Two medicines, side by side
Azithromycin vs ciprofloxacin
Azithromycin and ciprofloxacin are both labeled for bacterial infections. Drugs@FDA records approvals of azithromycin since 1991 and of ciprofloxacin since 1987. Pharmacies paid $0.266 per azithromycin 250 mg tablet and $0.123 per ciprofloxacin HCl 500 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Azithromycin's other strengths are brand-only: $98.51 per mL (Azasite 1% eye drops). Ciprofloxacin's other strengths are brand-only: $1.25 per mL (Cipro 5% suspension). In FDA's classes, azithromycin is a macrolide antimicrobial and ciprofloxacin a fluoroquinolone antibacterial.
Check it at the source: the azithromycin FDA label on DailyMed (effective December 4, 2025); the ciprofloxacin FDA label on DailyMed (effective March 2, 2026).
Highlights of the azithromycin record
Azithromycin (Zithromax) · label of December 4, 2025
Used for
From the label: indicationsAzithromycin tablets are macrolide antibacterial drug indicated for the treatment of patients with mild to moderate infections caused by susceptible strains of the designated microorganisms in the specific conditions listed below. […]
On the market
- Earliest approval on file
- November 1, 1991
- Generic labelers
- 55 labelers
- Pharmacy cost
- $0.266 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 11
Highlights of the ciprofloxacin record
Ciprofloxacin (Cipro) · label of March 2, 2026
SERIOUS ADVERSE REACTIONS INCLUDING TENDINITIS, TENDON RUPTURE, PERIPHERAL NEUROPATHY, CENTRAL NERVOUS SYSTEM EFFECTS AND EXACERBATION OF MYASTHENIA GRAVIS
Fluoroquinolones, including CIPRO ® , have been associated with disabling and potentially irreversible serious adverse reactions that have occurred together [see Warnings and Precautions ( 5.1 )], including:
Tendinitis and tendon rupture [see Warnings and Precautions ( 5.2 )].
Peripheral neuropathy [see Warnings and Precautions ( 5.3 )].
Used for
From the label: indicationsCIPRO is a fluoroquinolone antibacterial indicated in adults (18 years of age and older) with the following infections caused by designated, susceptible bacteria and in pediatric patients where indicated: • Skin and Skin Structure Infections ( 1.1 ) • Bone and Joint Infections ( 1.2 ) • Complicated Intra-Abdominal Infections ( 1.3 ) • Infectious Diarrhea ( 1.4 ) • Typhoid Fever (Enteric Fever) ( 1.5 ) • […]
On the market
- Earliest approval on file
- October 22, 1987
- Generic labelers
- 54 labelers
- Pharmacy cost
- $0.123 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 14
Source: FDA drug labels via openFDA (Azithromycin label of December 4, 2025, Ciprofloxacin label of March 2, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do azithromycin and ciprofloxacin differ on the record?
In FDA's classes, azithromycin is a macrolide antimicrobial and ciprofloxacin a fluoroquinolone antibacterial.
How each works, in its label's words: Azithromycin, “Azithromycin is a macrolide antibacterial drug. [see Microbiology ( 12.4 )]”; Ciprofloxacin, “Ciprofloxacin is a member of the fluoroquinolone class of antibacterial agents [see Microbiology ( 12.4 )].”
Half-life, in each label's words: Azithromycin, “Elimination Plasma concentrations of azithromycin following single 500 mg oral and IV doses declined in a polyphasic …”; Ciprofloxacin, “The serum elimination half-life in subjects with normal renal function is approximately 4 hours.”
Only the ciprofloxacin label carries a boxed warning.
Generics: azithromycin since 2005; ciprofloxacin since 2004 (Drugs@FDA).
| Azithromycin | Ciprofloxacin | |
|---|---|---|
| Labeled for | Bacterial infections | Diarrhea, Urinary tract infections, Bacterial infections |
| Pharmacologic class | Macrolide Antimicrobial | Fluoroquinolone Antibacterial, Quinolone Antimicrobial |
| How it works (label) | Azithromycin is a macrolide antibacterial drug. [see Microbiology ( 12.4 )] | Ciprofloxacin is a member of the fluoroquinolone class of antibacterial agents [see Microbiology ( 12.4 )]. |
| Half-life (label) | Elimination Plasma concentrations of azithromycin following single 500 mg oral and IV doses declined in a polyphasic pattern resulting in a mean apparent plasma clearance of 630 mL/min and terminal elimination half-life … | The serum elimination half-life in subjects with normal renal function is approximately 4 hours. |
| Earliest approval on file (Drugs@FDA) | November 1, 1991 | October 22, 1987 |
| First generic approved | November 14, 2005 | March 16, 2004 |
| Generic labelers (NDC) | 55 labelers | 54 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.266 per tablet (Azithromycin 250 mg tablet) | $0.123 per tablet (Ciprofloxacin HCl 500 mg tablet) |
| 12-month price change | -26% | -9% |
| Boxed warning | No | Yes |
| Shortage now | A presentation being discontinued | No current entry |
| Recalls recorded | 11 | 14 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 59,712 | 96,726 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to azithromycin
- every medicine labeled for the same conditions