Drug & supplement interaction

Wine + 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 Wine 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.

Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Wine 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 Wine 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.

Wine safety at a glance

Wine overall Use caution Wine contains alcohol, which can harm health and become habit-forming even in moderate amounts.
Pregnancy Likely Unsafe When used orally; alcohol is a teratogen. Use during pregnancy is associated with significant risk of spontaneous abortion, fetal alcohol syndrome, and developm... Read the full pregnancy detail
Breastfeeding Likely Unsafe When used orally. Alcohol is secreted in breast milk. Chronic use can cause abnormal psychomotor development and disrupt the infant's sleep-wake pattern. Alcoho... 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 Wine? 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. Wine has documented interactions with 37 drug classes — the most serious being aspirin (major), cisapride (propulsid) (major) and cns depressants (major) — 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

Wine Does Interact With Other Medications

Wine has 656 major, 270 moderate known drug interactions in our database — Azithromycin isn’t one of them. If you take anything else, check it against the full list below.

Major 656 Moderate 270 No known interaction 1,904 (incl. Azithromycin)
Taking anything else?

Check Another of Your Medications Against Wine

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

What to actually watch for

No Interaction Found — But Data Suggests Wine 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. 5 of them are worth acting on rather than waiting out — marked below.

  • Pancreatitis Worth acting on Additional detail

    Wine

    “Orally, wine can cause a variety of side effects which depend on the amount of alcohol ingested and can vary among individuals. Some common side effects include abdominal pain, diarrhea, indigestion, nausea, and vomiting.. Chronic alcohol use is also associated with pancreatitis.”

    Wine · Natural Medicines adverse-effect record, reported in diarrhea.

    5 sources cited
    1. 6843. Thun MJ, Peto R, Lopez AD, et al. Alcohol consumption and mortality among middle-aged and elderly US adults. N Engl J Med 1997;337:1705-14.
    2. 8972. Bosetti C, La Vecchia C, Negri E, Franceschi S. Wine and other types of alcoholic beverages and the risk of esophageal cancer. Eur J Clin Nutr 2000;54:918-20. PubMed
    3. 9004. Bosetti C, La Vecchia C, Negri E, Franceschi S. Wine and other types of alcoholic beverages and the risk of esophageal cancer. Eur J Clin Nutr 2000;54:918-20. PubMed
    4. 34013. Bode, C. and Bode, J. C. Alcohol's role in gastrointestinal tract disorders. Alcohol Health Res World 1997;21(1):76-83.
    5. 34031. Pehl, C., Wendl, B., and Pfeiffer, A. White wine and beer induce gastro-oesophageal reflux in patients with reflux disease. Aliment.Pharmacol Ther 6-1-2006;23(11):1581-1586. PubMed

    Azithromycin

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

  • An irregular heartbeat Worth acting on Additional detail

    Wine

    “Orally, chronic heavy alcohol ingestion of three or more drinks daily is associated with an increased risk of all-cause mortality, atrial fibrillation, cardiac myopathy, hypertension, ischemic stroke, and myocardial infarction (MI). Consumption of any amount of alcohol can increase the risk of hemorrhagic stroke.”

    Wine · Natural Medicines adverse-effect record, reported in atrial fibrillation.

    6 sources cited
    1. 2261. Pearson TA. Alcohol and heart disease. Circulation 1996;94:3023-5. PubMed
    2. 6843. Thun MJ, Peto R, Lopez AD, et al. Alcohol consumption and mortality among middle-aged and elderly US adults. N Engl J Med 1997;337:1705-14.
    3. 6892. Goldberg I, Mosca L, Piano MR, Fisher EA. AHA Science Advisory: Wine and your heart: a science advisory for healthcare professionals from the Nutrition Committee, Council on Epidemiology and Prevention, and Council on Cardiovascular Nursing of the America
    4. 8102. Thadhani R, Camargo CA, Stampfer MJ, et al. Prospective study of moderate alcohol consumption and risk of hypertension in young women. Arch Intern Med 2002;162:569-74. PubMed
    5. 9004. Bosetti C, La Vecchia C, Negri E, Franceschi S. Wine and other types of alcoholic beverages and the risk of esophageal cancer. Eur J Clin Nutr 2000;54:918-20. PubMed
    6. 33984. Seiler, C. [Alcohol, the heart and cardiovascular system]. Ther Umsch. 2000;57(4):200-204.

