Azithromycin and Alcohol: Everything You Need to Know

Written by

Jessica Guht

Jessica is a medical writer with an unquenched thirst to discover something new. She believes that medical content should be accessible to everyone and strives to write content that every single person can understand. When Jessica isn’t writing, she can usually be found reading a book with a dog cuddled in her lap. Jessica has a Masters of Engineering degree in Biomedical Engineering.

Medically reviewed by

Amy Dougherty, FNP-BC, AGAC

Amy is a Board Certified Family Health Nurse Practitioner (FNP) with over 15 years of experience working in Hospital Medicine, Urgent Care and Primary Care practices. Amy graduated Thomas Jefferson University with high distinction earning a Bachelor of Science in Nursing in 2008, a Master of Science in Nursing in 2010 and a Post Master's Certificate in Adult Gerontology Acute Care (AGAC) in 2014. She was recognized by the Elite American Nurses Association in 2013 for her dedication, achievements and leadership in the field Nursing. She served as a clinical preceptor for a number of Nurse Practitioner students and enjoys teaching the bright minds of future NPs.

There exist many different types of antibiotics that help to treat bacterial infections, and one type is azithromycin. A concern when taking antibiotics is whether or not alcohol can be drunk while taking them, as in many cases, alcohol can lessen their effectiveness. Azithromycin, however, remains just as potent even when drinking alcohol.

Despite the effectiveness of azithromycin when drinking, it is still important to consider the way that both azithromycin and alcohol cause extra stress to the liver, especially when taken at the same time. If you are interested in your individual case and if it is safe to drink alcohol while taking azithromycin, meeting with an online doctor offers a quick and convenient option.

Table of Contents

• What Is Azithromycin?
• Can You Drink Alcohol on Azithromycin?
• Azithromycin and Alcohol Interactions
• Azithromycin and Alcohol Risks
• How Long After Taking Azithromycin Can I Drink Alcohol?
• Other Interactions With Azithromycin
• How Can DrHouse Help You?
• Key Takeaways

What Is Azithromycin?

Azithromycin is a medicine classified as a macrolide antibiotic, which cures infections by stopping the growth of bacteria.

Azithromycin is used to treat certain bacterial infections, which can include:

• pneumonia
• bronchitis
• infections of the lungs, ears, skin, sinuses, throat, and reproductive organs
• sexually transmitted diseases (STDs)

Additionally, azithromycin is used to prevent disseminated Mycobacterium avium complex (MAC) infection, which is a lung infection that those with HIV are more susceptible to.

Azithromycin comes in many forms, such as a tablet, liquid, or extended-release liquid. The typical length of time that someone takes azithromycin is 1-5 days. However, for those taking azithromycin to prevent disseminated MAC infection, the tablets are often taken once a week.

Can You Drink Alcohol on Azithromycin?

It is safe to drink alcohol while taking azithromycin.

Multiple studies have shown that alcohol does not appear to reduce the effectiveness of azithromycin. For example, a study on rats compared azithromycin’s ability to cure pneumococcal pneumonia in rats fed a liquid diet with and without alcohol. The results showed that the antibiotics were equally effective in all rats, no matter their alcohol intake.

Azithromycin and Alcohol Interactions

While drinking alcohol does not impact the effectiveness of azithromycin, it may interact in a way that causes some unpleasant side effects. This is because alcohol can temporarily cause liver damage in some people, potentially increasing the severity of the side effects of azithromycin. Additionally, alcohol dehydrates the body, which can also increase the risk of side effects or worsen them.

The side effects of azithromycin, which alcohol can worsen, include:

• vomiting
• nausea
• stomach pain
• diarrhea
• headache

Azithromycin and Alcohol Risks

In rare cases, azithromycin may cause liver damage, resulting in more severe side effects. Because of this potential risk, it is often recommended to avoid anything that could cause extra stress to the liver while taking azithromycin, which includes drinking alcohol.

There is also an increased risk of discontinuing azithromycin when it is combined with alcohol because of the increase in adverse side effects. However, taking the entire course of antibiotic medication is crucial to ensure the infection is completely cured and won’t come back.

