Azithromycin Side Effects
Medically reviewed by Drugs.com. Last updated on Oct 7, 2022.
Commonly reported side effects of azithromycin include: diarrhea, loose stools, and nausea. Other side effects include: abdominal pain, and vomiting. Continue reading for a comprehensive list of adverse effects.
Applies to azithromycin: intravenous powder for solution.
Serious side effects of Azithromycin
Along with its needed effects, azithromycin may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur while taking azithromycin:
- Pain, redness, and swelling at the injection site
- Difficult or labored breathing
- loose stools
- tightness in the chest
- Abdominal or stomach cramps or pain (severe)
- abdominal or stomach tenderness
- diarrhea (watery and severe, which may be bloody)
- joint pain
- skin rash
- swelling of the face, mouth, neck, hands, and feet
Incidence not known
- black, tarry stools
- bleeding gums
- blistering, peeling, or loosening of the skin
- blood in the urine or stools
- bloody or cloudy urine
- blurred vision
- chest pain or discomfort
- darkened urine
- decreased urine output
- difficulty with swallowing
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- fast, pounding, or irregular heartbeat or pulse
- fever with or without chills
- general feeling of discomfort or illness
- greatly decreased frequency of urination or amount of urine
- hives or itching
- increased thirst
- irregular heartbeat recurrent
- irregular or slow heart rate
- large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
- light-colored stools
- loss of appetite
- muscle pain
- muscle twitching
- nausea or vomiting
- pains in the stomach, side, or abdomen, possibly radiating to the back
- pinpoint red spots on the skin
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- rapid weight gain
- red skin lesions, often with a purple center
- red, irritated eyes
- sore throat
- sores, ulcers, or white spots in the mouth or on the lips
- swelling of the hands, ankles, feet, or lower legs
- unusual bleeding or bruising
- unusual tiredness or weakness
- yellow eyes or skin
Other side effects of Azithromycin
Some side effects of azithromycin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
- Diarrhea (mild)
- stomach pain or discomfort (mild)
- weight loss
Less common or rare
- Acid or sour stomach
- burning feeling in the chest or stomach
- cracked lips
- excess air or gas in the stomach or intestines
- full feeling
- passing gas
- sleepiness or unusual drowsiness
- sore mouth or tongue
- stomach discomfort, upset, or pain
- white patches in the mouth, tongue, or throat
Incidence not known
- Attack, assault, or force
- bad, unusual, or unpleasant (after) taste
- burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- change in taste
- continuing ringing or buzzing or other unexplained noise in the ears
- difficulty with moving
- discoloration of the tongue
- dizziness or lightheadedness
- feeling of constant movement of self or surroundings
- hearing loss
- itching of the vagina or genital area
- lack or loss of strength
- loss of sense of smell
- muscle pain or stiffness
- pain during sexual intercourse
- sensation of spinning
- thick, white vaginal discharge with no odor or with a mild odor
- trouble sitting still
For Healthcare Professionals
Applies to azithromycin: intravenous powder for injection, oral capsule, oral powder for reconstitution, oral powder for reconstitution extended release, oral tablet.
Uncommon (0.1% to 1%): Palpitations, chest pain
Common (1% to 10%): Rash, pruritus
Rare (0.01% to 0.1%): Acute generalized exanthematous pustulosis, drug reaction with eosinophilia and systemic symptoms (DRESS)
Frequency not reported: Eczema, fungal dermatitis, vesiculobullous rash
Very common (10% or more): Diarrhea (up to 52.8%), nausea (up to 32.6%), abdominal pain (up to 32.2%), loose stools (up to 19.1%), vomiting (up to 13%), flatulence (up to 10.7%), abdominal discomfort
Frequency not reported: Clostridioides difficile-associated diarrhea, melena, infantile hypertrophic pyloric stenosis, mucositis, enteritis
Common (1% to 10%): Vaginitis/vaginal infection
Uncommon (0.1% to 1%): Dysuria, metrorrhagia, testicular disorder
Very common (10% or more): Decreased neutrophils (up to 29%)
Common (1% to 10%): Decreased lymphocyte count, decreased hematocrit, decreased hemoglobin, increased eosinophil count, increased platelet count, increased lymphocytes, increased basophils, increased monocytes, increased neutrophils
Uncommon (0.1% to 1%): Leukopenia, neutropenia, eosinophilia
Frequency not reported: Decreased white cell count, decreased platelet count, anemia
Hepatic failure has rarely resulted in death.