    Azithromycin

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

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

    Wine

    “People who are allergic to sulfites and/or yeast might react to wine. Wine is associated with triggering asthmatic reactions in people with a history of asthma, possibly due to salicylates and/or added sulfites contained in wines. A case report describes a 33-year-old female who developed allergic reactions ranging from mild symptoms to anaphylaxis after consumption of beer or wine.”

    Wine · Natural Medicines adverse-effect record, reported in allergic rhinitis (hay fever).

    2 sources cited
    1. 6174. Vally H, de Klerk N, Thompson PJ. Alcoholic drinks: important triggers for asthma. J Allergy Clin Immunol 2000;105:462-7. PubMed
    2. 107819. German-Sanchez A, Alonso-Llamazares A, Garcia-Gonzalez F, Matala-Ahmed B, Bartolome-Zavala B, Antepara-Ercoreca I. Allergy to beer and wine caused by Saccharomyces cerevisiae in a patient sensitized to fungi. J Investig Allergol Clin Immunol 2021. PubMed

    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 ›

  • Liver problems Worth acting on Additional detail

    Wine

    “Orally, chronic heavy alcohol ingestion (three or more drinks daily) can lead to cirrhosis and hepatotoxicity.”

    Wine · Natural Medicines adverse-effect record, reported in cirrhosis.

    2 sources cited
    1. 6843. Thun MJ, Peto R, Lopez AD, et al. Alcohol consumption and mortality among middle-aged and elderly US adults. N Engl J Med 1997;337:1705-14.
    2. 9004. Bosetti C, La Vecchia C, Negri E, Franceschi S. Wine and other types of alcoholic beverages and the risk of esophageal cancer. Eur J Clin Nutr 2000;54:918-20. PubMed

    Azithromycin

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

  • Drowsiness Additional detail

    Wine

    “Orally, wine can cause a variety of side effects which depend on the amount of alcohol ingested and can vary among individuals. Some common side effects include aggression, confusion, and emotional lability. Chronic heavy alcohol ingestion (three or more drinks daily) can lead to dementia, physical amnesia, and somnolence.”

    Wine · Natural Medicines adverse-effect record, reported in dementia.

    4 sources cited
    1. 6843. Thun MJ, Peto R, Lopez AD, et al. Alcohol consumption and mortality among middle-aged and elderly US adults. N Engl J Med 1997;337:1705-14.
    2. 9004. Bosetti C, La Vecchia C, Negri E, Franceschi S. Wine and other types of alcoholic beverages and the risk of esophageal cancer. Eur J Clin Nutr 2000;54:918-20. PubMed
    3. 34040. Bushman, B. J. and Cooper, H. M. Effects of alcohol on human aggression: an integrative research review. Psychol.Bull 1990;107(3):341-354.
    4. 8972. Bosetti C, La Vecchia C, Negri E, Franceschi S. Wine and other types of alcoholic beverages and the risk of esophageal cancer. Eur J Clin Nutr 2000;54:918-20. PubMed

    Azithromycin

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

  • Stomach upset / Stomach pain / Diarrhea / Nausea reported in 5.8% of FDA reports for Azithromycin Additional detail

    Wine

    Recorded for Wine in the same Natural Medicines adverse-effect record shown under Pancreatitis 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 ›

Showing the 10 most notable of 11 shared effects — ranked by how unusual each one is, not just whether both lists mention it.

Reported for Wine but not commonly for Azithromycin: a heart attack, dependence or withdrawal symptoms, mood changes or irritability and a stroke or mini-stroke.

Effects for Azithromycin come from the ADVERSE REACTIONS section of its FDA label; effects for Wine 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

Wine in Pregnancy & Breastfeeding

Pregnancy Likely Unsafe

When used orally; alcohol is a teratogen. Use during pregnancy is associated with significant risk of spontaneous abortion, fetal alcohol syndrome, and developmental and behavioral dysfunction in infants and children exposed to alcohol in utero; avoid using.

Lactation Likely Unsafe

When used orally. Alcohol is secreted in breast milk. Chronic use can cause abnormal psychomotor development and disrupt the infant's sleep-wake pattern. Alcohol also seems to reduce milk production; avoid using.

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

We hold 8 real supplement products containing Wine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Wine. Even though Wine 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 Wine 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 Wine
Top half

#619 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 Wine reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Wine and Azithromycin records this page draws on were last updated July 11, 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 Wine

What is Wine?

  • Social and relaxation use
  • Heart health (popular belief)
  • Antioxidant intake
  • Aiding digestion (traditional use)
  • Culinary flavoring

Wine is an alcoholic beverage made from fermented grapes and is not a true dietary supplement or medicine. Despite popular claims about heart benefits, the alcohol it contains carries real health risks, and no amount of drinking can be recommended to improve health. If you drink, do so in moderation, and avoid alcohol entirely during pregnancy or if you have certain medical conditions.

