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Azithromycin

About azithromycin

Azithromycin is an antibiotic.

It's widely used to treat chest infections such as pneumonia, infections of the nose and throat such as sinus infection (sinusitis), skin infections, Lyme disease, and some sexually transmitted infections.

Azithromycin is used in children, often to treat ear infections or chest infections.

It can also be used long term to prevent chest infections in people who keep getting them.

The medicine is available on prescription as capsules, tablets and a liquid that you drink. It can also be given by injection, but this is usually only done in hospital.

Key facts

  • Azithromycin is usually taken once a day. Try to take it at the same time each day.
  • If your doctor has prescribed azithromycin capsules, you should take them at least 1 hour before food or 2 hours after eating. If you have tablets or liquid, you can take them with or without food.
  • For most infections you should feel better within a few days, but you should still finish your full course of medicine.
  • The most common side effects of azithromycin are feeling or being sick, diarrhoea, headaches, or changes to your sense of taste.
  • Azithromycin is also called by the brand name Zithromax.

Who can and cannot take azithromycin

Azithromycin can be taken by adults and children.

It isn't suitable for some people. To make sure azithromycin is safe for you, tell your doctor if you have:

  • had an allergic reaction to azithromycin or any other medicines in the past
  • liver or kidney problems
  • heart problems, including irregular heartbeats (arrhythmia)
  • had diarrhoea when you have taken antibiotics before
  • myasthenia gravis - azithromycin can worsen the symptoms of this muscle-weakening illness
  • diabetes - azithromycin liquid contains sugar

How and when to take it

Azithromycin is usually taken once a day, unless you're having it by injection. Try to take your medicine at the same time each day.

The usual dose is 500mg a day for 3 to 10 days depending on the infection being treated.

For some infections, you'll be given a one-off higher dose of 1g or 2g.

The dose may be lower for children or if you have liver or kidney problems.

Azithromycin is sometimes prescribed long term to prevent chest infections if you keep getting them. In this case, it's usually taken 3 times a week, often on a Monday, Wednesday and Friday.

Important

Carry on taking this medicine until the course is completed, even if you feel better. If you stop your treatment early, your infection could come back.

How to take it

If your doctor has prescribed azithromycin capsules, you should take them at least 1 hour before food or 2 hours after eating.

If you have tablets or liquid, you can take them with or without food.

Swallow tablets and capsules whole with a glass of water.

Azithromycin liquid is available for children and people who find it difficult to swallow tablets.

If you or your child are taking azithromycin as a liquid, it'll usually be made up for you by your pharmacist. The medicine will come with a syringe or spoon to help you measure the right amount. If you don't have one, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not give the right amount.

The liquid can have a bitter aftertaste, so it can be a good idea to offer children a drink of fruit juice afterwards.

What if I forget to take it?

If you forget to take a dose, take it as soon as you remember, unless it's nearly time for your next one. In this case, just leave out the missed dose and take your next dose as normal.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for other ways to remember your medicine.

What if I take too much?

Taking an extra dose of azithromycin by accident is unlikely to harm you or your child. It may, however, increase the chance of temporary side effects, such as feeling or being sick or diarrhoea.

Talk to your pharmacist or doctor if you're worried, or if you or your child accidentally take more than 1 extra dose.

Side effects

Like all medicines, azithromycin can cause side effects, although not everyone gets them.

Common side effects

These common side effects of azithromycin happen in more than 1 in 100 people. Keep taking the medicine, but talk to your doctor or pharmacist if these side effects bother you or don't go away:

  • feeling sick (nausea)
  • diarrhoea or being sick (vomiting)
  • losing your appetite
  • headaches
  • feeling dizzy or tired
  • changes to your sense of taste

Serious side effects

Serious side effects are rare and happen in less than 1 in 1,000 people.

Call a doctor straight away if you get:

  • chest pains or a faster or irregular heartbeat
  • yellow skin or the whites of your eyes turn yellow, or pale poo with dark pee - these can be signs of liver or gallbladder problems
  • ringing in your ears (tinnitus), temporary hearing loss, or you feel unsteady on your feet (vertigo)
  • severe pain in your stomach or back - these can be warning signs of inflammation of the pancreas (pancreatitis)
  • diarrhoea (perhaps with muscle cramps) that contains blood or mucus - if you have severe diarrhoea without blood or mucus for more than 4 days you should also speak to a doctor

Serious allergic reaction

In rare cases it's possible to have a serious allergic reaction (anaphylaxis) to azithromycin.

These aren't all the side effects of azithromycin. For a full list, see the leaflet inside your medicine packet.

