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Updated on November 22, 2021

Azithromycin and Alcohol Interactions

What is Azithromycin?

Azithromycin is an FDA approved macrolide antibiotic medication. It is used to treat many different types of bacterial infections.

It is one of the most common antibiotics prescribed by doctors and can be used to treat several conditions, including:

  • Ear infections
  • Strep throat
  • Pneumonia 
  • Traveler’s diarrhea
  • Bronchitis
  • Sinus infections
  • Chlamydia
  • Tonsillitis
  • Genital ulcer disease
  • Legionnaires’ disease
  • Whooping cough

Azithromycin is typically a short-term antibiotic, but it can also be used longer-term as a preventative treatment.

It can be used to improve control over chest symptoms and exacerbations (lung attacks). It is a prescription-only drug and is available in capsule, tablet, oral liquid, or injection form. However, injections are typically only administered in the hospital. 

Azithromycin 1

This medicine is usually taken once a day, at the same time each day. Typically, capsules should be taken at least one hour before eating or two hours after ingesting any food.

Most infections should clear within a few days of beginning treatment with azithromycin. However, the full course of medicine should still be taken to prevent any recurring infections or drug resistance.

Azithromycin is sold under the brand name Zithromax, and it is chemically similar to both erythromycin and clarithromycin.

Side Effects of Azithromycin

Possible side effects of azithromycin include:

  • Upset stomach 
  • Nausea
  • Diarrhea or loose stools 
  • Vomiting
  • Stomach/abdominal pain 
  • Potential allergic reactions 

In rare cases, serious side effects can occur, such as: 

  • Irregular heart rhythm (irregular heartbeat)
  • Liver problems
  • Liver damage
  • Muscle weakness
  • Eye problems 
  • Loss of consciousness

Contact a healthcare professional if you experience any severe adverse effects after taking this medication.

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Is Azithromycin Addictive?

Despite the fact that it is only available with a doctor’s prescription, azithromycin is not addictive.  It has no narcotic effects and does not affect your ability to drive a vehicle, operate machinery, or do anything else that requires alertness.

The potential to abuse azithromycin is negligible. 

Can You Drink Alcohol With Azithromycin?

Azithromycin is generally a safe drug on its own. There are no serious dangers associated with drinking alcohol while taking this medication. 

However, if you drink alcohol while taking azithromycin, it could intensify side effects already experienced from taking this medicine. Keep in mind that a typical course of treatment with azithromycin is not very long. It is best to avoid using alcohol while taking this medication.

Drinking any alcohol while fighting an infection is not advised. Alcohol can lead to dehydration, poor sleep, and may ultimately hinder the body’s natural body to heal itself.

How Long Does Azithromycin Stay in Your System?

Azithromycin generally stays in your system for a little longer than two weeks (15.5 days, on average) after your final dose. This antibiotic has a reasonably long elimination half-life of 68 hours. This is thought to be prolonged due to the extensive uptake and subsequent slow release of azithromycin stored in tissues within the body. 

Given the relatively harmless interaction with alcohol, there is not an elevated risk of side effects if you choose to drink alcohol before this two-week period ends.

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Side Effects of Azithromycin and Alcohol

Side effects from taking azithromycin and drinking alcohol are typically the same as those experienced by taking either substance alone. Azithromycin can cause nausea, vomiting, and diarrhea. Similarly, alcohol can cause these symptoms as well as irritate the stomach lining. This increases the production of stomach acid as more alcohol is consumed. 

These effects, combined with the gastrointestinal effects commonly associated with azithromycin, can significantly increase the risk of an upset stomach, vomiting, and diarrhea.

Risks of Mixing Azithromycin and Alcohol

While there are typically no severe side effects from mixing alcohol and azithromycin, there are still risks involved with combining these substances. Both substances can cause diarrhea, and the resulting water loss and electrolyte imbalance in the body can be harmful to your health.  

Additionally, both substances can cause vomiting, leading to a tricky situation if a person vomits soon after taking the medication. If this happens, you should call a doctor to assess whether this would count as a missed dose, and you would need to take another one. 

There are other risks as well, including: 

  • Not allowing your body to properly heal by subjecting it to the effects of alcohol
  • Missing doses due to becoming intoxicated and forgetting, and potentially failing to finish the full course of treatment
  • Making the treatment less effective (even though alcohol does not directly hinder azithromycin from working, it can reduce the body’s natural immune system response and slow down recovery time)

Treatment Options for Alcohol Abuse & Addiction

Here are some of the best treatment options for alcohol use disorder:

Inpatient programs 

Inpatient treatment is the option for alcohol addiction treatment. These intensive programs are usually 30, 60, or 90 days. However, they can be longer in some instances.

Partial hospitalization programs (PHPs)

Partial hospitalization programs are also called intensive outpatient programs or IOPs. They're like inpatient programs, but you return home after each session.

Outpatient programs

Outpatient programs are less intensive and offer a more flexible treatment schedule. They're best for people who have responsibilities at work, home, or school and are highly motivated to achieve sobriety.

Medication-assisted therapy (MAT)

Certain people qualify for medication-assisted therapy. Medications can help you detox, reduce cravings, and normalize bodily functions.

MAT is most effective when combined with other treatment therapies.

Support groups

Support groups are peer-led groups that help people stay sober. They can be a first step in overcoming alcoholism or a component of an aftercare plan.

Many of them follow the 12-step approach. However, there are also secular options that don't follow the 12-step approach.


  1. National Center for Biotechnology Information . PubChem Compound Summary for CID 447043, Azithromycin. Retrieved January 25, 2021 from
  2. Mergenhagen KA, Wattengel BA, Skelly MK, Clark CM, Russo TA. Fact versus Fiction: a Review of the Evidence behind Alcohol and Antibiotic Interactions. Antimicrob Agents Chemother. 2020 Feb 21;64:e02167-19. doi: 10.1128/AAC.02167-19. PMID: 31871085; PMCID: PMC7038249.
  3. National Institute on Alcohol Abuse and Alcoholism. Harmful Interactions: mixing alcohol with medicines. NIAAA.

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