Fermented grapes (or other fruit) · Red wine, white wine, rosé, sparkling wine, fortified wine

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

Wine: dosing

There is no medicinal or supplement "dose" for wine, and no amount is recommended to improve health. If a person chooses to drink, public health guidelines generally define moderate drinking as up to one standard drink per day for women and up to two for men, with a standard drink being about 5 ounces of wine.Less is always better when it comes to alcohol, and not drinking at all is the safest choice.

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

Read the full Wine 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 & Wine

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

656Major
270Moderate
0Minor
1,903No known interaction
656 Major 270 Moderate 1,903 No interaction
Major

656 interactions

Showing 60 of 656 major interactions — see all 656 on the Wine page.

Moderate

270 interactions

Showing 60 of 270 moderate interactions — see all 270 on the Wine page.

No interaction 1,903 drugs checked — show the list

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

Showing the 60 most looked-up of 1,903 medications checked with no known interaction — see the full Wine list.

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

Wine References

The 73 references that drive our Wine 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. Burnham TH, ed. Drug Facts and Comparisons, Updated Monthly. Facts and Comparisons, St. Louis, MO.
  2. Hart CL, Smith GD, Hole DJ, Hawthorne VM. Alcohol consumption and mortality from all causes, coronary heart disease, and stroke: results from a prospective cohort study of Scottish men with 21 years of follow up. BMJ 1999;318:1725-9. PubMed
  3. Offman EM, Freeman DJ, Dresser GK, et al. Cisapride interaction with grapefruit juice and red wine. Clin Pharmacol Ther 2000;67:110 (abstract PI-83).
  4. Tsunoda SM, Christians U, Velez RL, et al. Red wine (RW) effects on cyclosporine (CyA) metabolites. Clin Pharmacol Ther 2000;67:150 (abstract PIII-35).
  5. Tsunoda SM, Harris RZ, Velez RL, et al. Red wine (RW) effects on cyclosporine (CyA) Pharmacokinetics. Clin Pharmacol Ther 1998;65:159 (abstract PII-51). DOI
  6. Pearson TA. Alcohol and heart disease. Circulation 1996;94:3023-5. PubMed
  7. Fraser AG. Pharmacokinetic interactions between alcohol and other drugs. Clin Pharmacokinet 1997;33:79-90. PubMed
  8. Stampfer MJ, Colditz GA, Willett WC, et al. A prospective study of moderate alcohol consumption and the risk of coronary disease and stroke in women. N Engl J Med 1988;319:267-73. PubMed
  9. Vally H, de Klerk N, Thompson PJ. Alcoholic drinks: important triggers for asthma. J Allergy Clin Immunol 2000;105:462-7. PubMed
  10. Thun MJ, Peto R, Lopez AD, et al. Alcohol consumption and mortality among middle-aged and elderly US adults. N Engl J Med 1997;337:1705-14.
  11. Goldberg I, Mosca L, Piano MR, Fisher EA. AHA Science Advisory: Wine and your heart: a science advisory for healthcare professionals from the Nutrition Committee, Council on Epidemiology and Prevention, and Council on Cardiovascular Nursing of the America
  12. Michaud DS, Giovannucci E, Willett WC, et al. Coffee and alcohol consumption and risk of pancreatic cancer in two prospective United States cohorts. Cancer Epidemiol Biomarkers Prev 2001;10:429-37.
  13. Dufour MC. If you drink alcoholic beverages do so in moderation: what does this mean? J Nutr 2001;131:552S-61S. PubMed
  14. Thadhani R, Camargo CA, Stampfer MJ, et al. Prospective study of moderate alcohol consumption and risk of hypertension in young women. Arch Intern Med 2002;162:569-74. PubMed
  15. Mukamal KJ, Longstreth WT, Mittleman MA. Alcohol consumption and subclinical findings on magnetic resonance imaging of the brain in older adults: the cardiovascular health study. Stroke 2001;32:1939-46. 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 Wine and Azithromycin Together: Common Questions

Is it safe to take Wine with Azithromycin?
We do not list a known interaction between Wine 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 Wine 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 Wine and Azithromycin combination checked?
Interactions in our licensed database are recorded against drug classes. Azithromycin is filed under 7 classifications, and Wine has documented interactions with 37 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 Wine interact with any other medications?
Yes. Wine has 926 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 — Wine 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

Wine 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 73 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Azithromycin and Wine?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.