Discontinuing your medication early also increases the risk of antibiotic-resistant bacteria, which makes it harder to find a medication that can treat the infection. So, if alcohol is causing the side effects of azithromycin to become unbearable and unpleasant, it is always recommended to stop drinking alcohol until you are finished taking your antibiotics.

How Long After Taking Azithromycin Can I Drink Alcohol?

Since alcohol does not inhibit the effectiveness of azithromycin, it is safe to drink it at any time during the course of your antibiotic.

However, for those who wish to avoid potentially worse side effects or those with past liver problems, it may be wise to wait until azithromycin is entirely out of your system before drinking alcohol again.

Azithromycin has a half-life of 68 hours, and experts calculate that it takes 4-5 half-lives for a drug to be removed entirely from the body. Because of this, it is estimated that azithromycin remains in the body for about 15 days after its last dose.

However, certain factors, such as metabolic rate, age, health, and body mass, can increase the amount of time azithromycin is in the system. If you are unsure about how long to wait before drinking alcohol, it is always best to check with a healthcare provider who can consider your individual case.

Other Interactions With Azithromycin

There are other medicines and supplements that can negatively interact with azithromycin, so it is always best to let your doctor know if you are taking any over-the-counter drugs, supplements, vitamins, or herbal remedies before being prescribed azithromycin.

Taking certain drugs with azithromycin can cause excess stress to the liver, especially for those with past liver problems.

Additionally, when the liver has to process multiple medications simultaneously, it may process them more slowly. This means that the drugs will remain in your bloodstream for longer, which can contribute to a higher risk and intensity of side effects.

How Can DrHouse Help?

If you need an azithromycin prescription, an online doctor can help. With DrHouse, you can meet with an online doctor in just 15 minutes to discuss your symptoms, determine if an antibiotic is needed, and write you an online prescription. 

Additionally, if you are experiencing any unpleasant side effects of azithromycin or would like to know when it is safe to drink alcohol, meeting with an online doctor allows you a quick and convenient method to gain this information from a medical professional. If your azithromycin is causing unpleasant side effects, your doctor can discuss options to limit these effects while still ensuring the bacterial infection is entirely cured.

Key Takeaways

Azithromycin is a medication used to treat bacterial infections such as pneumonia, bronchitis, and some STDs. In some cases, it is used long-term in those with HIV to prevent disseminated MAC infection, which they are more prone to.

Studies have shown that drinking alcohol while taking azithromycin does not impact the effectiveness of the antibiotic. However, alcohol may worsen the side effects that can accompany azithromycin, and it may also increase the risk of liver damage because both alcohol and azithromycin use place stress on the liver.

For those looking to avoid these interactions and risks, it is best to avoid drinking alcohol while azithromycin is in your system, which is typically until 15 days after your last dose. There are also other medications and supplements that can interact with azithromycin and causes extra stress to the liver, so talking to a doctor before taking azithromycin about all these medications is important.

Sources:

• Preheim, L. C., Olsen, K. M., Yue, M., Snitily, M. U., & Gentry, M. J. (1999). Ethanol feeding does not affect the efficacy or pharmacokinetics of azithromycin, trovafloxacin, or ceftriaxone in a rat model of pneumococcal pneumonia. Alcoholism, clinical and experimental research, 23(5), 842–849.
• Zithromax®. (2009).   https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/050693s014,050730s021lbl.pdf 
• Azithromycin: MedlinePlus Drug Information. (2022). Retrieved 28 July 2022, from https://medlineplus.gov/druginfo/meds/a697037.html 
• Sarkar, D., Jung, M. K., & Wang, H. J. (2015). Alcohol and the Immune System. Alcohol Research : Current Reviews, 37(2), 153–155.
• Mergenhagen, K. A., Wattengel, B. A., Skelly, M. K., Clark, C. M., & Russo, T. A. (2020). Fact versus Fiction: a Review of the Evidence behind Alcohol and Antibiotic Interactions. Antimicrobial agents and chemotherapy, 64(3), e02167-19. https://doi.org/10.1128/AAC.02167-19 
• Baciewicz, A., Al-Nimr, A., & Whelan, P. (2005). Azithromycin-induced hepatoxicity. The American Journal Of Medicine, 118(12), 1438-1439. doi: https://doi.org/10.1016/j.amjmed.2005.06.048