Azithromycin

Medically reviewed by Brittany A. Duke, PharmD, RPh on April 2, 2023
Written by Helen Marshall, BPharm, MRPharmS

This article describes azithromycin oral tablet’s uses and dosage, ways to save on cost, and more. Below you’ll find coupon options for azithromycin.

The Food and Drug Administration (FDA) approves prescription drugs such as azithromycin for certain conditions. Approved uses for azithromycin oral tablet are described below.

Use for certain infections

Doctors may prescribe azithromycin oral tablet for treating certain bacterial infections. For example:

In adults, azithromycin is used to treat:

• flare-ups of chronic (long-term) bronchitis caused by a lung infection
• community-acquired pneumonia (pneumonia that develops outside of a hospital setting)
• sinus infection
• strep throat or tonsillitis, if certain other antibiotics aren’t suitable
• skin infection
• some sexually transmitted infections (STIs), such as chlamydia, gonorrhea, and chancroid* (genital ulcer disease)

In children, azithromycin is used to treat:

• ear infection in children ages 6 months and older
• sinus infection in children ages 6 months and older
• community-acquired pneumonia in children ages 6 months and older
• strep throat or tonsillitis in children ages 2 years and older, if certain other antibiotics aren’t suitable

With bacterial infections, symptoms can vary depending on what the specific infection is. A fever is commonly a sign of infection.

Doctors only prescribe azithromycin for the above infections if they’re caused by certain types of bacteria. (Azithromycin won’t work to treat infections caused by viruses, such as colds or flu.) To identify the cause of an infection, your doctor may take a sample from the infected area and send it to a lab for identification. This helps your doctor prescribe the best treatment for the infection.

Azithromycin is usually prescribed as a short-term treatment.

Note: Doctors may not prescribe azithromycin oral tablet for young children who can’t swallow tablets. Instead, they’ll likely prescribe azithromycin liquid suspension (a liquid mixture). Also, doctors may not prescribe azithromycin oral tablet for certain people with pneumonia. Sometimes, pneumonia may need to be treated with injections of azithromycin or other antibiotics.

* Azithromycin is prescribed to treat chancroid in males only. Sex and gender exist on spectrums. In this article, we use the term “male” to refer to a person’s sex assigned at birth.

Azithromycin may cause mild or serious side effects. More common mild side effects of azithromycin oral tablet and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age and overall health and any other medications you take.

To learn more about azithromycin oral tablet’s side effects, see this article or ask your doctor or pharmacist. You can also read the prescribing information for azithromycin oral tablet.

Mild side effects

More common mild side effects reported with azithromycin oral tablet are listed below.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Azithromycin oral tablet’s mild side effects include:

• diarrhea
• nausea
• vomiting
• belly pain
• mild allergic reaction*

* For details about this side effect, see the “Warnings for azithromycin” section below.

Serious side effects

Serious side effects of azithromycin oral tablet are listed below. With many drugs, serious side effects are possible but not common.

If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

Azithromycin oral tablet’s serious side effects include:

• long QT syndrome (a heart problem that can cause irregular heart rhythms)
• liver problems, such as hepatitis (liver inflammation) and liver failure
• diarrhea caused by Clostridioides difficile (a type of bacteria often called C. diff), which can occur more than 2 months after taking azithromycin)
• severe allergic reaction*

* For details about this side effect, see the “Warnings for azithromycin” section below.

Below you’ll find answers to a few commonly asked questions about azithromycin oral tablet.

Will I take azithromycin 500 mg for only 3 days?

Yes, this is possible, depending on the infection being treated and your age. For example, the usual dosage for sinus infection in adults is 500 milligrams (mg) once a day for 3 days. This dosage may also be used to treat flare-ups of chronic (long-term) bronchitis caused by a lung infection in adults.

Your doctor will prescribe the most appropriate dosage and length of treatment for your infection.

Is azithromycin similar to amoxicillin, erythromycin, clarithromycin, or doxycycline?

Azithromycin, amoxicillin, erythromycin (Ery-Tab, Eryc, others), clarithromycin, and doxycycline are all antibiotic drugs. They’re all used to treat bacterial infections, but some may work better for certain types of infection. These drugs can cause some similar and some different side effects.

Azithromycin, erythromycin, and clarithromycin belong to a group of antibiotics called macrolides. Doctors sometimes prescribe these antibiotics to treat infections in people who are allergic to penicillin-type antibiotics, such as amoxicillin. Doxycycline belongs to a group of antibiotics called tetracyclines.

When choosing which antibiotic to prescribe, your doctor will take various factors into account. These include the type of bacteria causing your infection. Other factors include other health conditions you may have and any past allergic reactions you’ve had to antibiotics. If you have questions about the best choice of antibiotic for you, talk with your doctor.

How does azithromycin work? And how long does it take to start working?

