How Azithromycin (Z-Pak) for Bacterial Infections Makes You Feel - GoodRx (2024)

Getting sick with a bacterial infection like sinusitis, pneumonia, or strep throat is nobody’s idea of a good time. Yet, it’s an inevitable part of life for many of us at some point.

Fortunately, antibiotics like azithromycin (Zithromax) can stop certain bacteria from growing and spreading. Azithromycin is safe for most adults and children, and it’s typically taken by mouth once a day. You might have heard the term “Z-Pak,” which refers to a prepackaged dose of six 250 mg tablets taken over 5 days. People often appreciate the convenience and ease of this course of treatment.

Taking azithromycin is generally a safe and effective way to treat bacterial infections. Sometimes, however, the medication can lead to side effects such as diarrhea, nausea, and stomach pain, as well as dizziness, headaches, and rashes. In rare cases, azithromycin can cause dangerous changes to a person’s heart rhythm.

Below, three people describe what it’s like to take azithromycin for a bacterial infection.

A prescription brought ‘definite relief’

Amy Sandberg has taken azithromycin for bacterial infections, like sinusitis, many times. And in the process, she’s learned that it’s an effective way to feel better quickly.

Recently, for example, she got sick with a sinus infection after moving in heavy rain. “I thought I would never be healthy again,” says Amy, who is 34 and lives in Ventura, California.

But her doctor prescribed her a Z-Pak. And by the second day of treatment, she felt “definite relief” from annoying symptoms like coughing and a clogged nose. By the end of the 5-day course of medication, she was symptom-free.

“It works wonders,” she says. “It’s a miracle drug.”

Amy recommends avoiding alcohol while taking azithromycin. Otherwise, she says, you could get sick to your stomach or experience dizziness. And she suggests drinking lots of water and resting as much as possible during the recovery process.

“Even when you start to feel better, take it easy on your body,” she says. “Ease back into the gym or whatever your normal fitness or outdoor routine is.”

That way, she says, you’ll be more likely to stay healthy and not have a relapse of the symptoms that caused you to take azithromycin in the first place.

The case of the disappearing symptoms

Late in 2022, Aimee Stephens came down with strep throat. She had terrible throat and tonsil pain and inflammation, so she went to an urgent care clinic and was prescribed an antibiotic called cephalexin.

But the medication didn’t help her symptoms, so she went back to the clinic 2 days later. And the doctor sent her home with a Z-Pak.

Her symptoms were “gone the next day,” recalls Aimee, who is 46 and lives in Michigan. “It was really nice.”

Aimee had a similar experience when she was prescribed azithromycin for strep throat more than 10 years ago. The medication was so helpful that the episode stuck with her. “I remember it more than a decade later,” she says.

After taking azithromycin this time around, she felt even more energized than she did before she got sick. “I felt like I did in my early 20s,” Aimee says.

She felt like she finally had the energy to do all the projects and chores she’s usually too tired to complete. But, of course, she refrained from overdoing it, since she knew she was still recovering from strep throat.

Aimee did experience an occasional upset stomach while taking azithromycin this time. But she found that taking a probiotic at the same time was helpful. And even though her strep throat symptoms improved quickly, she made sure to complete the entire azithromycin course.

“Even though I was feeling better, I made sure to take all of them,” she says of the Z-Pak tablets. That way, she adds, she could be sure she was getting the medication’s full benefits and wouldn’t relapse.

A ‘go-to’ medication

For Donna Lubrano, the first sign of a sinus infection is her teeth hurting. The pain shoots up her jaw and into her eyes, and then her ears start pounding. She begins to feel terrible sinus pressure in her forehead and under her eyes. And sometimes, her vision becomes blurry.

“My face feels like it’s going to explode,” says Donna, who is 67 and lives in Boston.

Fortunately, her doctor knows exactly what she needs: a Z-Pak. She’s taken azithromycin for sinus infections multiple times over the years, and the medication has always been effective.

“It’s just so easy, and it works so fast,” she says.

Donna usually begins to notice an improvement in her symptoms after taking her second dose of azithromycin. The medication lessens her face pain, and her ears and teeth stop hurting at that point.

“It’s my doctor’s go-to for me,” she says.

While she’s taking azithromycin, Donna tries to eat well and have regular meals, so that she doesn’t get an upset stomach. But even an upset stomach is a minor inconvenience considering how well the medication works.

“For people who have chronic sinusitis, it’s a game-changer,” Donna says. “Within a day, I could be 100% better. It’s there to make you comfortable.”

What does the pharmacist say?

Joshua Murdock, PharmD, BCBBS

Pharmacy Editor

Azithromycin (Zithromax) is a popular antibiotic that’s available with a prescription from your healthcare provider. Most people take it as an oral tablet, but it also comes as an oral liquid, eye drop, and injection. This macrolide antibiotic can treat bacterial infections such as pneumonia, strep throat, chlamydia, and more.

You’ll likely only need to take azithromycin for a few days at a time. A prepackaged version of the medication, coined a “Z-Pak,” conveniently packages 6 tablets into a 5-day treatment course. You’ll take 2 tablets on the first day of treatment, followed by 1 tablet daily until you run out of pills. Alternatively, you may be instructed to take higher-dose tablets for just 1 to 3 days. The medication should help you feel better within a few days regardless of how you take it.

Azithromycin is effective for many people. But the side effects are sometimes a burden. Stomach-related symptoms — such as diarrhea, nausea, and stomach pain — are relatively common. But they should resolve after you finish taking the course of antibiotics.

There are some potential azithromycin interactions that can be problematic. So your pharmacist will review your history for medications that could pose an issue — like statins, heart medications, and antacids — before dispensing azithromycin to you. Make sure your pharmacist and healthcare provider have an updated list of the medications and supplements you take, so they can check for interactions.

Just like with other antibiotics, consistency is key when it comes to azithromycin. Make sure to keep taking it until the medication runs out — even if you’re feeling better. This will help ensure your infection is fully treated. It should also help prevent resistance to the antibiotic in the future.