Roxithromycin
Pronunciation: pronunciation varies by local usage.
- Generic name
- roxithromycin
- Drug class
- Semi-synthetic macrolide antibiotic
- Form
- Tablet
- Route
- Oral
- Legal status
- Prescription-only medicine
Availability and supply rules vary by country
Trade names by country: India
Australia: · Full directory
What roxithromycin is and how it works
Roxithromycin is a semi-synthetic macrolide antibiotic used to treat bacterial infections such as those of the chest, tonsils, skin, or genitals. It is not approved by the US FDA but is available in Australia, New Zealand, and some other countries. (1) (2) (3)
The usual adult dose is 300 mg once daily or 150 mg twice daily, with a lower 150 mg once-daily dose for documented cirrhosis of the liver. Treatment typically lasts 5–10 days; streptococcal throat infections require a full 10-day course. Roxithromycin can cause gastrointestinal upset, thrush, and can rarely be associated with abnormal heart rhythm changes. It is contraindicated with ergot alkaloids and not recommended in pregnancy. Seek immediate medical attention for allergic reactions, liver symptoms, or fainting/fast heartbeat.
Mechanism of action: how roxithromycin works
Roxithromycin is a semi-synthetic macrolide antibiotic. (1) (3)
What roxithromycin is used for
Bacterial infections
Roxithromycin is an antibiotic used to treat infections such as infections of the chest, tonsils, skin, or genitals, as identified in the reviewed consumer medicine information. (2)
Before taking roxithromycin
Do not take / not appropriate for
- Tell your prescriber or pharmacist if you have a known hypersensitivity to roxithromycin, other macrolide antibiotics (such as erythromycin), or any excipient — this is a contraindication they will need to assess before roxithromycin is prescribed. (all products) (3)
- Tell your prescriber or pharmacist if you have severely impaired hepatic function — this is a contraindication they will need to assess. (all indications) (3)
- Tell your prescriber or pharmacist if you are taking ergot alkaloids (e.g., ergotamine) — this combination is contraindicated due to risk of ergotism with possible peripheral necrosis, and your prescriber will need to assess and advise. (all indications) (3)
Tell your clinician about
- If you have liver disease, especially documented cirrhosis, as dose adjustment may be needed, or severely impaired hepatic function, which is contraindicated.
- If you have a heart condition, since roxithromycin carries a small increased risk of QT interval prolongation.
- If you are pregnant or planning pregnancy, as roxithromycin is not recommended in pregnancy.
- If you are taking ergot-containing medicines (such as ergotamine), as this combination is contraindicated.
- If you have had a hypersensitivity reaction to roxithromycin or other macrolide antibiotics (such as erythromycin).
How to take roxithromycin
- Take roxithromycin on an empty stomach, about 15 minutes before food or 3 hours after food. If it causes nausea, you may take it with food.
- Swallow the tablet whole with a glass of water.
- Take it at the same times each day.
- The usual adult dose is 300 mg once daily or 150 mg twice daily, for 5 to 10 days. For streptococcal throat infections, the course must be 10 days.
- If you have documented cirrhosis of the liver, your prescriber may prescribe a lower dose of 150 mg once daily. Do not change your dose yourself — this is a prescriber decision.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3)
Missed dose
No specific missed-dose information was identified in the reviewed sources. Contact your prescriber or pharmacist for advice.
Overdose
No specific overdose information was identified in the reviewed sources. Contact your prescriber, pharmacist, or local emergency/poison-information service for advice.
Side effects
Common side effects are mostly gastrointestinal. A small increased risk of abnormal heart rhythm (QT prolongation) exists.
Stomach upset, bloating, gas, nausea, vomiting, diarrhoea
What to notice: Mild to moderate gastrointestinal symptoms.
What to do: Reported as a common side effect in the reviewed consumer medicine information. (2)
Loss of appetite
What to notice: Reduced desire to eat.
What to do: Reported as a common side effect in the reviewed consumer medicine information. (2)
Dizziness
What to notice: Feeling lightheaded or unsteady.
What to do: Reported as a common side effect in the reviewed consumer medicine information. (2)
Oral thrush (white patches in mouth, furry tongue)
What to notice: White patches, redness, or soreness in the mouth.
What to do: Reported as a common side effect in the reviewed consumer medicine information. (2)
Vaginal thrush
What to notice: Itching, discharge, or discomfort in the vaginal area.
What to do: Reported as a common side effect in the reviewed consumer medicine information. (2)
Heart rhythm changes
What to notice: Fainting or feeling like your heart is beating too fast.
What to do: Seek immediate medical attention. (2)
Hearing problems
What to notice: New or worsening hearing difficulty.
