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Updated on January 13, 2023
5 min read

Azithromycin and Alcohol

Kelly Brown
Dr P. E. Pancoast, MD
Written by 
6 Sources Cited
Kelly Brown
Written by 
6 Sources Cited

What is Azithromycin?

Azithromycin is a prescription medication that treats bacterial infections, including pneumonia, bronchitis, STDs, gastrointestinal infections, and more. It is a macrolide antibiotic and works by halting the spread of the bacteria causing the infection.

Like all antibiotics, the use of Azithromycin must be carefully monitored. Antibiotics do not work for viral infections including colds and flu. They also should not be overused because this increases your risk of developing an antibiotic-resistant infection.


How and When to Take it

Azithromycin is available in tablet and liquid form. It can be taken with or without food once a day for up to five days. 

It’s important to complete the entire prescription given to you by your doctor. This is the only way to ensure that the bacteria is eliminated. Even if you begin to feel better and believe yourself to no longer be sick, you must complete the prescription.

The only time you should stop taking Azithromycin before you finish the prescription is if you experience severe side effects, such as vomiting. In the case of side effects, you should contact your doctor immediately. 


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Side Effects of Azithromycin & Other Antibiotics

Azithromycin is a relatively safe drug for most people. However, like all drugs, it can trigger side effects. 

You should contact your doctor if you experience any of the following possible side effects while using Azithromycin:

  • Nausea
  • Vomiting
  • Diarrhea
  • Stomach pain
  • Headache

If you experience any of the following serious side effects, you should stop using Azithromycin immediately and seek emergency medical treatment:

  • Dizziness
  • Fainting
  • Pounding, irregular, or sped-up heartbeat
  • Blisters or peeling of the skin
  • Rash or hives
  • Fever
  • Itching
  • Difficulty breathing or swallowing
  • Swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
  • Severe diarrhea
  • Jaundice
  • Extreme fatigue
  • Unusual bruising or bleeding
  • Loss of appetite
  • Pain in the upper right area of the abdomen
  • Darkened urine
  • Unusual muscle weakness or loss of control
  • Flu-like symptoms
  • Pink and swollen eyes

If you are giving Azithromycin to a baby six weeks old or younger, and they vomit or become irritable at feeding times, seek medical attention.

This is not a complete list of side effects. If anything seems unusual while using Azithromycin, contact your doctor immediately.

Is it Safe to Mix Azithromycin and Alcohol?

It is not recommended that you mix any prescription medication with alcohol. Some people have consumed moderate amounts of alcohol while taking the medication without any severe side effects. 

However, if you experience mild side effects when using the antibiotic, alcohol could exacerbate these symptoms. 

A course of Azithromycin is rarely more than five days, so doctors usually recommend forgoing alcohol until the prescription is complete. If you do choose to drink, consume only a small to moderate amount of alcohol.

What Other Types of Antibiotics Interact With Alcohol?

Several other types of antibiotics do not mix well with alcohol. In some cases, the mixing of alcohol and antibiotics triggers potentially dangerous reactions. 

Avoid alcohol if you are using any of the following medications:

  • Cefoperazone
  • Cefotetan
  • Doxycycline
  • Erythromycin
  • Griseofulvin
  • Isoniazid
  • Ketoconazole
  • Linezolid
  • Metronidazole
  • Tinidazole

It is recommended that you avoid alcohol for 2-3 days before you start and after you complete the course.


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How Does Alcohol Affect Infections? 

One of the biggest concerns there is about mixing alcohol and antibiotics is the effect alcohol has on the infection. 

In some cases, it’s not so much about what happens with the mix of medication and alcohol. Instead, it is how alcohol inhibits your body’s immune system and the healing process. 

The best thing you can do when you are treating an infection with an antibiotic is to make sure you eat healthily and get enough rest. 

Alcohol interferes with these things. It interrupts your sleep patterns and interferes with your body’s absorption of nutrients. It also increases blood sugar levels and reduces your energy. For chronic heavy drinkers, these are issues with or without a bacterial infection. 

Seek medical advice if you believe it will be a challenge to avoid alcohol while taking Azithromycin.


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Side Effects of Mixing Antibiotics and Alcohol

Some of the common side effects associated with mixing alcohol and antibiotics include:

  • Nausea
  • Vomiting and upset stomach
  • Abdominal pain
  • Flushing
  • Headache
  • Fast heartbeat
  • Stomach cramps

Dangers of Mixing Antibiotics and Alcohol

In addition to the immediate interactions and side effects that are a risk when you mix antibiotics and alcohol, the mix also puts you at risk for liver damage and high blood pressure. These are long-term issues that require ongoing management.

When Can I Drink Alcohol After Taking Azithromycin?

Azithromycin doesn’t pose the same severe risk as other antibiotics when mixed with alcohol. Many people can drink moderately or begin drinking as soon as they finish their course of the medication. 

However, it is recommended that you wait three days before consuming alcohol after using an antibiotic. This way you’ll know the drug is completely out of your system. 

The warning label on your prescription provides information specific to your situation. You can also ask your doctor if you have concerns or questions about drinking alcohol while taking Azithromycin.

Also keep in mind, even if it is generally safe to consume alcohol while taking Azithromycin, that doesn’t mean you will not experience side effects. This is true even if you have mixed the antibiotic and alcohol in the past. Sometimes, side effects occur due to age or overall health, which changes with time.

To avoid problems while taking Azithromycin and ensure it is as effective as possible, follow your doctor’s direction and try to avoid alcohol while using the medication.

Treatment Options for Alcohol Use Disorder

Some people struggle to limit alcohol consumption while taking Azithromycin because they have alcohol use disorder. 

Abstaining feels impossible for them. If this is the case for you and you feel you cannot give up drinking during the short time you are using an antibiotic, it might be time to seek treatment or speak to a healthcare professional.

If alcohol use has interfered with your everyday life, you’ve found yourself prioritizing alcohol over other things in your life including your health, or you’ve failed at changing your drinking habits, treatment can help.

Treatment options for alcohol use disorder include:

Updated on January 13, 2023
6 sources cited
Updated on January 13, 2023
All Alcoholrehabhelp content is medically reviewed or fact checked to ensure as much factual accuracy as possible.

We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies.
  1. “Azithromycin: MedlinePlus Drug Information.”, Oct. 2019,

  2. “Alcohol Related Liver Disease and Alcohol Damage - ALF.” American Liver Foundation, 26 Mar. 2021,

  3. “Azithromycin: MedlinePlus Drug Information.”,

  4. “Azithromycin (Oral Route) Proper Use - Mayo Clinic.”,

  5. Center for Drug Evaluation and Research. “FDA Drug Safety Communication: Azithromycin (Zithromax or Zmax) and the Risk of Potentially Fatal Heart Rhythms.” FDA, 21 June 2019,

  6. CDC. “About Antimicrobial Resistance.” Centers for Disease Control and Prevention, 10 Sept. 2018,

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