Can You Mix Alcohol and Azithromycin?

By Terez Malka, MD
Medically reviewed checkmarkMedically reviewed
January 24, 2022

Azithromycin is one of the most common antibiotics prescribed to treat bacterial infections.

It works by preventing further growth and multiplication of bacteria in the body.

However, there’s a lot about this medication you will want to know if your doctor or health care provider prescribes it to you.

While using azithromycin, you may wonder if it’s safe to take it with your favorite alcoholic drink or if you have to skip drinking alcohol to keep the medicine effective.

What is Azithromycin?

Azithromycin is a macrolide antibiotic that treats bacterial infections by stopping the growth of bacteria in the body. It is only available with a prescription from a doctor or health care provider.

Azithromycin treats bacterial infections such as:

Because it is an antibiotic, azithromycin does not work for viral or fungal infections.

Avoid unnecessary use of azithromycin to prevent the development of antibiotic resistance.

Antibiotic resistance means the drug is no longer effective against the bacteria.

What Happens When You Mix Alcohol and Azithromycin?

There is no known adverse interaction between alcohol and azithromycin.

However, this does not mean that mixing both is a good idea.

Mixing azithromycin and alcohol can worsen the medication’s side effects, leading to one or more of the following problems: 

Liver issues

Liver toxicity is one of the severe side effects of using azithromycin. 

The liver is the main organ that eliminates azithromycin.

It is also the organ responsible for processing alcohol.

When you consume both substances together, it takes a toll on your liver, increasing the risk of liver damage.

Some symptoms of liver issues are:

If you have a pre-existing liver condition, discuss this with your doctor or pharmacist.

They will usually find an alternative antibiotic to prescribe or monitor you closely for symptoms.

Nausea, vomiting, diarrhea

Generally, antibiotics are known to cause gastrointestinal upset.

This is because they affect both the good and bad bacteria in your digestive system resulting in gastrointestinal side effects like nausea, vomiting, and diarrhea.

Consuming alcohol will increase the risk of an upset stomach.

This means that you have a higher chance of experiencing these symptoms intensely than you would with only azithromycin.

Frequent vomiting can reduce the effectiveness of your medication since less than the prescribed concentration is absorbed into your bloodstream.

Headache or lightheadedness

People who use azithromycin may suffer from headaches.

Alcohol is also known to cause headaches in some patients.

It can become challenging to know whether you’re experiencing side effects from the medication or the alcohol. 

The same applies to feeling lightheadedness or dizziness. It is also common among those who consume large quantities of alcohol.

Consuming alcohol while on azithromycin is only likely to compound headaches.

Slower recovery

Alcohol is known to suppress the immune system which helps to fight off infections, including bacterial infections.

If the immune system is weak, it is harder to fight the infection, slowing the healing process. 

Since alcohol worsens the severity of azithromycin side effects, you tend to feel worse even when you should be feeling better.

Other Possible Side Effects

Other possible side effects of mixing alcohol and azithromycin are:

  • Dehydration: Because alcohol is a diuretic, it makes you lose fluid from your body faster, leaving you dehydrated. Dehydration can make you feel worse.
  • Hides serious side effects: The side effects of alcohol consumption are similar to those of using azithromycin, so it can be challenging to know which substance is causing the symptoms. This can make it harder to decide the next course of action.
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Other Substances that Interact with Azithromycin

Drug interactions exist and in such cases, the use of one drug affects the efficacy of the other drug used by the same patient.

Some other substances that interact with azithromycin include:

  • Antacids containing magnesium hydroxide or aluminum hydroxide
  • Nelfinavir used in the treatment of HIV
  • Migraine medication like ergotamine
  • Blood thinners like warfarin
  • Gout medication like colchicine
  • Amiodarone used for treating irregular heartbeat

These drugs should ideally not be used with azithromycin.

In some rare cases, the doctor will resort to dosage adjustment or careful monitoring of the patient. 

When to See a Doctor

If you think you have a bacterial infection, speak with a doctor who will then decide whether you need azithromycin or any other medication.

You must present a doctor’s prescription before you can purchase azithromycin. 

While using azithromycin, if you experience any side effects, make sure to speak with your doctor.

Even if you think the side effects are a result of your alcohol intake, still make the call.

Based on the severity of the reaction, your doctor or health care provider will then decide whether you should discontinue the drug or advise you on how to manage the symptoms.

How K Health Can Help 

Curious about how to manage the side effects of mixing azithromycin and your favorite alcoholic beverage?

You should speak to a doctor. Did you know you can get affordable primary care with the K Health app?

Download K Health to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.

Frequently Asked Questions

How quickly will azithromycin begin to work?
It can take 3 to 10 days before you start to feel better, depending on your dosage and severity of infection. You can begin to feel better even before you complete your course but make sure you finish it.
Will drinking alcohol make a bacterial infection worse?
Alcohol consumption can suppress your immune system which is the body system responsible for fighting off infections. It will slow down your body's ability to fight off bacterial infections which could make symptoms last longer or not respond as well to your antibiotic.
How long should you wait to drink alcohol after taking antibiotics?
Although we recommend staying off alcohol while on medication, not all antibiotics require that you do so. For antibiotics like azithromycin and amoxicillin, you can consume alcohol in moderation alongside the medication. However, alcohol consumption will likely worsen the side effects of the drugs. With other antibiotics like metronidazole and imidazole, you should stay off alcohol for at least three days after your last dose.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

Terez Malka, MD

Dr. Terez Malka is a board-certified pediatrician and emergency medicine physician.