What to do: Seek immediate medical attention. (2)
Liver problems
What to notice: Yellowing of the skin or eyes, dark urine, abdominal pain.
What to do: Get immediate medical help. (2)
Allergic reaction
What to notice: Itchy skin, rash, swollen lips or tongue, difficulty breathing.
What to do: Obtain emergency medical care immediately. (2)
Serious warnings
QT interval prolongation and heart rhythm disorders — warning
Symptoms: Fainting or a sensation of the heart beating too fast.
Action: A small increased risk exists. If you experience fainting or a sensation of the heart beating too fast, seek immediate medical attention. (1)
Liver problems — emergency
Symptoms: Yellowing of skin/eyes, dark urine, abdominal pain.
Action: Seek immediate medical attention. Let the clinician you see advise on whether to continue or stop roxithromycin. (2)
Ergot toxicity when used with ergot alkaloids — warning
Symptoms: Ergotism with possible peripheral necrosis, as identified in the reviewed information.
Action: Tell your prescriber or pharmacist about any ergot-containing medicines you use before starting roxithromycin, since this combination is contraindicated; they will assess and advise. Seek medical help immediately if you notice any concerning symptoms after starting treatment. (3)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Ergot alkaloids (e.g., ergotamine) | Concomitant use can cause ergotism, with risk of possible peripheral necrosis. | Tell your prescriber or pharmacist about any ergot-containing medicines you use. This combination is contraindicated, and your prescriber will decide the appropriate course of treatment. (3) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Roxithromycin is not recommended for use during pregnancy. Discuss with your doctor. (3)
Breastfeeding
No specific breastfeeding guidance was available from the sources reviewed. Consult your doctor.
People with liver disease
In documented cirrhosis, the dose is reduced to 150 mg once daily. Roxithromycin is contraindicated in severe hepatic impairment. (1) (3)
People at risk of heart rhythm disorders
Roxithromycin is associated with a small increased risk of QT interval prolongation and abnormal cardiac electrical changes. (1)
Monitoring
Before starting
- No specific monitoring protocols were established from the reviewed sources.
During treatment
- No specific monitoring protocol was established from the reviewed sources.
Storage
Storage information was not provided in the research notes. Refer to the product leaflet.
Professional information
Clinician-facing context only. Use the current local prescribing information and guidelines.
All regions
Indication: Bacterial infections
Dose summary: Adults: 300 mg once daily or 150 mg twice daily. Duration: 5–10 days (10 days for streptococcal pharyngitis). Cirrhosis: 150 mg once daily.
Renal context: The sources reviewed for this page give no roxithromycin dose adjustment for renal impairment. Roxithromycin is eliminated mainly by non-renal routes and the data sheet's only stated dose reduction is for cirrhosis (150 mg once daily), not for reduced kidney function. Renal status should be assessed by the prescriber rather than adjusted from a published table. (1) (2)
Hepatic guidance
Cirrhosis: reduce to 150 mg once daily, per the Medsafe data sheet dose statement carried in this record.
Frequently asked questions
How should I take roxithromycin?
Swallow the tablet whole with a glass of water. Take it on an empty stomach (15 minutes before food or 3 hours after), unless it upsets your stomach; then you may take it with food. (2)
How long does treatment usually last?
Most infections are treated for 5 to 10 days. Streptococcal throat infections require a full 10-day course. (1) (2)
Can I take roxithromycin if I have liver problems?
Roxithromycin is contraindicated if you have severely impaired hepatic function. For documented cirrhosis of the liver, your prescriber may use a lower dose of 150 mg once daily, but this is a decision only your prescriber can make. Always inform your doctor about any liver conditions. (1) (3)
What are the common side effects?
Common side effects include stomach upset, nausea, diarrhoea, dizziness, and thrush. Seek immediate medical attention if you develop signs of an allergic reaction, liver problems, or fainting/a sensation of the heart beating too fast. (2)
References
- Arrow-Roxithromycin Data SheetMedsafe, New Zealand Medicines and Medical Devices Safety Authority · New Zealand · accessed 2026-08-05 · source 1
- RoxithromycinHealthify NZ (Ministry of Health-funded national health information service) · New Zealand · accessed 2026-08-05 · source 2
- Roxithromycin Sandoz / Roxithromycin SCP product informationNPS MedicineWise / Australian TGA-regulated medicine finder · Australia · accessed 2026-08-05 · source 3
Brand names by country
Single-ingredient roxithromycin names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
India
- Roxid150 mg, 300 mg · Alembic Pharmaceuticals Ltd
- Roxikem150 mg · Alkem Laboratories Ltd
- Roxychem150 mg · Biochem Pharmaceutical Industries