Two medicines, side by side
Clarithromycin vs azithromycin
Clarithromycin and azithromycin are both labeled for bacterial infections. Drugs@FDA records approvals of clarithromycin since 1991 and of azithromycin since 1991. Pharmacies paid $0.466 per clarithromycin 500 mg tablet and $0.266 per azithromycin 250 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). How each works, in its label's words: Clarithromycin, “Clarithromycin is a macrolide antimicrobial drug [see Microbiology (12.4) ].”; Azithromycin, “Azithromycin is a macrolide antibacterial drug. [see Microbiology ( 12.4 )]”
Check it at the source: the clarithromycin FDA label on DailyMed (effective April 9, 2026); the azithromycin FDA label on DailyMed (effective December 4, 2025).
Highlights of the clarithromycin record
Clarithromycin (Biaxin) · label of April 9, 2026
Used for
From the label: indicationsClarithromycin is a macrolide antimicrobial indicated for mild to moderate infections caused by designated, susceptible bacteria in the following: Acute Bacterial Exacerbation of Chronic Bronchitis in Adults (1.1) Acute Maxillary Sinusitis (1.2) Community-Acquired Pneumonia (1.3) Pharyngitis/Tonsillitis (1.4) Uncomplicated Skin and Skin Structure Infections (1.5) Acute Otitis Media in Pediatric Patients (1.6) […]
On the market
- Earliest approval on file
- October 31, 1991
- Generic labelers
- 26 labelers
- Pharmacy cost
- $0.466 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 3
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
Source: FDA drug labels via openFDA (Clarithromycin label of April 9, 2026, Azithromycin label of December 4, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do clarithromycin and azithromycin differ on the record?
How each works, in its label's words: Clarithromycin, “Clarithromycin is a macrolide antimicrobial drug [see Microbiology (12.4) ].”; Azithromycin, “Azithromycin is a macrolide antibacterial drug. [see Microbiology ( 12.4 )]”
Both are in FDA's class macrolide antimicrobials.
Half-life, in each label's words: Clarithromycin, “The elimination half-life of clarithromycin was about 3 hours to 4 hours with 250 mg administered every 12 hours but …”; Azithromycin, “Elimination Plasma concentrations of azithromycin following single 500 mg oral and IV doses declined in a polyphasic …”
Generics: clarithromycin since 2004; azithromycin since 2005 (Drugs@FDA).
| Clarithromycin | Azithromycin | |
|---|---|---|
| Labeled for | Bacterial infections, Acid reflux and ulcers | Bacterial infections |
| Pharmacologic class | Macrolide Antimicrobial | Macrolide Antimicrobial |
| How it works (label) | Clarithromycin is a macrolide antimicrobial drug [see Microbiology (12.4) ]. | Azithromycin is a macrolide antibacterial drug. [see Microbiology ( 12.4 )] |
| Half-life (label) | The elimination half-life of clarithromycin was about 3 hours to 4 hours with 250 mg administered every 12 hours but increased to 5 hours to 7 hours with 500 mg administered every 8 hours to 12 hours. | 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 … |
| Earliest approval on file (Drugs@FDA) | October 31, 1991 | November 1, 1991 |
| First generic approved | May 25, 2004 | November 14, 2005 |
| Generic labelers (NDC) | 26 labelers | 55 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.466 per tablet (Clarithromycin 500 mg tablet) | $0.266 per tablet (Azithromycin 250 mg tablet) |
| 12-month price change | +6% | -26% |
| Boxed warning | No | No |
| Shortage now | No current entry | A presentation being discontinued |
| Recalls recorded | 3 | 11 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 34,134 | 59,712 |
| 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 clarithromycin
- every medicine labeled for the same conditions