How to Take Azithromycin Z-Pak: Side Effects, Dosage
Learn how to take Azithromycin (Z-Pak) as directed, proper dosage, common side effects and precautions for responsible use.
Not medical advice. Speak with a healthcare professional before using any medication.
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Updated Feb, 15
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Information sourced from FDA-approved prescribing information and peer-reviewed medical references.
How to Take Azithromycin Z-Pak
How to Take Azithromycin Z-Pak
The following information reflects FDA-approved prescribing information for Azithromycin Z-Pak (azithromycin). Always follow your prescriber's specific instructions:
- Per FDA-approved prescribing information, adults: Take 2 tablets (500 mg) once on Day 1, then 1 tablet (250 mg) once daily on Days 2–5.
- Per FDA-approved prescribing information, children 6 months and older: Dose is based on weight. • 22–30 lbs (10–14 kg): Day 1 = 100 mg; Days 2–5 = 50 mg daily • 31–44 lbs (14–20 kg): Day 1 = 200 mg; Days 2–5 = 100 mg daily • 45–55 lbs (20–25 kg): Day 1 = 250 mg; Days 2–5 = 125 mg daily • 56–75 lbs (25–34 kg): Day 1 = 300 mg; Days 2–5 = 150 mg daily • Over ~75 lbs (34+ kg): Adult schedule is typically used.
Per FDA-approved prescribing information, you may take it with or without food. If it upsets your stomach, a small meal may help. Swallow tablets with a glass of water.
Per FDA-approved prescribing information, try to take each dose at about the same time every day. If you miss a dose and remember the same day, take it then; if it's the next day, skip the missed dose and continue as scheduled.
Per FDA-approved prescribing information, finish all doses, even if you start feeling better — this helps ensure the infection is fully treated.
Warnings Before Taking Azithromycin Z-Pak
- Per FDA-approved prescribing information, tell your doctor if you have heart rhythm issues, especially QT prolongation or if you take medications that affect heart rhythm.
- Per FDA-approved prescribing information, report any liver problems now or in the past, as this medicine is processed through the liver.
- Per FDA-approved prescribing information, discuss allergies to macrolide antibiotics such as erythromycin or clarithromycin.
- Per FDA-approved prescribing information, mention kidney disease, myasthenia gravis, or pregnancy/breastfeeding.
Azithromycin Z-Pak Side Effects
common
Mild
Nausea
Per FDA-approved prescribing information, nausea is one of the most commonly reported reactions to azithromycin. It often feels like mild stomach queasiness and typically resolves once the medication course is finished.
Per FDA-approved prescribing information. Contact your prescriber if side effects persist or worsen.
Normally lasts for:
2–12 hours
common
Mild
Diarrhea
Per FDA-approved prescribing information, azithromycin can affect intestinal motility. Loose stools are a commonly reported side effect and are typically short-lived.
Per FDA-approved prescribing information. Contact your prescriber if side effects persist or worsen.
Normally lasts for:
1–2 days
common
Mild
Abdominal Discomfort
Per FDA-approved prescribing information, some people notice mild cramps or bloating while taking azithromycin.
Per FDA-approved prescribing information. Contact your prescriber if side effects persist or worsen.
Normally lasts for:
4–24 hours
uncommon
Mild
Headache
Per FDA-approved prescribing information, a small number of patients report headaches while taking azithromycin.
Per FDA-approved prescribing information. Contact your prescriber if side effects persist or worsen.
Normally lasts for:
1–12 hours
uncommon
Mild
Dizziness
Per FDA-approved prescribing information, some patients may feel slightly lightheaded while taking azithromycin.
Per FDA-approved prescribing information. Contact your prescriber if side effects persist or worsen.
Normally lasts for:
10 minutes–2 hours
rare
Mild
Mild Rash
Per FDA-approved prescribing information, occasionally a light, itchy rash can appear. Contact your prescriber if a rash develops, as some skin reactions may require evaluation.
Per FDA-approved prescribing information. Contact your prescriber if side effects persist or worsen.
Normally lasts for:
24–72 hours
Contact Us for a Personalized Care Plan
Have questions about compounding? Contact Voshell's Pharmacy — we prepare patient-specific medications pursuant to valid prescriptions from your licensed prescriber.
What If You Forgot to Take Azithromycin Z-Pak
What If You Forgot to Take Azithromycin Z-Pak?
If you miss a dose, take it as soon as you remember. If it's already close to the time for your next scheduled dose, skip the missed one and simply return to your usual timing.
Do not double up to make up for a missed dose — that won't improve effectiveness and may increase stomach upset.
Per FDA-approved prescribing information, if you vomit within an hour of taking a dose, it is reasonable to repeat it.
If it has been longer than an hour, you can usually continue as planned.
When unsure, call your prescribing clinician or pharmacy for clarity.
What If You Took Too Much Azithromycin Z-Pak
If You Accidentally Took Too Much Azithromycin Z-Pak
If more than the prescribed amount was taken, contact Poison Control at 1-800-222-1222 right away or seek emergency medical care immediately.
- Do not take additional doses until you have spoken with Poison Control or your prescriber.
- Per FDA-approved prescribing information, azithromycin overdose may cause gastrointestinal symptoms or cardiac rhythm changes. If symptoms such as severe nausea, vomiting, or a racing heartbeat occur, call 911 or seek emergency medical care immediately.
- Keep this and all medications out of reach of children.
How Much Does Azithromycin Z-Pak Cost
How Much Does Azithromycin Z-Pak Cost With Insurance?
With many U.S. insurance plans, an azithromycin Z-Pak is usually affordable. Some plans set a standard tier-1 or tier-2 copay, so your cost may be similar to other common generics. Using a preferred pharmacy within your network may reduce your out-of-pocket cost.
Prices vary by pharmacy, dose, location, and insurance plan and may have changed since this page was written. Contact your pharmacy or insurance provider for current pricing.
How Much Does Azithromycin Z-Pak Cost without Insurance
Cost of Azithromycin Z-Pak Without Insurance
In most U.S. pharmacies, the cash price for an azithromycin 5-day Z-Pak varies. Some big-box or grocery store pharmacies may offer lower pricing, and using pharmacy discount cards or coupons often brings the cost down further, even without insurance.
Prices vary by pharmacy, dose, location, and insurance plan and may have changed since this page was written. Contact your pharmacy or insurance provider for current pricing.
