Azithromycin oral tablet side effects: A detailed guide

Specifically, the Food and Drug Administration (FDA) has approved azithromycin oral tablet to treat certain bacterial infections in adults and certain children. This includes the following mild or moderate infections:

• sinus or middle ear infection
• skin infection
• urethral or cervical infection
• a certain kind of pneumonia
• strep throat or tonsil infection

This article describes possible side effects of azithromycin oral tablet. You’ll also find information on ways to save and coupon options for azithromycin.

Azithromycin oral tablet is a generic version of the brand-name drug Zithromax. (Your healthcare professional may refer to azithromycin or Zithromax as a “Z-Pak.”) Azithromycin also comes in other forms, including a liquid suspension that you swallow and an injectable form. These forms aren’t described in this article. To learn more about them, talk with your doctor.

You can explore this overview article to learn more about azithromycin oral tablet, including the drug’s uses, dosage, ways to save on cost, and more.

More common side effects of azithromycin

Azithromycin oral tablet may cause mild or serious side effects. Below are some of the more common side effects of this medication.

Commonly reported side effects of azithromycin oral tablet include:

• mild diarrhea
• nausea
• abdominal (belly) pain
• vomiting

Mild side effects of azithromycin

Azithromycin may cause certain mild side effects. In most cases, mild side effects are temporary and can be easily managed. Tell your doctor or pharmacist if you have side effects that don’t go away or become bothersome.

Mild side effects of azithromycin oral tablet that occurred in studies include:

• mild diarrhea
• nausea
• abdominal (belly) pain
• vomiting
• indigestion (upset stomach)
• flatulence
• headache
• dizziness
• fatigue (low energy)
• mild allergic reaction*

* To learn more about this side effect, see the “Side effects of azithromycin in detail” section below.

Azithromycin oral tablet may cause more mild side effects than those listed above. For more details, see the drug’s prescribing information.

Serious side effects of azithromycin

Azithromycin may cause certain serious side effects. If you have any serious side effects from azithromycin oral tablet, call your doctor right away. But if you think you’re having a medical emergency or your side effects feel life threatening, take immediate action. Call 911, or a local emergency number, or go to the nearest emergency room.

After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Visit MedWatch’s website if you’d like to notify the FDA about a side effect you’ve had with azithromycin oral tablet.

Serious side effects of azithromycin oral tablet that occurred in studies include:

• liver damage
• long QT syndrome (a condition that affects heart rhythm)*
• Clostridioides difficile (C. diff) infection*
• severe allergic reaction*

* To learn more about this side effect, see the “Side effects of azithromycin in detail” section below.

Side effects of azithromycin in children

Azithromycin treats certain mild or moderate bacterial infections in certain children. These infections include:

• middle ear infection in children ages 6 months and older
• a certain kind of pneumonia in children ages 6 months and older
• sinus infection in children ages 6 months and older
• throat or tonsil infection in children ages 2 years and older

In general, side effects of azithromycin in children are similar to those reported in adults. Some other side effects that may occur in children include:

• agitation
• nervousness
• overactivity

Also, a condition called infantile hypertrophic pyloric stenosis (IHPS) has occurred in infants (42 days and younger) who were given azithromycin. IHPS causes a thickening of the opening between the stomach and intestines. This can block food from entering the intestines. It can cause forceful vomiting and irritability.

Call your child’s doctor if your young child develops these symptoms while taking azithromycin. Talk with your child’s doctor to learn more about azithromycin and side effects in children.

Common questions about side effects of azithromycin

Here are answers to some common questions about side effects of azithromycin oral tablet. If you have other questions, talk with your doctor or pharmacist.

How do side effects of azithromycin compare with those of brand-name Zithromax?

Azithromycin is the generic version of brand-name Zithromax. Azithromycin and Zithromax are expected to cause the same side effects. This is because Zithromax contains azithromycin as its active drug. (An active drug is the ingredient that makes a medication work.)

Talk with your doctor or pharmacist if you’d like to know more about brand-name Zithromax and how it compares with generic azithromycin.

How long do side effects of azithromycin last? Are there ways to reduce how long they last?

