What is Azithromycin?
Azithromycin is a prescription-only macrolide antibiotic used to treat bacterial infections including chlamydia and gonorrhoea. This guide covers everything you need to know — from how it works to how to get it prescribed online — plus the full official Patient Information Leaflet (PIL).
Azithromycin: An Overview
Azithromycin belongs to a class of antibiotics called macrolides. It works by preventing bacteria from producing the proteins they need to grow and multiply — allowing your immune system to clear the infection naturally.
In the UK, azithromycin is a prescription-only medicine (POM). It cannot be purchased over the counter, but it can be legally prescribed online by a registered prescriber following a short consultation.
Access Doctor prescribes azithromycin exclusively for the treatment of sexually transmitted infections — specifically chlamydia and gonorrhoea. For other uses, please speak to your GP.
What Does Azithromycin Treat?
Azithromycin is used to treat a range of bacterial infections, including:
- Chlamydia — the most common STI in the UK, caused by Chlamydia trachomatis
- Gonorrhoea — typically prescribed alongside another antibiotic
- Chest & respiratory infections — bronchitis, pneumonia, sinusitis
- Throat & ear infections — tonsillitis, pharyngitis, otitis media
- Skin and soft tissue infections
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How Does Azithromycin Work?
Azithromycin targets the ribosomes inside bacteria — the structures responsible for producing proteins essential to bacterial growth and survival. By binding to these ribosomes, azithromycin stops the bacteria from replicating and spreading.
For chlamydia specifically, the antibiotic disrupts the ability of Chlamydia trachomatis to replicate inside human cells. This is why even a short course — sometimes a single dose — can be highly effective when treatment is started promptly.
Azithromycin Dosage
The correct dose depends on the condition being treated. Always follow the instructions provided by your prescriber. General guidance is outlined below.
For Chlamydia
1g day 1
Two 500mg tablets taken together as a single dose, followed by one 500mg tablet per day for the next two days. Take one hour before or three hours after a meal.
For Gonorrhoea
1g–2g
Prescribed in combination with ceftriaxone. The exact regimen will be determined by your prescriber based on your consultation responses.
Do not adjust your dose without speaking to your prescriber. If you are unsure about your dosage instructions, contact Access Doctor or your nearest sexual health clinic.
How Long Does Azithromycin Take to Work?
Most people with chlamydia begin to notice an improvement in symptoms within a few days. However, it typically takes one to two weeks for the infection to clear completely.
It is important to avoid sexual contact until both you and any partners have completed treatment and confirmed the infection has cleared. Do not assume you are no longer infectious just because symptoms have resolved.
If symptoms persist after completing the full course, contact your prescriber or visit a sexual health clinic for a follow-up test.
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Azithromycin Side Effects
Like all medicines, azithromycin can cause side effects, although not everyone experiences them. Because treatment for chlamydia is short, side effects are usually mild and brief.
Common side effects
- Nausea or vomiting
- Diarrhoea or loose stools
- Stomach cramps or indigestion
- Headaches or dizziness
- Skin rash
- Loss of appetite
- Joint pain
- Pins and needles
Seek help immediately
- Irregular or fast heartbeat
- Severe allergic reaction
- Swelling of face, lips or throat
- Difficulty breathing
- Yellowing of skin or eyes
If you experience any serious side effects, stop taking azithromycin and contact a healthcare professional or call 999 immediately.
Interactions & Who Should Not Take Azithromycin
Drug interactions
Azithromycin may interact with the following medicines. Always declare everything you are taking during your consultation:
- Warfarin or other anticoagulants (blood thinners)
- Digoxin (used for heart failure)
- Colchicine (used for gout)
- Ciclosporin (immunosuppressant)
- Fexofenadine (for hay fever or skin allergies)
- Antacids — take at least 2 hours apart from azithromycin
Who should tell their prescriber before taking azithromycin
- Anyone with liver or kidney problems
- Anyone with a history of heart conditions or irregular heartbeat
- Anyone with a known allergy to macrolide antibiotics
- Anyone who is pregnant or breastfeeding
During your Access Doctor online consultation, you will be asked about all relevant medical history and medications. Your prescriber will only issue a prescription if it is clinically safe and appropriate for you.
Can I Get Azithromycin Without Seeing a GP?
Yes. In the UK, azithromycin can be legally prescribed through a registered online pharmacy without a GP visit, provided you complete a clinical consultation first.
At Access Doctor, the process is straightforward:
1
Complete an online health consultation
Takes around five minutes. Answer questions about your symptoms, medical history and current medications.
