Medically Reviewed by HaVy Ngo, Pharm.D.

Last Reviewed: Jun 10, 2022


Follow all directions on the prescription label, and take azithromycin directly as prescribed by your doctor. Do not increase or decrease the dose unless directed by your doctor since the dosing and length of therapy are different for each type of infection. Taking azithromycin around the same time every day will help you remember to take the medication.

Food or without food? 

  • The tablets and oral suspension (Zithromax) can be taken with or without food. However, if you experience nausea, vomiting, or stomach pain/upset, you can take this medication with food or snacks to alleviate this side effect.
  • The extended-release suspension (Zmax) should be taken on an empty stomach, about 1 hour before or at least 2 hours after a meal.

How to use an immediate-release azithromycin powder for suspension (Zithromax) in a single 1-gram packet? Mix the powder with 2 ounces (60 mL) of water. Stir the mixture well and drink all of the content right away. Add an additional 2 ounces (60 mL) of water to the same glass, mix and drink it to make sure that you receive the entire dose. Any immediate-release oral suspension that has not been used within 10 days should be discarded. 

How to use an extended-release azithromycin powder for suspension (Zithromax)? Open the bottle, then add 2 ounces (60 mL) of water to the bottle. Close the bottle tightly and shake well to mix the content. After 12 hours of adding water to the powder, any remaining content that has not been used within 12 hours should be discarded. 

For both immediate-release and extended-release oral suspension: shake the liquid well before measuring a dose. To get the most accurate dosing, use the dosing syringe, dose-measuring spoon, or medicine cup. These dosing devices are available at most pharmacies, and you can ask your pharmacist if you don’t have one. 

Do not take antacids that contain aluminum or magnesium within 2 hours before or after taking azithromycin. These antacids can make azithromycin less effective when taken together. These antacids are over-the-counter (OTC) products at most pharmacies. Examples of these antacids are Rolaids, Mylanta, MinTox, Milk of Magnesia, Maalox, Aldroxicon, Maldroxal, Genaton. Different pharmacies carry different OTC products--you can seek medical advice from your pharmacist if you have other questions regarding these interactions. 

Finish the whole course of antibiotics as prescribed by your doctor even if your symptoms start to improve. Do not stop taking this medication unless you experience severe adverse effects, and in that case, you should inform your doctor immediately. Skipping doses of antibiotics can increase your risk of developing antibiotic-resistant infections. 

How should I take azithromycin?

Missed dose: Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Storage: Keep the medication in the original container; keep it tightly closed, out of reach of children, pets, and other people. Just like any other medications that are dispensed only with prescriptions, this medication should not be shared with anyone. Azithromycin tablets, immediate-release suspension, and extended-release suspension should be stored at room temperature, away from heat and moisture. A lot of consumers store their medications in the bathroom; this is not a recommended place to store medication due to moisture and heat. Extended-release suspension should not be stored in the refrigerator or freezer. 

Unused medications: Similar to other prescription medications, do not consume azithromycin after the expiration date. This medication is a prescription drug that is intended for your use only. Unneeded medication should be disposed appropriately so that children, pets, and other people cannot get to it. Your local pharmacy can provide information about medication drug take-back programs. You can also learn more about proper medication disposal.


NOTEThis sheet is a summary and may not contain all possible information. If you have questions about lisinopril, talk to your doctor, pharmacist, or health care provider.


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