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Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects can include: If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 911 or go to the nearest emergency room. Don’t take this drug again if you’ve ever had an allergic reaction to it. Disclaimer: Our goal is to provide you with the most relevant and current information. In March 2013, the US Food and Drug Administration issued a warning about potential cardiac problems with the antibiotic azithromycin. The warning indicated that some people may have an increased risk of sudden death when taking this drug, especially people with certain kinds of heart disease. The FDA warning led to widespread media coverage, and given the popularity of the Z-Pack (which is prescribed an estimated 60 million times per year), it also led to widespread fear and consternation among patients and physicians alike. And in certain individuals — those who are born with a variant of the long QT syndrome, which is a genetic condition that can produce cardiac arrhythmias — anything that prolongs the QT interval can increase the risk of a dangerous arrhythmia called ventricular tachycardia. Azithromycin thus joins a long list of drugs that can prolong the QT interval, and which can, therefore, increase the risk of sudden death in susceptible individuals who have a variant of long-QT syndrome or heart disease. These drugs, in addition to antibiotics, include several antiarrhythmic medications (drugs that, ironically, are supposed to prevent arrhythmias), several antidepressant drugs, and several drugs used for gastrointestinal symptoms. There is no reason to think that azithromycin is any more dangerous than any of the other drugs on this lengthy list: that is, for people with a variant of the long QT syndrome or various kinds of heart disease, any of these drugs can be potentially dangerous. 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