It depends. In general, side effects of azithromycin are temporary and go away in a few hours or days. But in rare cases, the drug can cause long-term side effects. See the “Does azithromycin cause long-term side effects?” question just below to learn more.

Whether there are ways to reduce how long side effects from azithromycin last depends on the side effects. For example, if you have a headache or nausea as a side effect of azithromycin, you may be able to take an over-the-counter (OTC) medication to treat your symptoms. This can help reduce how long your side effects last. Ask your doctor about OTC medications that are safe for you to take.

Are heart-related side effects possible while taking azithromycin?

Yes, there is a heart-related side effect azithromycin may cause, but this is rare.

Specifically, azithromycin may cause long QT syndrome. This is a condition that affects heart rhythm. To learn more about this side effect, see the “Side effects of azithromycin in detail” section below.

Can azithromycin cause changes in my toddler’s behavior?

It’s possible. Azithromycin can cause agitation, nervousness, or overactivity in children, according to studies.

That said, these behavior changes are very rare. And they should go away once your toddler finishes taking azithromycin. Keep in mind that having an infection can also lead to changes in a child’s behavior. Azithromycin is used to treat certain infections.

Talk with your child’s doctor if you have concerns about behavioral side effects of azithromycin.

Does azithromycin cause long-term side effects?

Yes, it’s possible, but this is rare. Long-term side effects are those that either:

• start during treatment and continue for a long time, possibly after stopping treatment, or
• start after you’ve taken the drug for a long time or after ending treatment

Long-term side effects reported with azithromycin include:

• liver damage, which may occur at any time while you’re taking the drug, but isn’t likely after you’ve stopped taking it
• long QT syndrome (a condition that affects heart rhythm)*
• diarrhea due to Clostridioides difficile (C. diff) infection*

* To learn more about this side effect, see the “Side effects of azithromycin in detail” section below.

Talk with your doctor if you’d like to know more about possible long-term side effects of this drug.

Coupon for azithromycin

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Side effects of azithromycin in detail

Below you’ll find details on some of the side effects of azithromycin oral tablet.

Long QT syndrome

In rare cases, treatment with azithromycin can cause long QT syndrome. This is a condition that affects heart rhythm.

Long QT syndrome often doesn’t cause symptoms, but it’s possible to experience:

• fatigue (low energy)
• tiring quickly during physical activity
• dizziness
• lightheadedness
• weakness
• shortness of breath

Since azithromycin was approved for use, a potentially life threatening irregular heart rhythm called torsades de pointes has also been reported.

The symptoms of torsades de pointes are similar to those of long QT syndrome described above. Another symptom is suddenly feeling your heart beating faster. Torsades de pointes tends to come on suddenly without warning.

Medical conditions and factors that increase your risk of torsades de pointes as a side effect of azithromycin include:

• long QT syndrome that was present at birth or developed later in life
• slow heart rate
• heart failure
• low magnesium levels
• low potassium levels
• taking other drugs that can cause long QT syndrome or affect your heart’s rhythm
• being age 65 years or older

Ways to manage

Due to this risk, doctors may not prescribe azithromycin if you have a risk factor described above. If your doctor does prescribe azithromycin, they’ll closely monitor your heart health. This includes watching for symptoms of an abnormal heart rhythm.

Call your doctor right away if you notice symptoms of long QT syndrome while taking azithromycin. They’ll likely want to see you to evaluate your symptoms. Then, they can recommend the best treatment for your symptoms. This may include stopping treatment with azithromycin.

Clostridioides difficile infection

In rare cases, azithromycin treatment can lead to a Clostridioides difficile (C. diff) infection and diarrhea due to C. diff. This is a known side effect of most antibiotics.

Antibiotics, including azithromycin, work by killing bacteria in the body. This is beneficial for killing bacteria that cause infection. But the body also contains helpful bacteria that keep the digestive system healthy. (This type of bacteria is also known as “good” bacteria.)

Because azithromycin kills harmful and healthy bacteria, taking it can lead to too much C. diff bacteria in the digestive system. This may lead to a C. diff infection and diarrhea.

Symptoms can include:

• severe diarrhea
• abdominal (belly) pain and cramping
• nausea
• loss of appetite
• feeling unwell

This side effect is most likely to occur during treatment with azithromycin or shortly after your last dose. That said, C. diff infections have been reported over 2 months after taking the last dose of an antibiotic.

