lurks even though it may not show up on a plate. The object is to keep the numbers low enough so that we can live a normal life. Some nebulise antibiotic for this also scrupulous clearancr helps. Occasionally the numbers have a party then cipro is needed. 750mg twice daily for 14 days is what bronchs need. Unfortunately most docs balk at prescribing this but true bronch specialists insist on it. When this doesn't suit, IV for 2 wks usually gets everything back on an even keel.I have had pseudo since 1986 and have had a normal life.

Littlepom profile image
Littlepom in reply to Phill1

You are getting a lot of replies on dosage from the lovely copd people on here. Their dosage is different to ours. Their input on whether to take it with food etc is very useful. 500mg is taken once each day.

stones93 profile image
stones93 in reply to Phill1

Azithromycin can cause abnormal changes in the electrical activity of the heart. Hence in my case I had to have an ECG , to make sure it was normal, before being put on azithromycin. I've now been on it for several years at the lower dose and take it with food at breakfast time. No problems.

Phill1 profile image
Phill1 in reply to stones93

Wasn’t offered an ECG beforehand.. just follow up Liver Function Tests in one monthMight mention an ECG to my GP.. but doubt I’ll get one..

500mg is fine, I was on that but came down to 250 because I have hearing problems & they were concerned 500 was making it worse. I don’t find the 250 all that helpful, tbh, but it helps thin the mucus, so I’m sticking with it.

It doesn’t treat pseudomonas but its anti inflammatory effect does help keep it under control

Phill1 profile image
Phill1 in reply to Hanne62

Thanks for that.. I have bad hearing in one ear and tinnitus so I’ll keep a wary watch on any deterioration

I take 500mg x 3 per week. Have done for over 10 years. I take mine in the evening .Althought lots of other medication have caused me difficulties regarding my stomach ,taking azithromycin in the evening works fine for me. I do think sometimes it can be a bit of trial and error to find what's best for individuals.

I hope it works for you. They have been a great help to me over the years. I take mine continuously throughout the year.

Phill1 profile image
Phill1 in reply to teddyd

Good to know.. thanks

Hi phill1 ,I take mine at 10.30am and at about 3 in the afternoon I get stomach disturbances but only on the odd occasion but I am on a 500mg dose

Phill1 profile image
Phill1 in reply to B0xermad

Hi .. are you taking 500mg twice a day? Or is it 250mg 10.30 and 3.00 pm? Thanks

B0xermad profile image
B0xermad in reply to Phill1

500mg once a dayat 10.30am but by 3pm I have stomach upsets

I take 250mg Mon Wed Fri. Cant take it in the morning as causes problems. I take mine last thing at night and no problems. xxSheila.

Phill1 profile image
Phill1 in reply to garshe


Hi PhilI too have Azithromycin long term for bronchiectasis and emphysema, I take mine Sunday Tuesdat and Thusday at bedtime, much better on the tummy I find, the body gets use to them and any early tummy problems, settles down, well in my case anyway. Good luck.


Phill1 profile image
Phill1 in reply to Trishe

Thanks.. I’ll start today Here’s hoping no tummy problems

I take mine before food in the mornings. If I take it after food then I tend to get an upset stomach later in the afternoon.

Phill1 profile image
Phill1 in reply to MarieW-F


Hi Phill1. I take 250mg daily just before bed as I’ve found that for some reason it doesn’t give me the tummy cramps that I experienced when I took them in the morning. I did persevere with them for a few weeks hoping that they would settle, but they never did 🤷‍♀️

Phill1 profile image
Phill1 in reply to Jandm

So many different posts re best time etcDecided I’m Going to try morning with breakfast first.. Then in evening if I get upset tum


I take mine Mon, Wed, Fri following/with my breakfast and have had no stomach upsets etc.

Phill1 profile image
Phill1 in reply to Digger0

Thanks 👍

I'm inclined to get mouth ulcers, and when I was put on this medication I ended up with the worst bout of mouth ulcers ever. Needless to say, I didn't carry on with them. I was put on Azithromycin as I used to get chest infections one after the other (18 bugs in 2017). After we found black mould on our bathroom floor and eradicated that, I have had hardly any more chest infections. Read into that what you will.

I also avoid NSAID's and SLS in toothpaste, which can cause mouth ulcers.

Phill1 profile image
Phill1 in reply to Lutontown

Not the sort of side effect anyone would want !Hope all’s still well ..

Hi I spent 3 years on them and took them first thing in the morning with my coffee and they did the trick I am now lots better than I was when I kept getting one infection after another. Keep safe Mags

Phill1 profile image
Phill1 in reply to 1947Mags

Thanks 🙏

Hi, I take mine after breakfast. I also eat yoghurt every day to keep stomach problems at bay. I have taken them now for 11 years and they have kept me well. Takecare, Maximonkey

Phill1 profile image
Phill1 in reply to Maximonkey

Nice to hear good news from those who have taken it for a while.. thanks

Hi there I take that as well 3 times a week 250 mg have been on it since January. I have tried different times of day but first thing in the morning on an empty stomach works best for me.

Phill1 profile image
Phill1 in reply to TL13

👍 ..

Hi Phil, I’ve only been taking mine for 3 weeks. It’s probably trial and error as to when or wether before or after a meal.I had terrible stomach cramps to start with, but found if I have 3dessert spoonfuls of yoghurt (I have coconut yoghurt) I don’t get any pain. Good luck and I hope you find a way of taking it that suits you.

I’ll get more yogurt in then😁Thanks for the advice

Been on az for 2 years no probs only on 250mgs 3 times a week had no infections for over 12 months ...fab xx

Phill1 profile image
Phill1 in reply to Tinker26

Good to hear.. thanks 👍

I’d say don’t take it on an empty stomach. 500 seems a high dose to start with perhaps you could query that if your taking it x3 times weekly.

Phill1 profile image
Phill1 in reply to Kristicats

👍 will do ..

I have been taking Azith 3 times a week for 3 years. It's interesting reading the posts on how people are taking it at different times of the day and with food. I have always taken it 1 hour before breakfast on an empty stomach, as indicated in the leaflet. As I'm having some gastric and bowel upset I am going to try taking it with breakfast. I follow the guide lines and wait for 2 hours after, before taking my calcium tabs. It certainly helps to have all the opinions of our lung buddies. Thank you xxx

Phill1 profile image
Phill1 in reply to HollyBoyd

So true.. such a helpful forum.. going to try the with food option first 👍

One of my doctors told me years ago to always take medication with food as it helps your tummy. Hope this works for you x

Phill1 profile image
Phill1 in reply to Izb1


I’ve just on my second month of a four month course of Azrithromycin 250mg once a day. I have Bronchiectasis and having issues with strep pneumonia infections which is being investigated by an immunologist as my antibodies are low for my pneumococcal jab.

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