Azithromycin treats bacterial infections by stopping the bacteria that are causing the infection from increasing in numbers. It does this by preventing the bacteria from forming certain proteins needed to multiply (increase in numbers). The remaining bacteria die or are killed by your immune system.

Azithromycin starts working as soon as you start taking it, but it might take a couple of days for the symptoms of your infection to get better. For some infections, only one dose is needed to treat the infection. For others, you might need to take a short course of treatment.

It’s important to complete your prescribed course of azithromycin, even if you feel better. Stopping treatment early may lead to the infection not being fully cleared, so it may come back or get worse. Stopping treatment early can also allow the bacteria to become resistant to azithromycin. This means the infection may become harder to treat with azithromycin or other antibiotics.

Is there a best time of day to take azithromycin?

No, there’s no best time of day to take azithromycin. You’ll typically take one dose per day, and you can take it at any time of day.

If your course of treatment lasts more than 1 day, it’s best to take your dose at the same time each day. Taking azithromycin around the same time each day helps it work more effectively against the infection. You can take azithromycin without food or with food (either before or after food).

What should I do if I miss a dose of azithromycin?

If you miss a dose of azithromycin, take the missed dose as soon as possible. But if it’s nearly time for your next scheduled dose, take only one dose. Then continue taking the medication as scheduled until you complete your prescribed treatment. Never take two doses together to try to catch up on a missed dose.

Can azithromycin tablets be crushed, split, or chewed?

No. Azithromycin tablets aren’t meant to be crushed, split, or chewed. If you have trouble swallowing the tablets, talk with your doctor. Azithromycin is also available in a liquid suspension form (a liquid mixture) that may be more suitable for you.

The dosage of azithromycin oral tablet your doctor prescribes may vary based on your condition and certain other factors. Talk with your doctor about the dosage you should take.

Taking azithromycin

Azithromycin oral tablets are swallowed whole.

Your doctor will talk with you about how to take azithromycin oral tablet. They’ll explain how much to take and how often. Always follow your doctor’s recommendation.

Azithromycin oral tablet can be taken with or without food. If you have digestive side effects with azithromycin, these may be reduced by taking the drug with food.

See the “Common questions about azithromycin” section for information on missed doses and the best time to take this drug.

Overdose of azithromycin

You should not take more azithromycin than your doctor prescribes. For some drugs, doing so may lead to serious side effects or overdose.

If you think you’ve taken too much azithromycin, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

For some medications, certain things may affect how the drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you take azithromycin, ask your doctor to check for possible interactions. They can check for interactions these items may cause with azithromycin. Be sure to tell them about any of the following you take or use:

• prescription medications
• over-the-counter medications
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for azithromycin” section below.

Information about azithromycin and pregnancy and breastfeeding is described below.

Azithromycin and pregnancy

In general, azithromycin oral tablet is considered safe to take during pregnancy. That said, check with your doctor about whether they feel it’s safe for you specifically.

Azithromycin and breastfeeding

In general, azithromycin oral tablet is considered safe to take while breastfeeding. That said, check with your doctor about whether they feel it’s safe for you specifically.

If you take azithromycin while breastfeeding, you should contact your doctor if your breastfed child develops any of the following:

• diarrhea
• vomiting
• rash

Azithromycin should not be taken by certain people. And it should be taken cautiously by certain other people. Precautions for taking this drug are described below.

Warnings

Azithromycin could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether azithromycin oral tablet is a safe option for you.

Tell your doctor about your overall health and any past health conditions before you take azithromycin oral tablet. Health conditions and other factors you and your doctor should discuss include:

• past allergic reactions to other antibiotics, especially erythromycin (Ery-Tab, Eryc, others) or clarithromycin
• past or current liver problems
• heart problems, such as long QT syndrome, a slow or irregular heartbeat, or heart failure
• myasthenia gravis

Allergic reaction

Azithromycin can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to azithromycin, any of its ingredients, or other similar antibiotics, your doctor will likely not prescribe azithromycin. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to azithromycin, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

You may be able to save money on your prescription for azithromycin oral tablet by using our Perks discount coupons. These can be found at the end of this article.

If you have questions about how to pay for azithromycin, talk with your doctor or pharmacist. You can also learn more about the cost of azithromycin in this article.

Note: Optum Perks coupons cannot be used with insurance copays or benefits.

This article describes azithromycin oral tablet’s uses and dosage, ways to save on cost, and more. Let your doctor know if you have questions about azithromycin or would like more details about it.

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

• How long will I need to take azithromycin for?
• Are any other antibiotics suitable for my infection?
• Can other medications make azithromycin less effective?
• Do I need to avoid anything while taking this medication?

• Azithromycin- azithromycin monohydrate tablet, film coated. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/89a8e05f-b60c-4b8f-96c4-d49222163fbc/spl-doc
• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm

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.