These infections are typically mild but can be severe. In extreme cases, a C. diff infection can be life threatening.

Ways to manage

Call your doctor right away if you develop diarrhea while taking azithromycin. Your doctor can review your symptoms and order a test to determine whether you have a C diff. infection.

If your doctor confirms you have a C diff. infection, they’ll have you stop taking azithromycin.

Allergic reaction

For some people, azithromycin oral tablet can cause an allergic reaction. But this side effect was rarely reported in the drug’s studies.

Symptoms can be mild or serious, and they may include:

• itchiness
• skin rash
• swelling under the skin, usually affecting eyelids, lips, hands, or feet
• swelling of the mouth, tongue, or throat, which can make it hard to breathe
• flushing (temporary warmth, redness, or deepening of skin color)

In addition, very rare but serious allergic skin reactions can occur with azithromycin. These reactions are life threatening and can be fatal when they do occur. These reactions include:

• Stevens-Johnson syndrome
• toxic epidermal necrolysis
• acute generalized exanthematous pustulosis
• drug reaction with eosinophilia and systemic symptoms

Ways to manage

For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep taking the medication.

For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to azithromycin oral tablet, your doctor may recommend taking a different medication instead.

Warnings for azithromycin

Below are some factors you may want to discuss with your doctor before taking azithromycin oral tablet.

Warnings

It may not be safe for you to take azithromycin oral tablet if you have specific health conditions. These are sometimes called drug-condition interactions. Other things may also affect whether azithromycin oral tablet is a safe treatment option for you.

Before taking azithromycin oral tablet, tell your doctor about your health and medications you take. Things to consider include those listed below.

Heart problems. Long QT syndrome (a condition that affects heart rhythm) is a rare side effect of azithromycin. If you have an existing heart problem, you may be at higher risk for this side effect. This includes having an irregular heart rhythm, for example. Your doctor can discuss the risks and benefits of azithromycin based on your heart health.

Liver problems. In rare cases, liver damage in people taking azithromycin was reported. If you have a liver problem, you may be at higher risk for this side effect. This includes alcohol-related liver disease, for example. Talk with your doctor to learn whether azithromycin is safe for you to take.

Myasthenia gravis. Azithromycin may worsen symptoms of myasthenia gravis. If you have this condition, ask your doctor about other treatment options that may be better for you.

Allergic reaction. If you’ve had an allergic reaction to azithromycin oral tablet or any of its ingredients, your doctor will likely not prescribe this medication. Ask them about other treatment options that may be better for you.

Azithromycin and pregnancy

Azithromycin hasn’t been formally studied in pregnant people. But the drug has been used during pregnancy for several decades. There haven’t been reports of increased risk of pregnancy loss or problems with fetal development (also called birth defects).

That said, you should always talk with your doctor about the risks and benefits of taking any medication during pregnancy. Let your doctor know if you are pregnant or can become pregnant before taking azithromycin.

Azithromycin and breastfeeding

Azithromycin is present in breast milk. It may cause mild side effects in a child who is breastfed. These may include diarrhea, vomiting, and skin rash.

Talk with your doctor to decide whether to breastfeed or feed your child another way while taking azithromycin.

Azithromycin and alcohol

Azithromycin and alcohol can cause some similar side effects, including diarrhea and nausea. Drinking alcohol while taking azithromycin increases your risk of these side effects. It also increases the risk that they’ll be severe.

If you drink alcohol, talk with your doctor about whether it’s safe to consume it during azithromycin treatment.

What to ask your doctor

Azithromycin is an antibiotic that’s prescribed to treat a variety of bacterial infections, including certain sinus and throat infections. This article describes common and serious side effects of azithromycin oral tablet.

If your doctor prescribes this medication, they can discuss possible side effects with you. Let your doctor know if you have concerns or questions about treatment with this medication.

Here’s a list of some possible questions you may want to ask your doctor:

• If I had side effects the last time I took azithromycin, what is my risk of having them again with this medication?
• Is it safe to run or exercise while I’m taking azithromycin?
• Are there ways to lower my risk of side effects while taking azithromycin?

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.