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Key takeaways
People can combine azithromycin and ibuprofen without any real risk of additional side effects beyond those typically associated with each medication.
Taking azithromycin and ibuprofen can be helpful for patients dealing with bacterial infections by addressing various symptoms.
Both ibuprofen and azithromycin can interact with several other medications and conditions, so talking to a healthcare provider before taking either is crucial.
Azithromycin, known as Zithromax, is a prescription antibiotic and treatment option for common bacterial infections, such as sinus infections, pneumonia, and some sexually transmitted diseases.
Ibuprofen, known by the brand names Advil and Motrin, is an over-the-counter (OTC) nonsteroidal anti-inflammatory drug (NSAID) that can help with pain relief. Both ibuprofen and azithromycin have been approved by the U.S. Food and Drug Administration (FDA). Generally speaking, the two medications can be taken together if needed.
Can you take ibuprofen with azithromycin?
Experts offer a comforting answer to whether these two medications can be combined: “Generally, yes, azithromycin and ibuprofen are safe to be taken together, regardless of condition, at regularly prescribed doses,” says Dr. Brandon Hawkins, PharmD, BCIDP, AAHIVP, a pharmacist at the University of Tennessee’s Health Science Center.
Beyond having no reported risks, he continues, this mix can actually be beneficial since it treats different symptoms of the same condition. “Azithromycin is often used as an antibiotic to treat bacterial infections,” says Dr. Christina Madison, PharmD, FCCP, AAHIVP founder and CEO of The Public Health Pharmacist, PLLC. “Ibuprofen may be recommended to treat the fever that is typically seen with bacterial infections.”
However, not all antibiotics or medications can be safely taken with ibuprofen. Those that affect the stomach, such as doxycycline and prednisone, can interact with ibuprofen. Certain antibiotics and ibuprofen both cause a risk of bleeding, so taking them together increases bleeding risks.
Additionally, amoxicillin and ibuprofen can cause gastrointestinal side effects. Taking both of these medications together can be particularly unsafe for people with a heart condition, kidney condition, or liver condition.
As with any medication change, talk to a healthcare provider first. Many antibiotics exist, and they affect each user differently.
When consulting with a medical professional, patients are encouraged to let them know if they take any of the following medications before starting azithromycin since they can cause drug interactions: antacids, ergotamine or dihydroergotamine, warfarin, ciclosporin or tacrolimus, colchicine, digoxin, rifabutin, nelfinavir, or a statin medicine. Also, amiodarone or sotalol, citalopram, antipsychotics, domperidone, moxifloxacin, and others that can increase heart rate or cause an irregular heartbeat shouldn’t be taken with azithromycin.
Lastly, while on azithromycin, limit or avoid drinking alcohol. Magnesium supplements (if taken) should be ingested one to two hours apart from the antibiotic.
What happens if you take azithromycin and ibuprofen together?
Taking certain medications together sometimes affects the efficacy of one or both of them. Thankfully, that’s not the case here. “Ibuprofen will not impact the effectiveness of azithromycin,” Dr. Hawkins says.
Dr. Madison agrees that the effectiveness won’t be reduced, adding, “Unless the person experiences nausea and vomiting associated with taking ibuprofen.” However, serious side effects can be prevented. “This can be mediated by taking medication with food to prevent the gastrointestinal side effects,” Dr. Madison continues.
Dr. Hawkins says that there are no expected side effects or precautions to take before consuming both medications. However, each medication has its own side effects.
More common side effects of azithromycin include diarrhea or loose stools, while less common effects include blistering, irritation, dry skin, fever, and swelling.
Side effects of the OTC medication ibuprofen include abdominal pain, burping, bloating, decreased urine output, indigestion, itchy skin, shortness of breath, and more.
According to Dr. Hawkins, while there are no conditions in which an individual should avoid taking azithromycin with ibuprofen, there are conditions in which individuals should carefully consider each medication separately.
For azithromycin, he says caution is needed for people who have had a previous allergic reaction to other macrolide antibiotics, such as clarithromycin or erythromycin, and for
those who are taking certain cholesterol medications, such as lovastatin or simvastatin, or medications that modify the heartbeat, such as, but not limited to, amiodarone, flecainide, mexiletine, sotalol, and dofetilide.
For ibuprofen, caution is needed in people with a previous allergic reaction to aspirin or other NSAIDs, reduced kidney function or chronic renal disease, heart failure, and aspirin-sensitive asthma. Those taking blood thinners, angiotensin-converting enzyme (ACE) inhibitors, such as lisinopril or benazepril, and angiotensin receptor blockers (ARBs), such as losartan or valsartan, should also practice caution.
Some substances are also contraindicated with ibuprofen. “There is a serious interaction with ibuprofen and alcohol, which can cause a gastrointestinal bleed,” Dr. Madison says. “It is also not recommended to smoke cigarettes or take ibuprofen while pregnant.”
As always, a patient’s best bet is to get medical advice from a healthcare provider about what will be safe and most effective for their body. If you or someone else experiences serious, scary, or life-threatening side effects, contact a provider or the local emergency room immediately.
How long should I wait to take ibuprofen after taking azithromycin?
According to the pharmacists, there’s no need to worry about dosing modification with these two agents.
Dr. Hawkins shares a general regimen for each. When a healthcare professional prescribes azithromycin to treat bacterial pneumonia, the patient may take 500 mg by mouth on day one, followed by 250 mg once daily for four days. He says this is known as a “Z-Pak” or Zmax.
A common dosing regimen for ibuprofen, he says, would be 200 mg to 400 mg by mouth every four to six hours, not exceeding a daily dose of 1200 mg. “Ibuprofen should not be used for greater than 10 days unless directed by a healthcare provider,” he adds.
Dr. Madison adds, “Both medications should be taken as directed by their healthcare professional.”
Is it safe to mix azithromycin and ibuprofen?
Generally speaking, yes, it is safe to mix azithromycin and ibuprofen. It can be helpful. “Taking ibuprofen with azithromycin will not enhance its antibacterial effect, but it may help the patient ‘feel better’ (to some degree) in the interim,” Dr. Hawkins says.
According to Dr. Madison, the main risk to be aware of is mixing the two medications when pregnant. NSAIDs such as ibuprofen aren’t recommended for pregnant patients since there’s an increased risk of harming the fetus. Breastfeeding patients can generally take ibuprofen or acetaminophen, though, since there are no known effects.
Dr. Madison also encourages taking these medications with food to prevent possible GI side effects.
Ibuprofen and azithromycin can be purchased at a lower price using a SingleCare prescription discount card.
Sources
- Taking or using ibuprofen with other medicines and herbal supplements, NHS (2021)
- Taking azithromycin with other medicines and herbal supplements, NHS (2022)
- Azithromycin (oral route), Mayo Clinic (2024)
- Ibuprofen (oral route), Mayo Clinic (2024)
