Q. Is taking Azithromycin for a person with one kidney advisable?

Answered by
Dr. Samer Samer Juma Ali Altawil
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 30, 2022

Hi doctor,

I have been prescribed Azithromycin for ureaplasma. I was born with one kidney, which is 100% healthy. A few months ago, the lab report showed a slight decrease in function, probably due to the Advil I took after a dental procedure. I was prone to stones, but a recent KUB X-ray showed the result as zero. My gynecologist nurse was not sure how Azithromycin would affect my kidney. I have not been able to get a hold of my urologist nurse for three days. Even after leaving three messages. I need to take the antibiotic, but I am not comfortable until I know it will not harm my kidney.

I am a 45-years-old female. I have asthma and acid reflux. I am allergic to Rocephin and IV contrast. Currently, I am taking Symbicort and Pepcid and recently started using Estradiol cream. I did a vaginal swab test and was diagnosed with bacterial vaginosis, so I was prescribed Flagyl for a week; now, it is gone.

Thank you



Welcome to

Azithromycin is excreted in the urine, and with a normal level of serum creatinine full dose can be taken like 500 mg once daily for three days safely. But when serum creatinine is increased, a dose of 250 mg once daily for three days should be taken. Is it possible to send me the result of your recent serum creatinine level?

If you have any more questions, please let me know.

Kind regards.

Hello doctor,

Thank you for the reply.

I do not know my serum creatinine level, unfortunately. The Azithromycin prescribed to me is two pills at 500 mg each. I am supposed to take both tablets at once.

Would that be fine, or should I contact them on Monday for a lower dose?

Thank you.



Welcome back to

Yes, you should contact them as the dose is high for a person with one kidney. The maximum dose is 500 mg once for three days. Regards.

Hi doctor,

Thank you for the reply.

Below attached is my lab report:

1) BUN measure: 12 units: mg/dL, reference range: 0.51 - 0.95.

2) Creatinine measure: 1.15 units: mg/dL, reference range: 0.51 - 0.95.

3) Calcium measure: 10.3 units: mg/dL, reference range: 8.6 - 10.2.

4) GFR estimate measure: 51, reference range: Above 60.

The GP doctor recommended retaking in October.



Welcome to

Ok, great creatinine is normal. But the dose is not right. So contact them back to adjust your dose to 500 mg once daily for three days. As also, two tablets are not enough.


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