How to cope with side effects

What to do about:

  • feeling sick (nausea) - stick to simple meals and do not eat rich or spicy food while you're taking this medicine.
  • diarrhoea or being sick (vomiting) - drink lots of fluids such as water or squash to avoid dehydration. Take small, frquent sips if you're being sick. Signs of dehydration include peeing less than usual or having strong-smelling pee. Do not take any other medicines to treat diarrhoea or vomiting without speaking to a pharmacist or doctor.
  • losing your appetite - eat when you would usually expect to be hungry. If it helps, eat smaller meals more often than usual. Snack when you're hungry. Have nutritious snacks that are high in calories and protein, such as dried fruit and nuts.
  • headaches - rest and drink plenty of water. Ask your pharmacist to recommend a painkiller if you need one. Talk to your doctor if the headaches last longer than a week or are severe.
  • feeling dizzy or tired - if you feel dizzy when you stand up, try getting up very slowly or stay sitting down until you feel better. If you begin to feel dizzy, lie down so you don't faint, then sit until you feel better. Do not drive or use tools or machines if you feel dizzy or tired. Do not drink alcohol as it may make you feel worse.
  • changes to your sense of taste - talk with your doctor if this is bothering you.

Pregnancy and breastfeeding

Azithromycin isn't normally recommended during pregnancy or while breastfeeding. But your doctor may prescribe it if the benefits of taking azithromycin are greater than the risks.

For more information about how azithromycin can affect you and your baby during pregnancy, visit the Best Use of Medicines in Pregnancy (BUMPS) website.

Cautions with other medicines

There are some medicines that do not mix well with azithromycin.

Tell your doctor if you're taking these medicines before you start azithromycin:

  • antacids for indigestion
  • ergotamine or dihydroergotamine - for migraine
  • warfarin - to thin blood or prevent blood clots
  • ciclosporin or tacrolimus - medicines to stop your immune system overreacting
  • colchicine for gout
  • digoxin for some heart problems
  • rifabutin - an antibiotic
  • nelfinavir - a medicine for HIV
  • a statin medicine to lower your cholesterol - such as simvastatin and atorvastatin

You should also let your doctor know if you're taking any medicines for an irregular heartbeat (arrhythmia), such as amiodarone or sotalol.

Azithromycin can sometimes affect your heartbeat, so it's best not to take it with other medicines that have the same side effect.

For this reason, it's important that you tell your doctor if you're taking medicines that can affect your heartbeat as a side effect.

These can include:

  • antidepressants - such as citalopram
  • antipsychotics - used to treat severe mental health problems
  • some antisickness medicines - such as domperidone
  • some antibiotics - such as moxifloxacin

Check the leaflets that come with your medicines and talk to a pharmacist or your doctor if you have any worries.

Mixing azithromycin with herbal remedies and supplements

There are no known problems with taking herbal remedies or supplements alongside azithromycin.

Common questions

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376 public posts

Azithromycin

I just took the 1g powder form of Azythromicin and I stupidly decided to google it and there was a warning that it can lead you to have fatal arrhythmias. I have the worst heart anxiety already so this is making me think that i’m going to drop dead any minute now. Some people were also saying it gave
I just took the 1g powder form of Azythromicin and I stupidly decided to google it and there was a warning that it can lead you to have fatal arrhythmias. I have the worst heart anxiety already so this is making me think that i’m going to drop dead any minute now. Some people were also saying it gave
Guzman13
in Anxiety Support

Azithromycin for the 1st time not agreeing with me

Hi all,Regarding when people 1st went on Azithromycin and it didn’t agree with them what happened next regarding long term antibiotic treatment ?
Hi all,Regarding when people 1st went on Azithromycin and it didn’t agree with them what happened next regarding long term antibiotic treatment ?
Homer12
in British Lung Foundation

Covid jab with Azithromycin.

As well asPMR I suffer from bronchiectasis and take Azithromycin 3 times a week to prevent infection. I know antibiotics would not normally interfere with a virus jab but have read that this particular one was once considered as a cure for Covid. I’m now worrying I’ve stopped my jab from working.
As well asPMR I suffer from bronchiectasis and take Azithromycin 3 times a week to prevent infection. I know antibiotics would not normally interfere with a virus jab but have read that this particular one was once considered as a cure for Covid. I’m now worrying I’ve stopped my jab from working.
Tiramisu76
in PMRGCAuk
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Am I clinically extremely vulnerable?