Common (1% to 10%): Increased AST, increased ALT, increased GGT, increased blood bilirubin
Uncommon (0.1% to 1%): Hepatitis, abnormal liver function tests
Rare (0.01% to 0.1%): Abnormal hepatic function, cholestatic jaundice
Frequency not reported: Liver enzyme abnormalities, increased transaminase levels, jaundice
Postmarketing reports: Hepatic failure, fulminant hepatitis, hepatic necrosis
Uncommon (0.1% to 1%): Hypersensitivity
Severe (rarely fatal) anaphylactic reaction has been reported.
Common (1% to 10%): IV site pain, injection site inflammation (with IV administration), IV site disorders (infection/inflammation/edema/pain reactions), local inflammation, infusion site reaction
Frequency not reported: Local inflammation at infusion site
Uncommon (0.1% to 1%): Increased bicarbonate
Postmarketing reports: Dehydration
Common (1% to 10%): Arthralgia, increased creatine phosphokinase
Common (1% to 10%): Headache, dizziness, paresthesia, dysgeusia
Frequency not reported: Hyperkinesia
Common (1% to 10%): Visual impairment, abnormal vision
Frequency not reported: Conjunctivitis, blurred vision
Very common (10% or more): Increased blood alkaline phosphatase (up to 20%)
Common (1% to 10%): Deafness, fatigue, increased potassium, increased lactate dehydrogenase, reversible hearing impairment
Uncommon (0.1% to 1%): Candidiasis/moniliasis, ear disorder, asthenia, malaise, chest pain, edema, hearing impaired, abnormal blood potassium, fungal infection, bacterial infection, hot flush, face edema, pyrexia/fever, pain, peripheral edema, increased chloride, abnormal sodium, postprocedural complications
Frequency not reported: Increased phosphate, decreased sodium, decreased potassium
Postmarketing reports: Hearing disturbances (including hearing loss, deafness, tinnitus)
Rare (0.01% to 0.1%): Agitation, depersonalization
Frequency not reported: Delirium, hallucination
Postmarketing reports: Aggression/aggressive reaction, anxiety
Common (1% to 10%): Increased blood urea/BUN, increased blood creatinine
Uncommon (0.1% to 1%): Renal pain
Frequency not reported: Nephritis, renal function abnormality
Postmarketing reports: Acute renal failure, interstitial nephritis
Common (1% to 10%): Dyspnea
Frequency not reported: Bronchospasm, cough, pleural effusion
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Related treatment guides
1. "Product Information. Zithromax IV (azithromycin)." Pfizer U.S. Pharmaceuticals Group (2022):
2. "Product Information. Zithromax (azithromycin)." Pfizer U.S. Pharmaceuticals Group (2021):
3. "Product Information. Zithromax (aziTHROMYCIN)." Pfizer Australia Pty Ltd (2022):
4. "Product Information. Zithromax IV (aziTHROMYCIN)." Pfizer Australia Pty Ltd (2019):
5. "Product Information. AziTHROMYCIN (Mylan) (aziTHROMYCIN)." Alphapharm Pty Ltd (2022):
6. "Product Information. Zedbac (azithromycin)." Aspire Pharma Ltd (2022):
7. "Product Information. Zithromax (azithromycin)." Pfizer Ltd (2022):
8. "Product Information. Azithromycin (azithromycin)." Sandoz Ltd (2022):
9. "Product Information. Azithromycin (azithromycin)." Accord Healthcare Ltd (2022):
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Some side effects may not be reported. You may report them to the FDA.