Z-Pak Side Effects

Generic name: azithromycin

Medically reviewed by Drugs.com. Last updated on Aug 27, 2023.

Note: This document provides detailed information about Z-Pak.

For Healthcare Professionals

Applies to azithromycin: intravenous powder for injection, oral capsule, oral powder for reconstitution, oral powder for reconstitution extended release, oral tablet Side Effects associated with azithromycin. Some dosage forms listed on this page may not apply specifically to the brand name Z-Pak.

For Healthcare Professionals

Applies to azithromycin: intravenous powder for injection, oral capsule, oral powder for reconstitution, oral powder for reconstitution extended release, oral tablet.

General

The most commonly reported side effects were diarrhea/loose stools, nausea, abdominal pain, and vomiting.^[Ref]

Cardiovascular

• Uncommon (0.1% to 1%): Palpitations, chest pain
• Postmarketing reports: Torsades de pointes, arrhythmia (including ventricular tachycardia), ECG QT prolonged, hypotension, cardiovascular death

Dermatologic

• Common (1% to 10%): Rash, pruritus
• Uncommon (0.1% to 1%): Angioedema, photosensitivity reaction, Stevens-Johnson syndrome, urticaria, dermatitis, dry skin, hyperhidrosis/sweating
• Rare (0.01% to 0.1%): Acute generalized exanthematous pustulosis, drug reaction with eosinophilia and systemic symptoms (DRESS)
• Frequency not reported: Eczema, fungal dermatitis, vesiculobullous rash
• Postmarketing reports: Toxic epidermal necrolysis, erythema multiforme, serious skin reactions

Gastrointestinal

• Very common (10% or more): Diarrhea (up to 52.8%), nausea (up to 32.6%), abdominal pain (up to 32.2%), loose stools (up to 19.1%), vomiting (up to 13%), flatulence (up to 10.7%), abdominal discomfort
• Common (1% to 10%): Dyspepsia, stomatitis
• Uncommon (0.1% to 1%): Gastritis, gastroenteritis, oral candidiasis/moniliasis, constipation, dysphagia, abdominal distension, dry mouth, eructation, mouth ulceration, salivary hypersecretion
• Frequency not reported: Clostridioides difficile-associated diarrhea, melena, infantile hypertrophic pyloric stenosis, mucositis, enteritis
• Postmarketing reports: Pyloric stenosis, pseudomembranous colitis, pancreatitis, tongue discoloration

Genitourinary

• Common (1% to 10%): Vaginitis/vaginal infection
• Uncommon (0.1% to 1%): Dysuria, metrorrhagia, testicular disorder

Hematologic

• Very common (10% or more): Decreased neutrophils (up to 29%)
• Common (1% to 10%): Decreased lymphocyte count, decreased hematocrit, decreased hemoglobin, increased eosinophil count, increased platelet count, increased lymphocytes, increased basophils, increased monocytes, increased neutrophils
• Uncommon (0.1% to 1%): Leukopenia, neutropenia, eosinophilia
• Frequency not reported: Decreased white cell count, decreased platelet count, anemia
• Postmarketing reports: Thrombocytopenia, hemolytic anemia

Hepatic

• Common (1% to 10%): Increased AST, increased ALT, increased GGT, increased blood bilirubin
• Uncommon (0.1% to 1%): Hepatitis, abnormal liver function tests
• Rare (0.01% to 0.1%): Abnormal hepatic function, cholestatic jaundice
• Frequency not reported: Liver enzyme abnormalities, increased transaminase levels, jaundice
• Postmarketing reports: Hepatic failure, fulminant hepatitis, hepatic necrosis

Hepatic failure has rarely resulted in death.

Hypersensitivity

• Uncommon (0.1% to 1%): Hypersensitivity
• Postmarketing reports: Anaphylactic reaction/anaphylaxis (e.g., anaphylactic shock), allergic reactions

Severe (rarely fatal) anaphylactic reaction has been reported.

Local

• Common (1% to 10%): IV site pain, injection site inflammation (with IV administration), IV site disorders (infection/inflammation/edema/pain reactions), local inflammation, infusion site reaction
• Frequency not reported: Local inflammation at infusion site

Metabolic

• Common (1% to 10%): Decreased blood bicarbonate, anorexia, decreased blood glucose, increased blood glucose
• Uncommon (0.1% to 1%): Increased bicarbonate
• Postmarketing reports: Dehydration

Musculoskeletal

• Common (1% to 10%): Arthralgia, increased creatine phosphokinase
• Uncommon (0.1% to 1%): Osteoarthritis, myalgia, back pain, neck pain

Nervous system

• Common (1% to 10%): Headache, dizziness, paresthesia, dysgeusia
• Uncommon (0.1% to 1%): Somnolence, hypesthesia, tinnitus, vertigo
• Frequency not reported: Hyperkinesia
• Postmarketing reports: Syncope, convulsion, psychomotor hyperactivity, anosmia, ageusia, parosmia, myasthenia gravis, hyperactivity

Ocular

• Common (1% to 10%): Visual impairment, abnormal vision
• Frequency not reported: Conjunctivitis, blurred vision

Other

• Very common (10% or more): Increased blood alkaline phosphatase (up to 20%)
• Common (1% to 10%): Deafness, fatigue, increased potassium, increased lactate dehydrogenase, reversible hearing impairment
• Uncommon (0.1% to 1%): Candidiasis/moniliasis, ear disorder, asthenia, malaise, chest pain, edema, hearing impaired, abnormal blood potassium, fungal infection, bacterial infection, hot flush, face edema, pyrexia/fever, pain, peripheral edema, increased chloride, abnormal sodium, postprocedural complications
• Frequency not reported: Increased phosphate, decreased sodium, decreased potassium
• Postmarketing reports: Hearing disturbances (including hearing loss, deafness, tinnitus)

Psychiatric

• Uncommon (0.1% to 1%): Nervousness, insomnia
• Rare (0.01% to 0.1%): Agitation, depersonalization
• Frequency not reported: Delirium, hallucination
• Postmarketing reports: Aggression/aggressive reaction, anxiety

Renal

• Common (1% to 10%): Increased blood urea/BUN, increased blood creatinine
• Uncommon (0.1% to 1%): Renal pain
• Frequency not reported: Nephritis, renal function abnormality
• Postmarketing reports: Acute renal failure, interstitial nephritis

Respiratory

• Common (1% to 10%): Dyspnea
• Uncommon (0.1% to 1%): Pneumonia, pharyngitis, rhinitis, respiratory disorder, epistaxis
• Frequency not reported: Bronchospasm, cough, pleural effusion

Frequently asked questions

• What are the best antibiotics for a tooth infection?
• What antibiotics kill Covid-19 (coronavirus)?
• What is the best antibiotic to treat strep throat?
• How long does azithromycin stay in your system?
• Does azithromycin cure chlamydia: How much / how long?
• What are the best antibiotics for pneumonia?
• What antibiotics are used to treat chlamydia and gonorrhea?
• Can you drink alcohol with Z-Pak (Azithromycin)?
• Was azithromycin in my system long enough to treat chlamydia after throwing up?

Further information

Z-Pak side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer