Experiences with
Azithromycin

Azithromycin is an antibiotic medicine.

It's used to treat infections including:

chest infections such as pneumonia
ear, nose and throat and nose infections such as sinus infection (sinusitis)
skin infections
Lyme disease
some sexually transmitted infections (STIs)

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

Azithromycin is from a group of medicines called macrolide antibiotics. Macrolide antibiotics work by killing the bacteria that cause the infection.

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

Who can take azithromycin

Most adults and children can take azithromycin.

Who may not be able to take azithromycin

Azithromycin is not suitable for some people. To make sure it's safe for you, tell your doctor if you have:

ever had an allergic reaction to azithromycin or any other medicine
liver or kidney problems
heart problems, including irregular heartbeats (arrhythmia)
ever had diarrhoea when you have taken antibiotics before
myasthenia gravis – azithromycin can make the symptoms of this muscle-weakening condition worse
diabetes – azithromycin liquid contains sugar

Dosage and strength

Azithromycin tablets come as either 250mg or 500mg strengths. The capsules are 250mg. The liquid comes as 200mg in 5ml.

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 you will usually need to take it 3 times a week, often on a Monday, Wednesday and Friday.

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.

You'll usually take azithromycin once a day. Try to take your medicine at the same time each day.

Swallow tablets and capsules whole with a drink of water. If you are taking azithromycin capsules, 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.

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

Do not take medicines for indigestion 2 hours before or after you take this medicine.

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, your pharmacist will usually make it up for you. The medicine will come with a syringe or spoon to help you measure the right amount. If you do not have one, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount.

If you 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 at the usual time.

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 help you remember to take your medicine.

If you take too much

Taking an extra dose of azithromycin 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 take more than 1 extra dose.

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. There are things you can do to help cope with them:

Stick to simple meals and do not eat rich or spicy food while you're taking this medicine.

Drink lots of fluids such as water or squash to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.

If you take contraceptive pills and you have severe diarrhoea for more than 24 hours, your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.

Take small frequent sips of water or squash to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat vomiting without speaking to a pharmacist or doctor.

If you take the combined contraceptive pill or progestogen-only pill and you're being sick, your contraception may not protect you from pregnancy. Look on the pill packet to find out what to do.

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.

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.

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 do not faint, then sit until you feel better.

Do not drive, ride a bike or use tools or machinery if you feel dizzy or tired. Do not drink alcohol as it may make you feel worse.

Talk to your doctor if this is bothering you.

Keep taking the medicine, but talk to your doctor or pharmacist if these side effects bother you or do not go away.

Serious side effects

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

Call a doctor or call 111 now if:

you have a faster or irregular heartbeat (arrhythmia)
the whites of your eyes turn yellow, or your skin turns yellow (this may be less noticeable on brown or black skin), or you have pale poo with dark pee – these can be signs of liver or gallbladder problems
you get ringing in your ears (tinnitus), temporary hearing loss, or you feel unsteady on your feet (vertigo)
you have severe pain in your stomach or back – this can be a sign of inflammation of the pancreas (pancreatitis)
you have 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

you have chest pain – this could be a sign of heart attack

A&E safety messaging (for 999 only)

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

Meds New IA (H4) - serious allergic reaction

These are not all the side effects of azithromycin. For a full list see the leaflet inside your medicines packet.

Azithromycin and pregnancy

Azithromycin is generally thought to be OK to take during pregnancy if you have an infection that needs treatment. However, other antibiotics may be more suitable for you, depending on your type of infection.

Talk to your doctor about taking azithromycin as it should only be taken if the benefits outweigh the possible risks.

Azithromycin and breastfeeding

If your doctor or health visitor says that your baby is healthy, it's OK to take azithromycin while breastfeeding.

Azithromycin passes into breast milk in small amounts. It has not been known to cause any side effects in breastfed babies.

Talk to your health visitor, midwife, pharmacist, or doctor as soon as possible if:

your baby is not feeding as well as usual or has an upset stomach
your baby has a rash or oral thrush (a fungal infection in their mouth)
you have any other concerns about your baby

Azithromycin and fertility

There's no clear evidence to suggest that taking azithromycin reduces fertility in either men or women.

Meds New IA (H2) - Pregnancy non-urgent care card

Cautions with other medicines

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

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

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

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

Tell your doctor if you're taking medicines that can affect your heartbeat, including:

any medicines for an irregular heartbeat (arrhythmia), such as amiodarone or sotalol
antidepressants such as citalopram
antipsychotics used to treat mental health conditions
some anti-sickness medicines, such as dimperidone
some antibiotics, such as moxifloxacin

Check the leaflets that come with your medicines and talk to a pharmacist or your doctor if you are worried.

Mixing azithromycin with herbal remedies and supplements

There's not enough information to say that complementary medicines and herbal remedies are safe to take with azithromycin. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Meds New IA (H2) - Cautions with other medicines alert