Two medicines, side by side
Azithromycin vs levofloxacin
Azithromycin and levofloxacin are both labeled for bacterial infections. Drugs@FDA records approvals of azithromycin since 1991 and of levofloxacin since 1996. Pharmacies paid $0.266 per azithromycin 250 mg tablet and $0.259 per levofloxacin 750 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). In FDA's classes, azithromycin is a macrolide antimicrobial and levofloxacin a fluoroquinolone antibacterial.
Check it at the source: the azithromycin FDA label on DailyMed (effective December 4, 2025); the levofloxacin FDA label on DailyMed (effective July 10, 2024).
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 levofloxacin record
Levofloxacin (Levaquin) · label of July 10, 2024
SERIOUS ADVERSE REACTIONS INCLUDING TENDINITIS, TENDON RUPTURE, PERIPHERAL NEUROPATHY, CENTRAL NERVOUS SYSTEM EFFECTS AND EXACERBATION OF MYASTHENIA GRAVIS See full prescribing information for complete boxed warning.
Used for
From the label: indicationsLevofloxacin is a fluoroquinolone antibacterial indicated in adults (18 years of age and older) with infections caused by designated, susceptible bacteria and in pediatric patients where indicated ( 1 , 12.4 ). […]
On the market
- Earliest approval on file
- December 20, 1996
- Generic labelers
- 44 labelers
- Pharmacy cost
- $0.259 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 13
Source: FDA drug labels via openFDA (Azithromycin label of December 4, 2025, Levofloxacin label of July 10, 2024); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do azithromycin and levofloxacin differ on the record?
In FDA's classes, azithromycin is a macrolide antimicrobial and levofloxacin a fluoroquinolone antibacterial.
How each works, in its label's words: Azithromycin, “Azithromycin is a macrolide antibacterial drug. [see Microbiology ( 12.4 )]”; Levofloxacin, “Levofloxacin 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 …”; Levofloxacin, “The mean terminal plasma elimination half-life of levofloxacin ranges from approximately 6 to 8 hours following single …”
Only the levofloxacin label carries a boxed warning.
Generics: azithromycin since 2005; levofloxacin since 2010 (Drugs@FDA).
| Azithromycin | Levofloxacin | |
|---|---|---|
| Labeled for | Bacterial infections | Bacterial infections, Urinary tract infections |
| Pharmacologic class | Macrolide Antimicrobial | Fluoroquinolone Antibacterial |
| How it works (label) | Azithromycin is a macrolide antibacterial drug. [see Microbiology ( 12.4 )] | Levofloxacin 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 mean terminal plasma elimination half-life of levofloxacin ranges from approximately 6 to 8 hours following single or multiple doses of levofloxacin given orally or intravenously. |
| Earliest approval on file (Drugs@FDA) | November 1, 1991 | December 20, 1996 |
| First generic approved | November 14, 2005 | December 20, 2010 |
| Generic labelers (NDC) | 55 labelers | 44 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.266 per tablet (Azithromycin 250 mg tablet) | $0.259 per tablet (Levofloxacin 750 mg tablet) |
| 12-month price change | -26% | -11% |
| Boxed warning | No | Yes |
| Shortage now | A presentation being discontinued | No current entry |
| Recalls recorded | 11 | 13 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 59,712 | 59,954 |
| 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