Azithromycin medication against a pink background

Can You Buy Azithromycin Over The Counter?

Written on September 13, 2023 by Sendra Yang, PharmD, MBA. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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When you’re sick, and it doesn’t go away, you probably go to see a healthcare provider. If they determine that you have an infection caused by a bacteria, your healthcare provider will prescribe you an antibiotic.[1] Antibiotics are medicines used to fight infections only caused by bacteria by killing it (bactericidal) or limiting its growth (bacteriostatic).[2] Bacteria are germs or microbes that live everywhere in the environment, including inside and outside the human body. There are harmless bacteria and those that cause infections, such as strep throat or urinary tract infections.

Different classes of antibiotics are available.[2] One of the most common antimicrobial drugs in the United States is azithromycin.[3] If you are wondering if you can buy azithromycin over the counter, continue reading to find out more about azithromycin and where you can get it.

What Is Azithromycin?

Azithromycin belongs to a class of antibiotics called macrolides.[3] The brand name for azithromycin is Zithromax®.[4] It is available in an oral formulation, intravenous administration, and as an eye drop solution.[3] Azithromycin is considered a broad-spectrum antimicrobial because it has activity against a wide range of bacteria.[2,3] Some of the microorganisms that azithromycin covers include[3,4]:

  • Haemophilus influenzae
  • Moraxella catarrhalis
  • Streptococcus pneumoniae
  • Mycoplasma pneumoniae
  • Streptococcus pyogenes
  • Staphylococcus aureus
  • Chlamydia trachomatis
  • Neisseria gonorrhoeae

The U.S. Food and Drug Administration (FDA) has approved azithromycin for the treatment of conditions such as[3,4]:

  • Community-acquired pneumonia
  • Upper respiratory infections, including acute ear infections, exacerbations of chronic obstructive pulmonary disease (COPD), pharyngitis, acute bacterial sinusitis
  • Skin infections that are uncomplicated
  • Inflammation of the urethra or cervix

Your healthcare provider will determine if azithromycin is appropriate for you based on the indication and the specific microbe causing the illness, combined with your medical history and individual situation.[3,4]

Private STD consultations

How Azithromycin Works

Azithromycin works by interfering with bacteria protein synthesis. Mechanistically, in more scientific terms, azithromycin binds to a specific bacterial ribosomal subunit to inhibit the translation of messenger RNA, which is critical for protein synthesis.[3,4] Azithromycin primarily inhibits bacterial growth, but at higher doses, it can have bactericidal properties for certain microbes.[3]

Where You Can Get Azithromycin

So, can you buy azithromycin over the counter? The answer is no. Currently, in the U.S., azithromycin is only available with a prescription. The prescription must be issued from a licensed healthcare provider with prescriptive authority or, in other words, allowed to prescribe medications.[3,4] There are various ways you can access a healthcare provider and speak to them about getting a prescription for azithromycin. You can visit your healthcare provider in person or use telehealth to virtually meet with a certified clinician to discuss getting a prescription.

Azithromycin Safety Information

Commonly reported side effects with azithromycin are gastrointestinal, such as nausea, diarrhea, abdominal pain, and vomiting.[3,4] Other side effects may include fatigue, headache, chest pain, rash, and photosensitivity.[4] Allergic reactions and severe hypersensitivity reactions can also occur with azithromycin use. Azithromycin, similar to other macrolides, can cause issues with the heart, causing QTc prolongation or tachycardic conditions. Azithromycin should not be used in patients with a history of liver dysfunction associated with previous use of the drug.[4] Azithromycin use should also be avoided with certain medications, such as some antipsychotic drugs.[3,4] The macrolide antibiotics are also associated with Clostridioides difficile infection, which causes severe watery diarrhea and blood stools.[3,4]

Tips On Taking Azithromycin

Here are some tips on taking azithromycin to help ensure you are taking the medication correctly and decrease antibiotic resistance[4]:

  1. Azithromycin can be taken with or without food
  2. Do not take antacids that contain aluminum or magnesium at the same time as azithromycin
  3. Stop azithromycin use immediately and contact your healthcare provider if you experience any signs of an allergic reaction
  4. Take azithromycin exactly as directed by your healthcare provider
  5. Do not skip doses or not complete taking the medication as per your healthcare provider’s instructions
  6. Contact your healthcare providers if you experience watery and bloody stools, even if it’s been two or more months after taking the antibiotic

Next Steps With Everlywell

Everlywell offers a telehealth option for online STD treatment. You can connect virtually with a certified clinician to help address your symptoms all from the comfort of your own home. The healthcare provider will ask questions to learn about your medical history, symptoms, health concerns, and goals. You can get access to a personalized care plan, which may include testing, prescriptions, and lifestyle recommendations. A Virtual Care Visit is a starting point to assist you in understanding your symptoms, speaking with an expert, and developing a care plan with the next steps. The latest industry-leading technology is used to ensure your personal information remains safe and confidential.

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  1. Patel P, Wermuth HR, Calhoun C, et al. Antibiotics. [Updated 2023 May 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Available from:
  2. Antibiotic use questions and answers. Centers for Disease Control and Prevention. October 6, 2021. Accessed August 23, 2023.
  3. Sandman Z, Iqbal OA. Azithromycin. [Updated 2023 Jan 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Available from:
  4. DailyMed - ZITHROMAX- azithromycin dihydrate tablet, film coated ZITHROMAX- azithromycin dihydrate powder, for suspension. U.S. National Library of Medicine. Accessed August 23, 2023.
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