2
A prescriber reviews your answers
One of our UK-registered prescribers assesses your consultation and, if appropriate, issues a prescription.
3
Discreet delivery to your door
Our GPhC-registered pharmacy dispenses and delivers your treatment in plain, unmarked packaging. Order before 3pm for next-day delivery.
All Access Doctor prescribers are registered with the General Medical Council (GMC). Our pharmacy is licensed by the General Pharmaceutical Council (GPhC No. 9011198) and regulated by the MHRA.
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Frequently Asked Questions
Is azithromycin the same as a Z-pack?
Yes. A “Z-pack” is a US term for a pre-packaged course of azithromycin. The medication is identical — the name simply refers to the branded packaging format commonly used in the United States.
Can I drink alcohol while taking azithromycin?
Alcohol is not known to directly interact with azithromycin, but drinking during any antibiotic course is generally not advisable. Alcohol can worsen side effects such as nausea and dizziness, and may reduce your immune system’s ability to fight the infection efficiently.
Does azithromycin treat UTIs?
No. Azithromycin is not effective against the bacteria that most commonly cause urinary tract infections (UTIs). UTIs are typically treated with antibiotics such as trimethoprim or nitrofurantoin. If you think you have a UTI, a separate consultation is required.
How do I know if azithromycin worked for chlamydia?
Symptoms such as discharge or discomfort should begin to improve within a few days of starting treatment. For full confirmation that the infection has cleared, a test of cure is recommended around four to six weeks after completing the course. Many sexual health clinics offer this routinely.
Can I buy azithromycin over the counter in the UK?
No. Azithromycin is a prescription-only medicine (POM) in the UK. It cannot be purchased without a valid prescription. However, you can obtain a prescription legally and quickly through a registered online pharmacy like Access Doctor, without needing to visit a GP in person.
What should I do if I miss a dose?
If you miss a dose, take it as soon as you remember — unless it is nearly time for your next dose, in which case skip the missed one. Never take two doses at the same time to make up for a missed dose. If you are unsure, contact your prescriber.
Patient Information Leaflet (PIL)
The following is the full official Patient Information Leaflet for Azithromycin film-coated tablets, last revised February 2019. Read it carefully before taking this medicine.
Official Document
Azithromycin Film-Coated Tablets — Patient Information Leaflet
Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
Important: Keep this leaflet — you may need to read it again. This medicine has been prescribed for you only. Do not pass it on to others. If you get any side effects, talk to your doctor or pharmacist. See section 4.
What is in this leaflet
1What Azithromycin is and what it is used for
Azithromycin is one of a group of antibiotics known as macrolides. It is used to treat bacterial infections caused by micro-organisms such as bacteria. These infections include:
- Chest infections such as bronchitis and pneumonia
- Infections in your sinuses, throat, tonsils or ears
- Mild to moderate skin and soft tissue infections — e.g. infection of the hair follicles (folliculitis), bacterial infection of the skin and its deeper layers (cellulitis), skin infection with shiny red swelling (erysipelas)
- Infections caused by a bacterium called Chlamydia trachomatis — they can cause inflammation of the tube that carries urine from your bladder (urethra) or where your womb joins your vagina (cervix)
2What you need to know before you take Azithromycin
Do not take Azithromycin if you:
- Are allergic to azithromycin, any other macrolide (such as erythromycin or clarithromycin) or ketolide antibiotic, or any of the other ingredients (listed in section 6). An allergic reaction may cause skin rash or wheezing.
Warnings and precautions
Talk to your doctor or pharmacist before taking Azithromycin if you:
- Have ever had a serious allergic reaction causing swelling of the face and throat, possibly with breathing problems, rash, fever, swollen glands or an increase in eosinophils (a type of white blood cell)
- Have severe kidney problems — your doctor may alter the dose
- Have liver problems — your doctor may need to monitor your liver function or stop the treatment
- Have myasthenia gravis (localised muscle weakness)
- Have been diagnosed with a neurological disease (a disease of the brain or nervous system)
- Have mental, emotional or behavioural problems
- Are taking medicines known as ergot alkaloids (such as ergotamine), used to treat migraine — azithromycin is not recommended in this case
Heart rhythm warning: Azithromycin may increase the risk of abnormal heart rhythm. Tell your doctor if you have any of the following — especially if you are female or elderly:
- Prolonged QT interval (a heart condition shown on an ECG) — azithromycin is not recommended
- Slow or irregular heartbeat, or reduced heart function (heart failure) — azithromycin is not recommended
- Low levels of potassium or magnesium in your blood — azithromycin is not recommended
- You are taking antiarrhythmics (e.g. quinidine, amiodarone, sotalol), cisapride, terfenadine, antipsychotics (e.g. pimozide), antidepressants (e.g. citalopram), or certain antibiotics (e.g. moxifloxacin) that can affect heart rhythm — azithromycin is not recommended
If you develop severe and persistent diarrhoea during or after treatment — especially if you notice blood or mucus — tell your doctor immediately.
