Zithromax Side Effects

Generic name: azithromycin

Medically reviewed by Drugs.com. Last updated on Dec 15, 2024.

Note: This document provides detailed information about Zithromax Side Effects associated with azithromycin. Some dosage forms listed on this page may not apply specifically to the brand name Zithromax.

Applies to azithromycin: intravenous powder for solution.

Other dosage forms:

• oral powder for suspension, oral powder for suspension extended release, oral tablet

Serious side effects of Zithromax

Along with its needed effects, azithromycin (the active ingredient contained in Zithromax) 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:

More common

• pain, redness, and swelling at the injection site

Less common side effects

• difficult or labored breathing
• loose stools
• tightness in the chest

Rare side effects

• abdominal or stomach cramps or pain (severe)
• abdominal or stomach tenderness
• diarrhea (watery and severe, which may be bloody)
• fever
• joint pain
• skin rash
• swelling of the face, mouth, neck, hands, and feet

Incidence not known

• agitation
• black, tarry stools
• bleeding gums
• blistering, peeling, or loosening of the skin
• bloating
• blood in the urine or stools
• bloody or cloudy urine
• blurred vision
• chest pain or discomfort
• chills
• coma
• confusion
• constipation
• convulsions
• cough
• darkened urine
• decreased urine output
• depression
• difficulty with swallowing
• dizziness
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• fainting
• 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
• headache
• hives or itching
• hostility
• increased thirst
• indigestion
• 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
• lethargy
• light-colored stools
• loss of appetite
• muscle pain
• muscle twitching
• nausea or vomiting
• pain
• 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
• stupor
• sweating
• 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 Zithromax

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:

Less common side effects

• diarrhea (mild)
• nausea
• stomach pain or discomfort (mild)
• weight loss

Less common or rare side effects

• acid or sour stomach
• belching
• burning feeling in the chest or stomach
• cracked lips
• excess air or gas in the stomach or intestines
• full feeling
• heartburn
• 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.

General adverse events

The most commonly reported side effects were diarrhea/loose stools, nausea, abdominal pain, and vomiting.^[Ref]

Cardiovascular

• Uncommon (0.1% to 1%): Palpitations, chest pain
• Postmarketing reports: Torsades de pointes, arrhythmia (including ventricular tachycardia), ECG QT prolonged, hypotension, cardiovascular death

Dermatologic

• Common (1% to 10%): Rash, pruritus
• Uncommon (0.1% to 1%): Angioedema, photosensitivity reaction, Stevens-Johnson syndrome, urticaria, dermatitis, dry skin, hyperhidrosis/sweating
• 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
• Postmarketing reports: Toxic epidermal necrolysis, erythema multiforme, serious skin reactions

Gastrointestinal

• 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
• Common (1% to 10%): Dyspepsia, stomatitis
• Uncommon (0.1% to 1%): Gastritis, gastroenteritis, oral candidiasis/moniliasis, constipation, dysphagia, abdominal distension, dry mouth, eructation, mouth ulceration, salivary hypersecretion
• Frequency not reported: Clostridioides difficile-associated diarrhea, melena, infantile hypertrophic pyloric stenosis, mucositis, enteritis
• Postmarketing reports: Pyloric stenosis, pseudomembranous colitis, pancreatitis, tongue discoloration

Genitourinary

• Common (1% to 10%): Vaginitis/vaginal infection
• Uncommon (0.1% to 1%): Dysuria, metrorrhagia, testicular disorder

Hematologic

• 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
• Postmarketing reports: Thrombocytopenia, hemolytic anemia

Hepatic

• 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

Hepatic failure has rarely resulted in death.

Hypersensitivity

• Uncommon (0.1% to 1%): Hypersensitivity
• Postmarketing reports: Anaphylactic reaction/anaphylaxis (e.g., anaphylactic shock), allergic reactions

Severe (rarely fatal) anaphylactic reaction has been reported.

Local

• 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

Metabolic

• Common (1% to 10%): Decreased blood bicarbonate, anorexia, decreased blood glucose, increased blood glucose
• Uncommon (0.1% to 1%): Increased bicarbonate
• Postmarketing reports: Dehydration

Musculoskeletal

• Common (1% to 10%): Arthralgia, increased creatine phosphokinase
• Uncommon (0.1% to 1%): Osteoarthritis, myalgia, back pain, neck pain

Nervous system

• Common (1% to 10%): Headache, dizziness, paresthesia, dysgeusia
• Uncommon (0.1% to 1%): Somnolence, hypesthesia, tinnitus, vertigo
• Frequency not reported: Hyperkinesia
• Postmarketing reports: Syncope, convulsion, psychomotor hyperactivity, anosmia, ageusia, parosmia, myasthenia gravis, hyperactivity

Ocular

• Common (1% to 10%): Visual impairment, abnormal vision
• Frequency not reported: Conjunctivitis, blurred vision

Other

• 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)

Psychiatric

• Uncommon (0.1% to 1%): Nervousness, insomnia
• Rare (0.01% to 0.1%): Agitation, depersonalization
• Frequency not reported: Delirium, hallucination
• Postmarketing reports: Aggression/aggressive reaction, anxiety

Renal

• 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

Respiratory

• Common (1% to 10%): Dyspnea
• Uncommon (0.1% to 1%): Pneumonia, pharyngitis, rhinitis, respiratory disorder, epistaxis
• Frequency not reported: Bronchospasm, cough, pleural effusion

Frequently asked questions

• What antibiotics kill Covid-19 (coronavirus)?
• What are the best antibiotics for pneumonia?
• Is Zithromax a penicillin?
• Can I drink alcohol while taking Zithromax?
• Is Zithromax available over the counter?
• What antibiotics are used to treat chlamydia and gonorrhea?
• How long does Zithromax stay in your system?
• Zithromax Z-Pak - can Tums (antacids) be taken with Z-Pak?
• Can you take antibiotics with Mavyret?

Further information

Zithromax side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer