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What are the Effects of Taking Azithromycin with Alcohol?

By Marlene Garcia
Updated Mar 03, 2024
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The most common effects of taking azithromycin with alcohol include dizziness, blurred vision, and an increase in urination; diarrhea is also experienced by many patients. Azithromycin is an antibiotic used to combat various infections in the body, and while pharmaceutical manufacturers don’t usually recommend that it be taken with alcohol, it isn’t usually prohibited or directly warned against, either. Alcohol won’t change the drug’s effectiveness, but it can cause a range of other sometimes unpleasant side effects. It can also exacerbate side effects that might occur anyway.

How the Drug Works

Azithromycin treats bacterial infections by killing or slowing the growth of proteins the bacteria need to thrive. It is commonly prescribed for strep throat, tonsillitis, and middle ear infections in children. Adults may find the drug effective for sinus infections, staph infections, pneumonia, and certain sexually transmitted diseases. In most cases, the active ingredients are metabolized in the liver, which is the same organ that breaks down alcohol. Taking both together can sometimes overwhelm things, which is where problems arise.

Dizziness and Vision Issues

Blurred vision, dizziness, and lightheadedness are the most common side effects of mixing azithromycin with alcohol, and can be experienced anytime within a few hours of when either substance was taken. In other words, a person doesn’t have to physically swallow the medication with an alcoholic drink to have “taken it with alcohol” — drinking shortly before or shortly after taking a dose also qualifies. People can expect possible symptoms anytime both alcohol and azithromycin are in the system,.

More Frequent Urination

This medication stays in the system longer than some antibiotics, and is designed to take longer to break down. Combining it with alcohol can increase stress on the liver, which can cause it to process through water and other fluids faster. The most immediate effect is more frequent urination; people don’t usually have more volume to pass, but often feel the urge to go at shorter intervals. People who drink excessively may deplete the medication from the body faster through this process.


Mild diarrhea is the most common side effect of the drug generally, and it is often exacerbated by the presence of alcohol. Alcohol is a diuretic, which means that it takes water out of the body, and this can cause inflammation in the bowels and intestinal tract when combined with this and similar medications. In rare cases, the diarrhea develops into a serious condition that causes pain, cramps, or bloody stools. Using an anti-diarrhea medicine might make the illness worse since this can stress the liver and digestive tract even more. The best course of action is usually just to wait it out, or make dietary changes like adding more fiber and staying hydrated.

Other Possible Interactions

Although drug manufacturers don’t usually address the effectiveness of azithromycin with alcohol directly, most do warn against using it with antacids that have an aluminum or magnesium base. Medicine used for heartburn or gastritis interferes with the absorption of azithromycin in the intestines when the two are used together. Those who use the antibiotic for long periods of time might also develop a secondary infection because healthy bacteria might be destroyed.

People taking the drug might also sunburn more quickly. Tanning booths and heat lamps should be avoided when on this medication whether a person has been drinking or not. It is advised to use sunscreen while outside, since the skin is often more sensitive to the sun’s harmful rays.

A long list of drugs may cause interactions with this type of antibiotic. Some decrease the effectiveness of azithromycin, while others increase the potential for side effects. Medications used for erratic heartbeat, for example, may actually increase the heart rate when combined with this drug. Herbal or vitamin supplements may also cause negative reactions. Anyone who is thinking about taking other medications or supplements alongside azithromycin should usually talk to their healthcare provider to understand the risks before proceeding.

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Discussion Comments
By anon968545 — On Sep 04, 2014

In the article, it says that the body can deplete the substance faster due to excessive urination. Doesn't the body want to metabolize the alcohol faster thus leaving the medication in your system longer?

I don't get why the body depletes the medication faster, yet the effects of the drug can be greater when consumed with alcohol. Can you please explain?

By anon958942 — On Jun 30, 2014

@stoneMason-- No offense, but I don't care what your personal philosophy about alcohol is. This is a discussion about physical effects of alcohol on your body while on this medication.

By serenesurface — On Oct 03, 2013

I drank once while I was on azithromycin. The alcohol hit me very badly and I was so dizzy and nauseated. I had to have a friend escort me home because I was scared of fainting. Alcohol definitely amplifies the side effects of azithromycin. I had mild nausea a few times before on the medication, but it was so much worse when I drank. I had intentionally taken the medication early in the day to avoid problems but it didn't make a difference.

By stoneMason — On Oct 03, 2013

@alisha-- Can you drink alcohol on azithromycin? Yes, a little bit. But should you? Not really.

I personally don't think it's a good idea to drink while on any medication. I didn't drink while I was on azithromycin even though my doctor would have probably allowed it.

Alcohol isn't good for the body because it causes so many changes. It's a diuretic and causes dehydration. It depresses the central nervous system and makes it difficult to think and perform activities. Alcohol is also said to weaken the immune system. I believe it because the liver treats alcohol as a toxin and leaves everything else it's metabolizing to metabolize alcohol and get it out of the body first.

When I'm already sick and my body is fighting an infection, the last thing I need is a weak immune system and an over-stressed liver. So I don't drink any alcohol while I'm sick and on medications. It's just common sense.

By discographer — On Oct 02, 2013

I was on azithromycin tablets for strep throat last week. I did drink while I was on it. My doctor said that it's okay to drink. I had a beer or two almost daily. I didn't have any bad side effects.

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