If your symptoms persist after treatment ends, or if you notice new and persistent symptoms, contact your doctor.
Other medicines and Azithromycin
Tell your doctor before taking Azithromycin if you are taking any of the following:
| Warfarin / blood clot medicines | Concomitant use can increase the risk of bleeding. |
| Ergotamine / dihydroergotamine (migraine) | Risk of ergotism (itching, muscle cramps, poor circulation). Concomitant use not recommended. |
| Ciclosporin (immunosuppressant) | Blood levels may need to be monitored and dose adjusted. |
| Digoxin (heart failure) | Digoxin levels may increase. Blood levels will be checked. |
| Colchicine (gout) | Notify your doctor. |
| Antacids (indigestion) | Take azithromycin at least 1 hour before or 2 hours after antacids. |
| Cisapride / terfenadine | Concomitant use may cause heart disorders. |
| Antiarrhythmics / statins (e.g. atorvastatin) | Notify your doctor. |
| Alfentanil / astemizole | Azithromycin may increase the effect of these medicines. |
Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines.
Pregnancy and breast-feeding
Pregnancy: There is insufficient information regarding the safety of azithromycin during pregnancy. Azithromycin is not recommended if you are pregnant or planning to become pregnant. However, your doctor may prescribe it in serious circumstances.
Breast-feeding: Azithromycin is excreted in human milk. You should not breast-feed whilst taking Azithromycin, as it may cause side effects in your baby including diarrhoea and infection. Discard milk during treatment and for 2 days after stopping. You may resume nursing two days after stopping treatment.
Driving and using machines
Azithromycin may cause dizziness and fits. If affected, do not drive or operate machinery.
Azithromycin contains soya oil
If you are allergic to peanut or soya, do not use this medicinal product.
Azithromycin contains sodium
This medicine contains less than 1 mmol sodium (23 mg) per tablet — essentially sodium-free.
3How to take Azithromycin
Always take this medicine exactly as your doctor or pharmacist has told you. Azithromycin tablets should be given as a single daily dose. Swallow with a drink of water. Can be taken with or without food.
Azithromycin 500mg — Recommended doses
Adults (including older patients), children and adolescents over 45 kg:
- Standard course: 1500 mg over either 3 days (500 mg once daily) or 5 days (500 mg on day 1, then 250 mg once daily on days 2–5)
- Chlamydia (inflammation of the urethra or cervix): 1000 mg as a single dose, for one day only
- For sinus infections: treatment is indicated for adults and adolescents aged 16 and over only
Children and adolescents 45 kg and under: Tablets are not indicated. Other pharmaceutical forms (e.g. suspensions) may be used.
Patients with kidney or liver problems: Tell your doctor as the dose may need to be altered.
If you take more than you should
Contact your doctor or pharmacist immediately. An overdose is likely to cause reversible hearing loss, severe nausea, vomiting and diarrhoea. Take this leaflet, any remaining tablets, and the container with you to the hospital.
If you forget to take Azithromycin
Take a tablet as soon as you remember, unless it is nearly time for the next one. Do not take a double dose to make up for a forgotten dose.
If you stop taking Azithromycin
Do not stop taking this medicine without talking to your doctor first, even if you feel better. It is very important to complete the full course — otherwise the infection may return.
4Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Stop taking the tablets and tell your doctor immediately or go to A&E if you experience:
- A severe skin reaction causing blisters/bleeding of the lips, eyes, nose, mouth and genitals (Stevens-Johnson syndrome) — Uncommon
- Yellowing of the skin and whites of the eyes, tiredness and loss of appetite (hepatitis) — Uncommon
- Yellowing of the skin or eyes (jaundice) — Rare
- Skin eruption with small pustules on red skin — Rare
- Skin rash with fever, swollen glands and increase of eosinophils — Very rare
- Severe allergic reaction: swelling of the lips, face or neck with difficulty breathing, skin rash or hives — Frequency not known
- Disturbances in heart rhythm (QT prolongation, Torsades de pointes, irregular heartbeat) — Frequency not known
- Liver failure — Frequency not known
- Fits — Frequency not known
The following side effects have been reported:
Very common
May affect more than 1 in 10 people
- Diarrhoea
- Feeling sick (nausea)
- Abdominal pain
- Flatulence (wind)
Common
May affect up to 1 in 10 people
- Headache
- Dizziness, drowsiness, taste disturbance, numbness or pins and needles
- Visual disturbances
- Deafness
- Being sick (vomiting)
- Indigestion
- Skin rash and itching
- Joint pain (arthralgia)
- Tiredness
- Changes in white blood cell count; low blood bicarbonate
Uncommon
May affect up to 1 in 100 people
- Reduced sense of touch or sensation
- Changes in liver function
- Skin more sensitive to light than normal
- Yeast infections of the mouth and vagina (thrush), vaginal infections, fungal/bacterial infections
- Allergic reactions of various severity
- Loss of appetite, feeling nervous, sleeplessness
- Ear disorder, vertigo, hearing impairment, tinnitus (ringing in ears)
- Heart palpitations, hot flushes
- Recurring infections with fever, chills, sore throat (may indicate low white blood cells)
- Serious lung infection (pneumonia) with fever, chills, shortness of breath, cough
- Nosebleeds, constipation, gastritis, difficulty swallowing, bloating, dry mouth, mouth ulceration
- Hives, dermatitis, dry skin, increased sweating
- Bone and joint pain, muscle pain, back pain, neck pain
- Pain when passing urine, kidney pain
- Abnormal vaginal bleeding; problems with testicles
- Swelling, chest pain, fever, swelling of lower limbs, general loss of strength
- Shortness of breath; abnormal laboratory test values
Rare
May affect up to 1 in 1,000 people
- Agitation
- Irritability
Frequency not known
Cannot be estimated from available data
- Blood taking longer to clot, bruising more easily (thrombocytopenia)
- Aggression, anxiety, severe confusion (delirium), hallucinations
- Fainting, feeling hyperactive, loss or altered sense of smell or taste
- Muscle weakness or worsening of muscle weakness (myasthenia gravis)
- Low blood pressure
- Tongue or tooth discolouration
- Severe skin peeling or itchy rash with pink-red rings (toxic epidermal necrolysis, erythema multiforme)
- Disturbances in heart rhythm (QT prolongation, Torsades de pointes)
- Feeling weak and breathless with yellowing of the skin (haemolytic anaemia)
- Prolonged diarrhoea with blood and mucus
- Stomach pain moving to the back with nausea/vomiting (pancreatitis)
- Back pain and problems passing water (kidney inflammation or failure)
- Liver failure
- Fits (convulsions)
Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. You can also report side effects directly via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine.
5How to store Azithromycin
- Keep this medicine out of the sight and reach of children
- This medicine does not require any special storage conditions
- Do not transfer the tablets to another container
- Do not use this medicine after the expiry date stated on the carton and blister after EXP
- Do not throw away medicines via wastewater or household waste — ask your pharmacist how to dispose of medicines you no longer use
6Contents of the pack and other information
What Azithromycin film-coated tablets contain
Active substance: Each tablet contains either 250 mg or 500 mg of azithromycin (as azithromycin monohydrate).
Other ingredients: Microcrystalline cellulose (E460), pregelatinised maize starch, sodium starch glycolate (Type A), anhydrous colloidal silica (E551), sodium lauryl sulphate, magnesium stearate (E470b). Film-coating: polyvinyl alcohol (partially hydrolysed), titanium dioxide (E171), talc (E553b), soya lecithin and xanthan gum (E415).
What the tablets look like and pack sizes
Both strengths are white to off-white oblong film-coated tablets. The 500 mg tablet has a break line on one side.
| 250 mg pack sizes | 4, 6, 12, 24, 50 or 100 tablets in blister strips |
| 500 mg pack sizes | 2, 3, 6, 12, 24, 30, 50 or 100 tablets in blister strips |
Not all pack sizes may be marketed.
Marketing Authorisation Holder
Mylan, Potters Bar, Hertfordshire, EN6 1TL, United Kingdom
Manufacturers
- McDermott Laboratories Ltd t/a Gerard Laboratories, 35/36 Baldoyle Industrial Estate, Dublin 13, Ireland
- Sandoz GmbH, Biochemiestraße 10, 6250 Kundl, Austria
- Sandoz S.R.L, Livezeni Street no 7A, 540472 Targu Mures, Romania
- Generics UK Limited, Station Close, Potters Bar, Hertfordshire, EN6 1TL, United Kingdom