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Clarithromycin vs. Azithromycin

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Clarithromycin (previously known by its brand name Biaxin) and azithromycin (Zithromax) are both macrolide antibiotics used to treat various bacterial infections, such as pneumonia, sinus infections, and strep throat. However, they differ in several ways. Clarithromycin is available as an immediate-release tablet, extended-release tablet, and liquid, while azithromycin is available as tablets and liquid, often in a convenient Z-Pak. Clarithromycin is typically taken twice a day, whereas azithromycin is taken once daily, with treatment usually lasting 3 to 5 days. Clarithromycin can treat *Helicobacter pylori* infections, which azithromycin cannot, while azithromycin can treat certain sexually transmitted infections, which clarithromycin cannot. Both medications can cause side effects like diarrhea and stomach pain, but clarithromycin may also cause a metallic taste. Clarithromycin has more drug interactions, especially with statins like lovastatin and simvastatin, while azithromycin can interact with antiarrhythmics and statins, raising the risk of heart rhythm problems. Both medications are available as lower-cost generics.

Clarithromycin

 

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Azithromycin

(Zithromax)

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Summary for Clarithromycin

Prescription only

Clarithromycin (previously known by its brand name Biaxin) is an antibiotic that's used to treat a variety of bacterial infections in adults and children. It's available as a generic immediate-release tablet and solution taken twice per day and an extended-release tablet taken once per day. Side effects include a metallic or sour taste, nausea, vomiting, and diarrhea.

Indications for Clarithromycin

Pros and Cons for Clarithromycin

Pros

  • Treats many types of infections
  • Available as an extended-release tablet, immediate-release tablet, and a liquid
  • Available as a lower-cost generic

Cons

  • Can cause changes in taste, diarrhea, and stomach upset
  • Has many drug interactions
  • Not the best option if you have kidney problems
  • Not safe during pregnancy

Common Side Effects for Clarithromycin

Warnings for Clarithromycin

  • Severe allergic and skin reactions
  • Liver damage
  • Drug interactions
  • Heart rhythm problems (QT prolongation)
  • Possible higher risk of death from heart problems
  • Infectious diarrhea
  • Worsening of certain muscle problems (myasthenia gravis)

Summary for Azithromycin

Prescription only

Azithromycin (Zithromax) is a macrolide antibiotic. It's used to treat many types of infections in children and adults, including strep throat, sinus infection, and pneumonia. Azithromycin (Zithromax) is taken by mouth once daily. Typically, the length of treatment ranges from 3 to 5 days, depending on the type of infection you have. For convenience, azithromycin (Zithromax) also comes pre-packaged as Z-Pak. Some of the more common side effects of azithromycin (Zithromax) include diarrhea, stomach pain, and nausea.

Indications for Azithromycin

Adults

Azithromycin (Zithromax) can treat certain types of:

Children

Azithromycin (Zithromax) can treat certain types of:

  • Ear infections (ages 6 months and older)
  • Pneumonia (ages 6 months and older)
  • Strep throat (ages 2 years and older)
  • Tonsil infections (ages 2 years and older)

Pros and Cons for Azithromycin

Pros

  • Taken by mouth once daily
  • Treatment typically lasts only 3 to 5 days
  • Comes as a liquid; good option for people who've trouble swallowing tablets
  • Available as a lower-cost generic

Cons

  • Might not be the best choice for people with severe liver problems or certain heart problems
  • Can cause stomach-related side effects, like diarrhea and stomach pain
  • Some bugs might be resistant to azithromycin (Zithromax)

Common Side Effects for Azithromycin

Adults

  • Diarrhea (4-5%)
  • Nausea (3%)
  • Stomach pain (2-3%)

Children

  • Diarrhea (2-6%)
  • Vomiting (1-6%)
  • Stomach pain (1-3%)

Warnings for Azithromycin

  • Severe allergic and skin reactions
  • Liver damage
  • Heart rhythm problems (QT prolongation)
  • Possible higher risk of death from heart problems
  • Diarrhea from Clostridioides difficile infection
  • Worsening of certain muscle problems (myasthenia gravis)
  • Doesn't treat syphilis

Prices with our coupons for Clarithromycin vs. Azithromycin

Price Card Drug Icon
Clarithromycin28 tablets / 500mg
$24.30$69.04
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Price Card Drug Icon
Azithromycin1 z-pak / 6 tablets of 250mg
$9.38$35.99
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