Drug & supplement interaction

Honey + Azithromycin

Azithromycin brand names: Zithromax, Zmax, Azasite.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Honey and Azithromycin in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Honey and Azithromycin

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Azithromycin and Honey in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Honey safety at a glance

Honey overall Generally safe Generally safe as a food for adults and children over 1 year of age.
Pregnancy Likely Safe When consumed in food amounts. The concern about botulism pertains to children under 12 months of age and not to pregnant adults. There is insufficient reliable... Read the full pregnancy detail
Breastfeeding Likely Safe When consumed in food amounts. The concern about botulism pertains to children under 12 months of age and not to pregnant adults. There is insufficient reliable... Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Azithromycin and Honey? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Azithromycin

Interactions in our licensed database are recorded against drug classes, not just single drug names. Azithromycin is filed under 7 classifications — including macrolide antibiotics, qt interval-prolonging drugs, antibiotic drugs. Honey has documented interactions with 3 drug classes — the most serious being phenytoin (dilantin) (moderate), anticoagulant/antiplatelet drugs (minor) and cytochrome p450 3a4 (cyp3a4) substrates (minor) — and none of Azithromycin’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Honey Does Interact With Other Medications

Honey has 5 moderate, 731 minor known drug interactions in our database — Azithromycin isn’t one of them. If you take anything else, check it against the full list below.

Moderate 5 Minor 731 No known interaction 2,094 (incl. Azithromycin)
Taking anything else?

Check Another of Your Medications Against Honey

Covers the 2,830 medications we’ve checked against Honey. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Honey and Azithromycin May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 3 of them are worth acting on rather than waiting out — marked below.

  • An irregular heartbeat Worth acting on Additional detail

    Honey

    “Honey from the Black Sea coast of Turkey has been linked with a unique form of poisoning. Honey from this region sometimes contains excessive concentrations of grayanotoxins from rhododendrons, which can cause bradycardia, atrioventricular (AV) block, cardiac arrhythmias, myocardial infarction, and hypotension within a few minutes to several hours after consumption. Fatalities have not been reported.”

    Honey · Natural Medicines adverse-effect record, reported in arrhythmia.

    6 sources cited
    1. 12220. Ozhan H, Akdemir R, Yazici M, et al. Cardiac emergencies caused by honey ingestion: a single centre experience. Emerg Med J 2004;21:742-4. PubMed
    2. 55110. Gunduz, A., Turedi, S., Uzun, H., and Topbas, M. Mad honey poisoning. Am J Emerg.Med 2006;24(5):595-598.
    3. 55126. Akinci, S., Arslan, U., Karakurt, K., and Cengel, A. An unusual presentation of mad honey poisoning: acute myocardial infarction. Int J Cardiol 2008;129(2):e56-e58. PubMed
    4. 55129. Yildirim, N., Aydin, M., Cam, F., and Celik, O. Clinical presentation of non-ST-segment elevation myocardial infarction in the course of intoxication with mad honey. Am J Emerg Med 2008;26(1):108.e-2. PubMed
    5. 55238. Yarlioglues, M., Akpek, M., Ardic, I., Elcik, D., Sahin, O., and Kaya, M. G. Mad-honey sexual activity and acute inferior myocardial infarctions in a married couple. Tex.Heart Inst.J 2011;38(5):577-580.
    6. 55269. Biberoglu, S., Biberoglu, K., and Komsuoglu, B. Mad honey. JAMA 4-1-1988;259(13):1943.

    Azithromycin

    Listed in the ADVERSE REACTIONS section of the FDA label for Azithromycin. Read the label on DailyMed ›

  • A severe allergic reaction Worth acting on Additional detail

    Honey

    “Orally, honey can cause allergic reactions, including anaphylaxis (6,11,108531,108532). These reactions may be due to various components of the honey, including the honey itself, pollen, or bee secretions. When used topically, local allergic reactions have been reported in people with pre-existing atopy. Allergic contact dermatitis related to honey enriched with propolis has been reported.”

    Honey · Natural Medicines adverse-effect record, reported in atopic disease.

