Azithromycin and Alcohol: Like Most Other Antibiotics and Alcohol It’s no Big Deal

“Is it OK to take azithromycin and alcohol?”  A very common question I hear in the office is if it is a problem if a patient drinks alcohol while taking an antibiotic. It’s not at all clear where the myth started that taking an antibiotic and drinking alcohol is somehow a lot worse than drinking and taking other medications, but it sure seems to be a common concern.  I think it’s a lot like the, “Don’t swim after eating,” myth, it just gets passed from generation to generation as fact.  For almost all antibiotics, with the clear exception of metronidazole, the honest answer is that the risks of drinking alcohol while on azithromycin, as with most other antibiotics is pretty minimal.  (Metronidazole has an antabuse like effect and can cause fairly severe flushing, hypotension, and a really sick sensation if taken with alcohol)  With azithromycin the main problem is that macrolide antibiotics including azithromycin fairly often have side effects of upset stomach, dizziness and vomiting.  These are symptoms also often seen from drinking alcohol, and the combined side effects of using them together may be increased.  There is really no major problem.  The antimicrobial effect of the azithromycin is not reduced and major problems are just not often noted with azithromycin and alcohol used in combination in most patients.  The azithromycin and alcohol combination is most often not a big concern.  Anyone who is sick obviously shouldn’t get drunk, lose sleep, and weaken themselves whether they are on an antibiotic or not.  Every mother and doctor tries to get us to get rest and take really good care of ourselves to allow our bodies to fight the infection and get well.  The benefits of  chicken noodle soup is almost certainly a more beneficial choice to take with azithromycin than alcohol, but even washed down with a beer or wine most antibiotics will still work just fine.

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