Azithromycin Precautions and Warnings

There are a number of precautions and warnings with azithromycin to be aware of. For instance, if you have severe kidney or liver disease, your healthcare provider may prescribe you a lower dosage of azithromycin or not prescribe the medicine at all. Also, azithromycin can cause severe diarrhea in some people. A few other azithromycin precautions and warnings to be aware of include potential drug interactions, an increased chance of oral and vaginal yeast infections in some people taking the drug, and the importance of never taking outdated azithromycin.

Azithromycin: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking azithromycin (Zithromax®) if you:
  • Have liver disease or failure
  • Have kidney disease or failure
  • Have any heart problems
  • Have myasthenia gravis 
  • Are pregnant or thinking of becoming pregnant
  • Are breastfeeding
  • Have any allergies to medications
  • Will be having any surgery.
Also tell your healthcare provider about all other medicines you may be currently taking, including prescription and non-prescription medicines, oral contraceptive, blood-thinners, antacids, vitamins, and herbal supplements.

Some Azithromycin Precautions and Warnings

Some precautions and warnings to be aware of with azithromycin include:
  • Rarely, azithromycin can cause a change in the heart rhythm known as QT prolongation. For many individuals, this is minor and inconsequential. However, in some cases it can lead to a fatal arrhythmia.

People who already have a long QT interval (due to genetics, heart problems, electrolyte imbalances, or other medications) are at highest risk for serious problems related to QT prolongation with azithromycin. Elderly individuals also appear to be at a higher risk for this problem.

  • Azithromycin can interact with certain other medications (see Azithromycin Drug Interactions).
  • Azithromycin is considered pregnancy Category B medicine. This means that it has not been studied in pregnant women. When studied in animals, however, azithromycin showed no negative effects on unborn babies. Before using azithromycin, let your healthcare provider know if you are pregnant or thinking of becoming pregnant.
  • If you have severe kidney disease, your healthcare provider may choose to lower the dose of azithromycin normally given or opt to not prescribe this medication at all.
  • If you have severe liver disease, your healthcare provider may choose to lower the dose of azithromycin normally given or not prescribe this medication at all.
  • It is known that azithromycin passes through breast milk. Therefore, check with your healthcare provider before taking this medication while breastfeeding (see Azithromycin and Breastfeeding for more information).
  • Many antibiotics, including azithromycin, have been known to cause pseudomembranous colitis (severe diarrhea). If you experience severe, watery diarrhea; blood in your stools; stomach pain; and/or a low-grade fever while taking azithromycin, contact your healthcare provider immediately.
  • Other infections have been known to occur during treatment with antibiotics. If you are taking azithromycin and you notice any symptoms unrelated to the condition you are being treated for, talk with your healthcare provider.



  • Taking azithromycin has been known to increase the chance of developing oral and vaginal yeast infections.  


  • Never take outdated azithromycin. Taking any outdated medication may cause serious problems because the intended effects often change after expiration.
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