Based on FDA | Is it safe to drink coffee while taking azithromycin, or can caffeine affect its absorption or effectiveness?

You can generally drink coffee while taking azithromycin, and typical caffeine intake does not appear to meaningfully affect azithromycin’s absorption or effectiveness. Azithromycin can be taken with or without food, and official guidance does not list caffeine or coffee as a concern. ^{[1] [2]} Azithromycin’s key interaction warning is with aluminum- or magnesium‑containing antacids taken at the same time, which can lower peak levels; coffee does not contain these antacids. ^{[1] [3]}

Quick answer

• Coffee and caffeine are not known to reduce azithromycin’s effectiveness or cause a clinically relevant interaction. ^[2]
• You can take azithromycin with or without food, and there is no specific restriction on caffeinated beverages. ^{[1] [2]}
• Avoid taking azithromycin at the same time as aluminum- or magnesium‑based antacids, which can reduce peak blood levels; this does not apply to coffee. ^{[1] [3]}

What official guidance says

• Azithromycin tablets and oral suspension may be taken with or without food. ^[1]
• Patients should be cautioned not to take aluminum‑ or magnesium‑containing antacids at the same time as azithromycin. ^[1]
• No routine food or beverage restrictions (including coffee) are specified for azithromycin tablets. ^[2]

What studies show about absorption

• In healthy volunteers, taking azithromycin with an aluminum/magnesium antacid reduced the peak concentration (Cmax) by about 24%, although overall absorption (AUC) was not significantly changed. This effect is specific to antacids and not to coffee or caffeine. ^[3]
• Large meals can reduce absorption for some azithromycin dosage forms (capsules), but tablets do not show a clinically meaningful “food effect.” ^{[4] [5]}
• Coffee does not act like an antacid and is not shown to alter azithromycin’s Cmax or AUC. ^{[3] [4]}

Practical tips

• If you take azithromycin tablets or oral suspension, you may have your usual coffee. ^[2]
• Separate azithromycin from aluminum/magnesium antacids by several hours to avoid lowering peak levels; this is not necessary for coffee. ^{[1] [3]}
• If you experience stomach upset, taking azithromycin with a light snack is reasonable, and having coffee is typically fine as tolerated. ^[2]
• If caffeine makes you jittery or worsens nausea, you might choose to limit coffee temporarily, but this is for comfort rather than drug interaction. ^[2]

Summary table: azithromycin with common co‑intakes

Item	Interaction with azithromycin	Practical guidance
Coffee/caffeine	Not known to affect absorption or effectiveness	Safe to consume in usual amounts with azithromycin tablets/suspension. [2] [4]
Aluminum/magnesium antacids	Lowers peak levels (Cmax) when taken simultaneously	Do not take at the same time; separate by several hours. [1] [3]
Food (tablets)	No meaningful effect on absorption	May take with or without food. [2] [5]
Large meal (capsules)	Can reduce bioavailability (dosage-form dependent)	Follow product instructions; tablets are not affected. [5]

Bottom line

Coffee is generally safe with azithromycin, and caffeine does not appear to hinder its absorption or effectiveness. ^[2] Focus on avoiding simultaneous use with aluminum/magnesium antacids, which can lower peak levels. ^{[1] [3]}