Compare Azithromycin vs. Flagyl

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

Zithromax
(azithromycin)

Flagyl
(metronidazole)

Kills bacteria. Zithromax (Azithromycin) is good for treating many bacterial infections. It is also available as generic. Talk to your doctor if you've ever had liver disease, myasthenia gravis, or on medications to thin the blood, as the doctor may write an alternative.Treats and prevents bacterial infections. Flagyl (metronidazole) is very good at treating certain bacterial infections, but you can't have any alcohol while on it since it'll make you throw up a lot.
Reviews & ratings
Filter group. All currently selected
Filter group. All currently selected
5.45Azithromycin
Reviews for Azithromycin
74%
of people (All ages) say Azithromycin is worth it
59%
say it works well
11%
say it's a big hassle
909 reviews
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Side effects
AzithromycinFlagyl
  • Diarrhea 5%
  • Nausea 3%
  • Abdominal pain 3%
  • Vomiting 6%
  • Rash 2%
  • Vaginitis 2%
More Azithromycin side effects »
  • Headache 18%
  • Nausea 10%
  • Metallic taste 9%
  • Genital itching 5%
  • Diarrhea 4%
  • Stomach problems 4%
  • Dizziness 4%
  • Stuffy nose 3%
  • Abnormal urine 3%
  • Menstrual cramps 3%
More Flagyl side effects »
How it works
AzithromycinFlagyl
Zithromax (Azithromycin) is an antibiotic. It kills bacteria by preventing them from reproducing and repairing themselves.Flagyl (metronidazole) is an antibiotic that kills bacteria by interacting with their DNA and preventing proteins from being made.
Type of medication
AzithromycinFlagyl
Prescription onlyPrescription only
Available as
AzithromycinFlagyl
  • Pill
  • Liquid
  • Eye drops
  • Pill
  • Extended-release pill
  • Injection
Used for
AzithromycinFlagyl
Risk factors for serious side effects
AzithromycinFlagyl
  • History of liver disease
  • History of myasthenia gravis
Detailed Zithromax (azithromycin) risks & warnings »
  • Taking high doses of Flagyl (metronidazole)
  • Taking Flagyl (metronidazole) for a long time
  • Taking Flagyl (metronidazole) incorrectly
Detailed Flagyl (metronidazole) risks & warnings »
Pregnancy

Research studies with animals haven’t found a risk to unborn babies, but it hasn’t been properly studied in humans.

Research studies with animals haven’t found a risk to unborn babies, but it hasn’t been properly studied in humans.

Interactions
AzithromycinFlagyl
No interactions related info.
  • Alcohol interacts with Flagyl (metronidazole) to cause a serious reaction in people that includes stomach upset, throwing up, feeling sick, or turning red. Avoid alcohol while you're taking Flagyl (metronidazole), and for 3 days after you're done taking it.
Alcohol
AzithromycinFlagyl
No alcohol related info.
  • Don't drink any alcohol (don't even use mouthwash with alcohol in it) while taking Flagyl (metronidazole) and for at least 3 days after using it, because it can cause a serious reaction in your stomach and make you throw up.
  • You can't drink alcohol while on Flagyl (metronidazole), and for at least 3 days after you finish it.
Food
AzithromycinFlagyl
  • Can take with or without food.
  • Can be taken with or without food.
  • If you're on blood thinners, let your doctor know. Flagyl (metronidazole) can interact with your medicines and make you more likely to bleed.
Kidneys and liver
AzithromycinFlagyl
  • There have been reports of liver damage that can require hospitalization or can cause death. These have been rare. Talk to your doctor if you notice pain in your abdomen, loss of appetite, yellowing of your skin or eyes, or dark colored urine.
No kidneys and liver related info.
Pain
AzithromycinFlagyl
  • Can cause abdominal pain, diarrhea, vomiting, and nausea.
No pain related info.
Upsides and benefits
AzithromycinFlagyl
  • Available in generic.
  • Available in different forms: tablet, capsule, and suspension.
  • Used to treat many types of bacterial infections.
  • Less resistance seen in bacteria to this antibiotic. Your doctor may run tests to see which antibiotics will kill the bacteria causing your infection.
  • Can be taken with or without food.
  • Flagyl (metronidazole) is good at killing a variety of bacteria.
  • Unlike many other antibiotics, Flagyl (metronidazole) is less likely to make bacteria resistant to it.
  • Most forms are available as a generic, so it's relatively cheap.
Downsides and risks
AzithromycinFlagyl
  • Must space out antacids by at least 2 hours.
  • Has to be used with caution in people who've had liver disease.
  • Can't be used in people who've had myasthenia gravis.
  • Must be used with caution in people who are on medications to thin the blood (anticoagulants) because of increased risk of bleeding.
  • Can cause abdominal pain, diarrhea, vomiting, and nausea.
  • You can't drink alcohol while on Flagyl (metronidazole), and for at least 3 days after you finish it.
  • Side effects can include nausea, headache, stomach upset, and a metallic taste in your mouth.
  • If you're taking Flagyl (metronidazole) for a long time, there's a risk of more side effects, such as nerve damage.
  • If you're on blood thinners, let your doctor know. Flagyl (metronidazole) can interact with your medicines and make you more likely to bleed.
Tips from our pharmacists for people taking the medication
AzithromycinFlagyl
  • Take the medication exactly how your doctor tells you to.
  • Can cause diarrhea, nausea or vomiting.
  • Space out any antacids with magnesium or aluminum by at least 2 hours.
  • Can take with or without food.
  • Don't drink any alcohol (don't even use mouthwash with alcohol in it) while taking Flagyl (metronidazole) and for at least 3 days after using it, because it can cause a serious reaction in your stomach and make you throw up.
  • Take this medicine exactly as your doctor or pharmacist tells you. Don't stop taking it early, or the bacteria left in your body could become resistant.
  • If you're taking the extended-release (ER) form, take it 1 hour before, or 2 hours after you eat.
Learn more
More about AzithromycinSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Zithromax (azithromycin)?
Worth itNot sureNot worth it
More about FlagylSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Flagyl (metronidazole)?
Worth itNot sureNot worth it