    6 sources cited
    1. 6. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
    2. 11. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
    3. 108531. Jhawar N, Gonzalez-Estrada A. Honey-induced anaphylaxis in an adult. QJM 2022;115(5):325-326. PubMed
    4. 108532. Di Costanzo M, De Paulis N, Peveri S, Montagni M, Berni Canani R, Biasucci G. Anaphylaxis caused by artisanal honey in a child: a case report. J Med Case Rep 2021;15(1):235. PubMed
    5. 91370. Vezir E, Kaya A, Toyran M, Azkur D, Dibek Misirlioglu E, Kocabas CN. Anaphylaxis/angioedema caused by honey ingestion. Allergy Asthma Proc. 2014 Jan-Feb;35(1):71-4. PubMed
    6. 16356. Simon A, Traynor K, Santos K, et al. Medical honey for wound care - still the 'latest resort'? Evid Based Complement Alternat Med 2009;6:165-73. PubMed

    Azithromycin

    Listed in the ADVERSE REACTIONS section of the FDA label for Azithromycin. Read the label on DailyMed ›

  • An allergic reaction Worth acting on reported in 5.0% of FDA reports for Azithromycin Additional detail

    Honey

    Recorded for Honey in the same Natural Medicines adverse-effect record shown under A severe allergic reaction above.

    Azithromycin

    Listed in the ADVERSE REACTIONS section of the FDA label for Azithromycin, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • Sweating / Dizziness Additional detail

    Honey

    “Orally, honey may cause nervousness, insomnia, and hyperactivity in children. Honey from the Black Sea coast of Turkey has been linked with a unique form of poisoning. Honey from this region sometimes contains excessive concentrations of grayanotoxins, which can cause dizziness, sweating, and weakness within a few minutes to several hours after consumption.”

    Honey · Natural Medicines adverse-effect record, reported in insomnia.

    6 sources cited
    1. 91366. Oduwole O, Meremikwu MM, Oyo-Ita A, Udoh EE. Honey for acute cough in children. Cochrane Database Syst Rev. 2014 Dec 23;12:CD007094. PubMed
    2. 97693. Oduwole O, Udoh EE, Oyo-Ita A, Meremikwu MM. Honey for acute cough in children. Cochrane Database Syst Rev. 2018;4:CD007094. PubMed
    3. 12220. Ozhan H, Akdemir R, Yazici M, et al. Cardiac emergencies caused by honey ingestion: a single centre experience. Emerg Med J 2004;21:742-4. PubMed
    4. 55110. Gunduz, A., Turedi, S., Uzun, H., and Topbas, M. Mad honey poisoning. Am J Emerg.Med 2006;24(5):595-598.
    5. 55119. Koca, I. and Koca, A. F. Poisoning by mad honey: a brief review. Food Chem Toxicol 2007;45(8):1315-1318. PubMed
    6. 55296. von Malottki, K. and Wiechmann, H. W. [Acute life-threatening bradycardia: food poisoning by Turkish wild honey]. Dtsch.Med.Wochenschr. 7-26-1996;121(30):936-938.

    Azithromycin

    Listed in the ADVERSE REACTIONS section of the FDA label for Azithromycin. Read the label on DailyMed ›

  • Low blood pressure Additional detail

    Honey

    Recorded for Honey in the same Natural Medicines adverse-effect record shown under An irregular heartbeat above.

    Azithromycin

    Listed in the ADVERSE REACTIONS section of the FDA label for Azithromycin. Read the label on DailyMed ›

  • Anxiety or restlessness / Trouble sleeping Additional detail

    Honey

    Recorded for Honey in the same Natural Medicines adverse-effect record shown under Sweating / Dizziness above.

    Azithromycin

    Listed in the ADVERSE REACTIONS section of the FDA label for Azithromycin. Read the label on DailyMed ›

  • Stomach pain Additional detail

    Honey

    Recorded for Honey in the same Natural Medicines adverse-effect record shown under An irregular heartbeat above.

    Azithromycin

    Listed in the ADVERSE REACTIONS section of the FDA label for Azithromycin. Read the label on DailyMed ›

  • Nausea reported in 5.8% of FDA reports for Azithromycin Additional detail

    Honey

    “Orally, honey may cause mild nausea, vomiting, and stomach ache. Honey from the Black Sea coast of Turkey has been linked with a unique form of poisoning. Honey from this region sometimes contains excessive concentrations of grayanotoxins. These toxins can cause increased salivation, nausea, and vomiting within a few minutes to several hours after consumption. Intranasally, honey may cause nausea.”

    Honey · Natural Medicines adverse-effect record, reported in nausea and vomiting.

