You generally can drink small amounts of alcohol with azithromycin, but it is safer to avoid alcohol until you finish the course and feel well again. Alcohol does not usually cause a dangerous direct interaction with azithromycin, but it can worsen side effects and slow recovery.
Safety and interactions
Azithromycin does not appear to have a strong, specific chemical interaction with alcohol in most people, and major guidelines note that drinking is technically allowed. However, both alcohol and azithromycin can affect the liver and the gut, so combining them may increase the chance of problems.
Side effects and feeling worse
Azithromycin commonly causes nausea, stomach upset, diarrhea, headache, dizziness, and fatigue. Alcohol can intensify these same symptoms, making you feel more unwell and increasing the risk of dehydration and poor sleep, which can delay recovery from your infection.
Practical advice
- If you feel dizzy, sick, or very tired on azithromycin, avoid alcohol entirely because it can make those symptoms worse.
- If you choose to drink, keep it strictly moderate (no more than 1–2 standard drinks) and stop if you feel any worsening symptoms.
- Many clinicians advise waiting at least a few days after your last dose (often about 72 hours) before drinking, especially if you were quite ill or have any liver issues.
When to seek medical help
Avoid alcohol and contact a doctor urgently if you develop yellowing of the skin or eyes, dark urine, severe abdominal pain, or persistent vomiting, as these can be signs of liver or serious drug side effects. People with liver disease, heavy alcohol use, heart rhythm problems, or many other medications should get personalized advice from their own clinician before drinking on azithromycin.