How Do You Take A Z-Pack?

In our latest question and answer, the pharmacist discusses how to properly take a Z-Pack (azithromycin).


If I took my first 2 Z-Pack pills at 2 am this morning when is safe for me to take my 1 pill today so that I may get on a decent schedule?

Asked by Tina On Jan 27, 2018

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Jan 29, 2018

The Z-Pak (also known as a Z-pack) is a 5 day course of the antibiotic azithromycin and contains 6 tablets. Azithromycin is classified as a macrolide antibiotic and is used for a variety of indications including bronchitis, sinusitis and pneumonia. 

In regard to how to take a Z-pack, the usual directions are as follows:

  • Take two tablets (500 mg) on the first day of therapy, followed by one tablet (250 mg) once daily for 4 days. The total cumulative dose is 1,500 mg in 5 days.

Ideally, you want to take your daily doses about 24 hours apart from one another. For example, if you take your first dose on Monday, at 3 PM, your next dose should be Tuesday at 3 PM. If you took your first dose at a time that you cannot continue at, try to take your next dose as close to 24 hours later as possible. In your situation, you could take your next dose in the evening before bed and continue at that time daily until you finish the pack. This should not decrease the effectiveness of azithromycin.

Azithromycin may be taken with or without food. If you are having nausea or stomach pains after taking the antibiotic, food may help to increase tolerability.

It is important to note that azithromycin has a very long half life (around 68 hours) and lasts a long time in the body. It is not uncommon to not feel completely healed after you have completed the Z-Pack. Generally, you should wait for 7 to 10 days from the start of therapy to assess whether or not azithromycin was effective in treating your infection.

About the Pharmacist

Dr. Brian Staiger Pharm.D

Dr. Brian Staiger is a licensed pharmacist in New York State and the founder of He graduated from the University At Buffalo with a Doctor of Pharmacy degree in 2010. He has been featured in numerous publications including the Huffington Post as well as a variety of health and pharmacy-related blogs. Please feel free to reach out to him directly if you have any inquiries or want to connect! He's answered thousands of medication and pharmacy-related questions and he's ready to answer yours! Office: 716-389-3076

Recent Questions