    6 sources cited
    1. 12220. Ozhan H, Akdemir R, Yazici M, et al. Cardiac emergencies caused by honey ingestion: a single centre experience. Emerg Med J 2004;21:742-4. PubMed
    2. 55119. Koca, I. and Koca, A. F. Poisoning by mad honey: a brief review. Food Chem Toxicol 2007;45(8):1315-1318. PubMed
    3. 55190. Shrestha, P., Vaidya, R., and Sherpa, K. Mad honey poisoning: a rare case report of seven cases. Nepal Med Coll J 2009;11(3):212-213.
    4. 55294. Sutlupinar, N., Mat, A., and Satganoglu, Y. Poisoning by toxic honey in Turkey. Arch.Toxicol. 1993;67(2):148-150. PubMed
    5. 97693. Oduwole O, Udoh EE, Oyo-Ita A, Meremikwu MM. Honey for acute cough in children. Cochrane Database Syst Rev. 2018;4:CD007094. PubMed
    6. 55216. Thamboo, A., Thamboo, A., Philpott, C., Javer, A., and Clark, A. Single-blind study of manuka honey in allergic fungal rhinosinusitis. J Otolaryngol Head Neck Surg 2011;40(3):238-243.

    Azithromycin

    Listed in the ADVERSE REACTIONS section of the FDA label for Azithromycin, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

Showing the 10 most notable of 12 shared effects — ranked by how unusual each one is, not just whether both lists mention it.

Reported for Honey but not commonly for Azithromycin: a heart attack and a slow heartbeat.

Effects for Azithromycin come from the ADVERSE REACTIONS section of its FDA label; effects for Honey come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 59,712 voluntary FDA FAERS reports for Azithromycin that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Honey in Pregnancy & Breastfeeding

Pregnancy And Lactation Likely Safe

When consumed in food amounts. The concern about botulism pertains to children under 12 months of age and not to pregnant adults. There is insufficient reliable information available about the safety of honey when used for medicinal purposes when pregnant or breast-feeding.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

From our Q&A

Questions About Honey or Azithromycin

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Honey or Azithromycin, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Azithromycin

This page covers Honey only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Azithromycin page lists 92 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 8 major · 71 moderate · 13 minor.

From our pharmacist’s overview on the Azithromycin page

“A five-day Z-Pak for a sinus or chest infection seems too brief to fuss over, but azithromycin (Zithromax, Zmax) deserves genuine caution around supplements, and the eight major-rated entries on this list are the ones to understand first. Most of those involve the heart.”

Reviewed by 2 · Jul 18, 2026

Open the Azithromycin interaction page

One more smart check

Taking Honey as Part of a Dietary Supplement Product? Check It for Interactions

We hold 298 real supplement products containing Honey, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Honey. Even though Honey itself has no known interaction with Azithromycin, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Honey and Azithromycin Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Honey
Top 25%

#264 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Azithromycin
Top 5%

#60 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Honey reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Honey and Azithromycin records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Honey

What is Honey?

Honey
  • Cough and sore throat
  • Wound and burn care
  • Soothing minor skin irritation
  • Sweetener and home remedy
  • Digestive upset

Honey is a natural food with some real, modest evidence for easing coughs and helping certain wounds, especially when special medical-grade or Manuka honey is used. It is generally safe for most adults and children over 1 year, but should never be given to infants under 12 months because of the risk of botulism.

Honey produced by honeybees from flower nectar · Raw honey, processed honey, Manuka honey, medical-grade honey, lozenges, syrups, topical wound dressings

An interaction check asks whether these two react with each other — it does not ask whether Honey is a good idea for someone in your situation. Here is what our Honey record says about it on its own.

Honey: dosing

There is no official standardized dose for honey.

From our Honey monograph — the full record covers uses, side effects and every documented interaction.

Read the full Honey monograph & all interactions
Medication

About Azithromycin

What Is Azithromycin Used For?

Brand names: Zithromax, Zmax, Azasite

  • Azithromycin is used to treat certain bacterial infections, such as bronchitis; pneumonia; sexually transmitted diseases (STD); and infections of the ears, lungs, sinuses, skin, throat, and reproductive organs. Azithromycin also is used to treat or prevent disseminated Mycobacterium avium complex (MAC) infection [a type of lung infection that often affects people with human immunodeficiency virus (HIV)]. Azithromycin is in a class of medications called macrolide antibiotics. It works by stopping the growth of bacteria.

  • Antibiotics such as azithromycin will not work for colds, flu, or other viral infections. Using antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.