Lots of infections initially so put on azithromycin 3x weekly. Last year pseudomonas identified several times & a course of ciprofloxacin in July. Subsequent pseudomonas evident, may be colonised. No letter to class me as extremely vulnerable & eligible for vaccine soon. Any thoughts please?
Lots of infections initially so put on azithromycin 3x weekly. Last year pseudomonas identified several times & a course of ciprofloxacin in July. Subsequent pseudomonas evident, may be colonised. No letter to class me as extremely vulnerable & eligible for vaccine soon. Any thoughts please?
Lfcpremier
in British Lung Foundation

Can’t tolerate Azithromycin,Any others options

Hi all, I was recently put on long term Azithromycin but after 3 weeks I’m really not tolerating it very well,For other people who started these antibiotics and couldn’t tolerate them want did your consultant do next ?? Is there another option ? Thanks
Hi all, I was recently put on long term Azithromycin but after 3 weeks I’m really not tolerating it very well,For other people who started these antibiotics and couldn’t tolerate them want did your consultant do next ?? Is there another option ? Thanks
Homer12
in British Lung Foundation

Regular Azithromycin user - new side effect

I have bronchiectasis and have been on Azithromycin 3 times a week to prevent chest infections for about 5 years now. My problem is that in the last couple of months, it has started to badly affect my stomach when I take it.
I have bronchiectasis and have been on Azithromycin 3 times a week to prevent chest infections for about 5 years now. My problem is that in the last couple of months, it has started to badly affect my stomach when I take it.
Cakebaker22
in British Lung Foundation

Ongoing infections and asthma

I've had 3 courses of steroids since November, doxycycline twice, azithromycin once and now on amoxicillin. I have several nose bleeds from my sinuses.
I've had 3 courses of steroids since November, doxycycline twice, azithromycin once and now on amoxicillin. I have several nose bleeds from my sinuses.
4127
in Asthma UK community forum

Side effects for Azithromycin

Daisy May I have been on Azithromycin every other day for about 3 years but suddenly I am feeling nauseous if I go out in sunny weather and have problems focusing on objects, also my skin keeps breaking out in small rough patches and itches - has anyone else had any side effects from this drug?
Daisy May I have been on Azithromycin every other day for about 3 years but suddenly I am feeling nauseous if I go out in sunny weather and have problems focusing on objects, also my skin keeps breaking out in small rough patches and itches - has anyone else had any side effects from this drug?
Hannah1943
in British Lung Foundation

Meds causing tendon inflammation

Azithromycin Carbocisteine Colomycin Can you tell me if any of the above medication can affect your tendons ? My daughter had been suffering from painful ankles for about six weeks & it seems up be getting worse . I thought I read somewhere that certain medications can cause tendon trouble.
Azithromycin Carbocisteine Colomycin Can you tell me if any of the above medication can affect your tendons ? My daughter had been suffering from painful ankles for about six weeks & it seems up be getting worse . I thought I read somewhere that certain medications can cause tendon trouble.
rossiedavid
in British Lung Foundation

Thanks for responses back

The 30mg Steroids were for only 6 days I will finish, however I am on7mg / day anyway for ‘another problem, and have been for 18 mths - so getting a good share of steroids - was really missing the Carboistiene/ Azithromycin which help during day + Co- Amoxicillin as must have a ‘flare up’ to be so bad
The 30mg Steroids were for only 6 days I will finish, however I am on7mg / day anyway for ‘another problem, and have been for 18 mths - so getting a good share of steroids - was really missing the Carboistiene/ Azithromycin which help during day + Co- Amoxicillin as must have a ‘flare up’ to be so bad
Kiwib
in British Lung Foundation

Can he have a hypersensitivity to inhaled cortecoids after 2 years of taking them

so doctor changed it to seretide, as soon as he got the blast of seretide he coughed non stop for 6 hours never used that again, so I took him off all inhalers eventually the throat clearing stopped but the cough was still there, respiratory specialist did no tests just gave me an 8 week course of azithromycin
so doctor changed it to seretide, as soon as he got the blast of seretide he coughed non stop for 6 hours never used that again, so I took him off all inhalers eventually the throat clearing stopped but the cough was still there, respiratory specialist did no tests just gave me an 8 week course of azithromycin
Sbolger1
in Asthma UK community forum

Bronchiectasis - All change of Treatment - maybe not...

