Can you eat grapefruit when taking azithromycin?

In this article, we are going to answer the question if you can eat grapefruit when taking azithromycin, what is azithromycin, and how does grapefruit affect azithromycin. 

Can you eat grapefruit when taking azithromycin?

No, you can’t eat or drink grapefruit if you are taking azithromycin. It can affect the metabolism of the antibiotic, azithromycin for up to 72 hours. The effect can be worse if you take the medication with grapefruit juice or the fruit itself and up to 4 hours before you take your medication. 

Grapefruit has been known to cause a medication overdose with different antibiotics, drugs that treat hypertension, high cholesterol, and cancer. 

What is grapefruit?

Grapefruit is a citrus fruit that tastes bitter sweet to sour. Grapefruit is a hybrid that was created back in time, in Barbados, by an accidental cross between sweet orange and pomelo. 

It’s a very nutritious fruit with a lot of vitamins and minerals, especially Vitamin C. The interior is segmented and varies in color from pale yellow to dark pink. Raw grapefruit is about 90% water and 8% carbohydrates. 

1 cup, 230 g with juice

%DV bases in a 2,000 calories diet
CarbohydratesTotal Carbs 24.5 gDietary fiber 3.7 gSugars 15.8 g
Fats0.3 g
Protein 1.8 g 
Vitamin A2645 UI53%
Vitamin C71.8 mg120%
Folate29.9 g7%

Grapefruit contains about 50% more citric acid than orange juice. It is perfect for making grapefruit desserts, juice, and grapefruit jam. 

Even if grapefruit is a very nutritious fruit that has been shown to have antibacterial, antiviral, antimicrobial, and antifungal effects, it should not be taken with antibiotics. 

What is azithromycin?

Azithromycin is an antibiotic used to treat bacterial infections. Is a macrolide type antibiotic that works by killing the bacteria that cause the infection rather than the toxin. Usually, it is one pill (one dose) per day, the dosage depending on the treatment and your overall health. It’s usually used for:

  • Chest infections
  • Ear, nose, and throat infections
  • Skin infections
  • Lyme disease
  • And some sexually transmitted infections (STIs)

How does grapefruit affect azithromycin?

Enzymes of the stomach and intestines break down macrolide antibiotics, including azithromycin. Chemicals (bioflavonoids)  in grapefruit, naringenin, and furanocoumarins, block these enzymes and disrupt their function. This leads to a longer stay of the antibiotic in your body and levels in your bloodstream may become too high. 

The effect of the antibiotic increases leading to more chances of having side effects and overdose. So, if you are on this antibiotic and you love grapefruit you have two options: ask your doctor for another medication or stay away from grapefruit while you are on treatment. 

Some research showed that taking one pill of azithromycin with one glass of grapefruit juice is like taking 5 pills of azithromycin with water. 

Azithromycin has interactions with a long list of medications apart from azithromycin. Some of these medications are

  • Amiodarone
  • Artemether
  • Buspirone
  • Carbamazepine
  • Carvedilol
  • Celiprolol
  • Cisapride
  • Clomipramine
  • Clopidogrel
  • Cyclosporine
  • Dextromethorphan
  • Estrogens
  • Etoposide

If you need the whole list follow this link. 

What are the side effects of azithromycin?

Azithromycin has several side effects that can increase if you take it with grapefruit juice or grapefruit 

  • The feeling of being sick
  • Diarrhea
  • Headaches 
  • Changes to your sense of taste
  • Losing appetite
  • Feeling dizzy or tired

Here is a link with more side effects. 

How should you take azithromycin?

Azitromycin can be taken with or without food but it is better tolerated with food. It is recommended to not take aluminum or magnesium-containing antacids, such as tums, two hours before and two hours after you take the medication. 

Antacids have been shown to reduce Azithromycin effectiveness. 

Where can I find grapefruit?

First, as the fruit itself or as grapefruit juice. In a study, it was found that 23 drinks had grapefruit juice without having it written on its label. So, be careful with those citrus juices you take. 

If you really love grapefruit, you can substitute it with orange, tangerines, lemon, and berries which are also fruits high in vitamin C. 

Other FAQs about Grapefruit that you may be interested in.

Can you eat grapefruit when pregnant?

Can you eat grapefruit when on Zoloft?

Should grapefruit be refrigerated


In this article, we answered the question if you can eat grapefruit when taking azithromycin, what is azithromycin, and how does grapefruit affect azithromycin. 

If you have any questions, please ask me! 


Was this helpful?

Thanks for your feedback!