Most-Reported Side Effects for Azithromycin

From FAERS, the FDA’s public side-effect reporting system (59,712 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Dyspnea 4,651 reports
Nausea 3,461 reports
Pneumonia 3,225 reports
Cough 3,120 reports
Drug hypersensitivity 2,991 reports
See full Azithromycin drug information
Keep checking

Other Drugs & Honey

Browse every other medication we’ve checked against Honey — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
5Moderate
731Minor
2,093No known interaction
5 Moderate 731 Minor 2,093 No interaction
Moderate

5 interactions

Minor

731 interactions

Showing 60 of 731 minor interactions — see all 731 on the Honey page.

No interaction 2,093 drugs checked — show the list

We also checked Honey against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,093 medications checked with no known interaction — see the full Honey list.

See the full Honey interactions page
See every supplement checked against Azithromycin, ranked by severity
Evidence & sources

Honey References

The 40 references that drive our Honey monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  3. Bose B. Honey or sugar in treatment of infected wounds? Lancet 1982;1:963. PubMed
  4. Ozhan H, Akdemir R, Yazici M, et al. Cardiac emergencies caused by honey ingestion: a single centre experience. Emerg Med J 2004;21:742-4. PubMed
  5. Centers for Disease Control. Botulism in the Unites Sates, 1899-1996. Handbook for epidemiologists, clinicians, and laboratory workers, 1998. Available online: http://www.cdc.gov/ncidod/dbmd/diseaseinfo/botulism.PDF.
  6. Simon A, Traynor K, Santos K, et al. Medical honey for wound care - still the 'latest resort'? Evid Based Complement Alternat Med 2009;6:165-73. PubMed
  7. Gethin G, Cowman S. Case series of use of Manuka honey in leg ulceration. Int Wound J 2005;2:10-15. PubMed
  8. Ingle R, Levin J, Polinder K. Wound healing with honey - a randomised controlled trial. S Afr Med J 2006;96:831-5.
  9. Johnson DW, van Eps C, Mudge DW, et al. Randomized, controlled trial of topical exit-site application of honey (Medihoney) versus mupirocin for the prevention of catheter-associated infections in hemodialysis patients. J Am Soc Nephrol 2005;16:1456-62. PubMed
  10. Sukriti and Garg, S. K. Influence of honey on the pharmacokinetics of phenytoin in rabbits. Ind J Pharmacol 2002;34(147).
  11. Jung, A. and Ottosson, J. [Infantile botulism caused by honey]. Ugeskr Laeger 2001;163(2):169.
  12. Gunduz, A., Turedi, S., Uzun, H., and Topbas, M. Mad honey poisoning. Am J Emerg.Med 2006;24(5):595-598.
  13. van der Vorst, M. M., Jamal, W., Rotimi, V. O., and Moosa, A. Infant botulism due to consumption of contaminated commercially prepared honey. First report from the Arabian Gulf States. Med Princ.Pract. 2006;15(6):456-458. PubMed
  14. Tushar, T., Vinod, T., Rajan, S., Shashindran, C., and Adithan, C. Effect of honey on CYP3A4, CYP2D6 and CYP2C19 enzyme activity in healthy human volunteers. Basic Clin Pharmacol Toxicol 2007;100(4):269-272. PubMed
  15. Nilforoushzadeh, M. A., Jaffary, F., Moradi, S., Derakhshan, R., and Haftbaradaran, E. Effect of topical honey application along with intralesional injection of glucantime in the treatment of cutaneous leishmaniasis. BMC Complement Altern Med 2007;7:13. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Honey and Azithromycin Together: Common Questions

Is it safe to take Honey with Azithromycin?
We do not list a known interaction between Honey and Azithromycin. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Honey and Azithromycin have any of the same side effects?
Yes — our sources link each of them separately to 10 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
How was the Honey and Azithromycin combination checked?
Interactions in our licensed database are recorded against drug classes. Azithromycin is filed under 7 classifications, and Honey has documented interactions with 3 drug classes — none of Azithromycin's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Honey interact with any other medications?
Yes. Honey has 736 documented drug interactions in our database — Azithromycin is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Azithromycin interact with any supplements?
Yes. Azithromycin has documented interactions with 92 supplements in our database — Honey is not one of them. The Azithromycin interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Honey monograph Uses, safety profile, and every drug interaction in one place Azithromycin drug information The full plain-English guide to this medication Azithromycin supplement interactions Every supplement checked against Azithromycin, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 40 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Azithromycin and Honey?

Our pharmacists answer your medication & supplement questions — free.

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.