Re my Bronchiectasis - Saw different Consultant and told to stop Carboistiene/ Azithromycin & move to 30mg Steroids/ day & Trelergy Steroid inhaler. 5 days later now worse than ever - bringing up heavy thick green sputum and was getting worse daily - spent last night 2am thro 5am coughing up sputum.
Re my Bronchiectasis - Saw different Consultant and told to stop Carboistiene/ Azithromycin & move to 30mg Steroids/ day & Trelergy Steroid inhaler. 5 days later now worse than ever - bringing up heavy thick green sputum and was getting worse daily - spent last night 2am thro 5am coughing up sputum.
Kiwib
in British Lung Foundation

Old Treatment ‘kicking in’ and slowly reverting back to My ‘normal’ Bronchiectasis mode..

Thank for everyone’s ongoing interest The 30mg/day was for only 7 day, now gone back to ‘old regime’ of Carbocisteiene/ Azithromycin and now 2 days later situation much better (The original and ongoing 7mg/day steroids is for a long standing Myopathy muscle problem, been taking for 18mths now..
Thank for everyone’s ongoing interest The 30mg/day was for only 7 day, now gone back to ‘old regime’ of Carbocisteiene/ Azithromycin and now 2 days later situation much better (The original and ongoing 7mg/day steroids is for a long standing Myopathy muscle problem, been taking for 18mths now..
Kiwib
in British Lung Foundation

Would appreciate advice

I am on azithromycin 250 mg three times week. But got another infection, so more clarithromycin. The antibiotics are playing havoc with my stomach. I did a really stupid thing, so angry at myself. I have lpr laryngopharangeal reflux.
I am on azithromycin 250 mg three times week. But got another infection, so more clarithromycin. The antibiotics are playing havoc with my stomach. I did a really stupid thing, so angry at myself. I have lpr laryngopharangeal reflux.
callistra
in British Lung Foundation

Bronchiectasis treatment

I am on Azithromycin Monday Wednesday and Fridays which I usually stop for 3 months in the summer. I am also taking Carbocisteine capsules twice a day. I am well at the moment but not sure whether to take the usual summer break because of covid-19.
I am on Azithromycin Monday Wednesday and Fridays which I usually stop for 3 months in the summer. I am also taking Carbocisteine capsules twice a day. I am well at the moment but not sure whether to take the usual summer break because of covid-19.
Cakebaker22
in British Lung Foundation

Pseudomonas advice

My son (2) has been on nebulised colomycin, azithromycin, inhalers and montelukast for a year to combat pseudomonas. This followed two weeks of IVs in hospital. Problem is - we cannot seem to find an underlying cause (negative for cystic fibrosis, bronchiectasis etc...).
My son (2) has been on nebulised colomycin, azithromycin, inhalers and montelukast for a year to combat pseudomonas. This followed two weeks of IVs in hospital. Problem is - we cannot seem to find an underlying cause (negative for cystic fibrosis, bronchiectasis etc...).
Puglife87
in British Lung Foundation

Bronchiectasis sufferers do you get this ?

Also I have just started to take Clarithromycin earlier this evening as I think I may have an infection starting, however I also take the 3 times a week Azithromycin as a preventative, so is it ok to take both ?
Also I have just started to take Clarithromycin earlier this evening as I think I may have an infection starting, however I also take the 3 times a week Azithromycin as a preventative, so is it ok to take both ?
TG58
in British Lung Foundation

Hydroxychloroquine, Azithromycin for COVID-19: cautionary warning from American Heart Association

Don't be foolish and think hydroxychloroquine and azithromycin will save you. It may, and then, it may not. Sharon
Don't be foolish and think hydroxychloroquine and azithromycin will save you. It may, and then, it may not. Sharon
sharoncrayn
in Parkinson's Movement

Bronchiectasis now added to nhs shielding list

Just received a letter from my bronch specialist advising that Bronchiectasis has now been added to the shielding list from last week ,was off work due to this but was social distancing since 11/3/2020.I’m on prophylactic azithromycin but classed as mild has anybody else received this update !
Just received a letter from my bronch specialist advising that Bronchiectasis has now been added to the shielding list from last week ,was off work due to this but was social distancing since 11/3/2020.I’m on prophylactic azithromycin but classed as mild has anybody else received this update !
Tinker26
in British Lung Foundation

Medication Dilemma

Although she does find the use of Azithromycin a little “unconventional” but bows to the expertise of the consultant. I think going back to by old regime, (there’s no pred involved) which resulted in less blue use, is the way to go but I’m not sure.
Although she does find the use of Azithromycin a little “unconventional” but bows to the expertise of the consultant. I think going back to by old regime, (there’s no pred involved) which resulted in less blue use, is the way to go but I’m not sure.
Junglechicken
in Asthma UK community forum
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