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Can You Get A Z-Pack Prescription Online?

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Can You Get A Z-Pack Prescription Online?

writtenByWritten by: Dr. Umer Khan
Dr. Umer Khan

Dr. Umer Khan

Medically reviewed by Dr Umer Khan, MD who is a Board Certified physician practicing in Pennsylvania. His special interests include wellness, longevity and medical IT.

Read more posts by this author.

November 5, 2020 Read Time - 9 minutes

Can an Online Doctor Prescribe Z-Pack?

The answer is yes, you can get a Z-Pack prescription online. If you’ve ever had a bacterial infection, you may have been prescribed a Z-Pack. Services like PlushCare are making it more convenient and affordable to get a Z-Pack prescription when you need one. 

Below, we’ll be helping you better understand what a Z-Pack is, what it treats, and how you can get one prescribed to you online. 

  • Book on our free mobile app or website.

    Our doctors operate in all 50 states and same day appointments are available every 15 minutes.

  • See a doctor, get treatment and a prescription at your local pharmacy.

  • Use your health insurance just like you normally would to see your doctor.


Can You Buy a Z-Pack Online?

In the United States, you are required to speak to a doctor before getting prescription medication.

Websites that claim you can buy a Z-Pack (or any other prescription medication) online and have the medication delivered to your door are skirting the law – and there is no guarantee they will send you the right dosage or even the right medication.

With online doctor services such as PlushCare, you can have an online video or phone appointment with one of our trusted doctors who will talk to you about your symptoms and design a treatment plan that’s right for you.

If they decide that Z-Pack is appropriate for treating your infection, they will electronically send the prescription to the pharmacy of your choice, where you can pick it up when it’s ready.

Read on to learn more about Z-Pack prescriptions.

Read: Fastest Way to Get Your Antibiotics Online

Can You Buy Z-Pack Over-the-Counter

No, you cannot buy Z-Pack over-the-counter. 

Z-Pack is a prescription drug and therefore must be prescribed to you by a doctor. Click here to set up an online appointment.

What is Z-Pack?

Z-Pack is the brand name for azithromycin, a macrolide-type antibiotic. It is mostly used to treat community acquired respiratory tract infections such as pneumonia. 

It comes in a simple, easy to understand blister pack, where you take two pills the first day, then one pill a day for 4 additional days. Z-Pack is prescribed about 60 million times per year.

How Does Z-Pack Work?

Z-Pack and other macrolide antibiotics work by preventing bacteria from making their own proteins. By preventing the production of these proteins, bacteria cannot multiply and die out.

Z-Pack Dosage and Treatment

Z-Pack comes in a convenient blister pack for easy dosing. Always follow your doctor’s instructions, but typical dosing is an initial dose of 500 mg (2 pills), then 250 mg (1 pill) per day for 4 days.

Z-Pack can be taken with or without food. Compared to other macrolides it is given once a day because it has a longer half-life and it is removed from your blood slowly. Many infections only require a once-a-day 5-day regimen.

Benefits of Z-Pack

Z-Pack is a convenient way to take antibiotics since it comes in an easy to understand blister pack. Z-Pack should not be used to treat viral infections. 

Some of the bacterial infections that Z-pack may treat include:

  • Cat-scratch disease
  • Skin infections
  • Ear infections
  • Throat or tonsil infections
  • Sinusitis
  • Bronchitis
  • Pneumonia
  • Whooping cough (pertussis)
  • Chronic obstructive pulmonary disease (COPD)
  • Genital ulcers
  • Gonorrhea
  • Infections of the cervix or urethra
  • Severe pelvic inflammatory disease

  • Book on our free mobile app or website.

    Our doctors operate in all 50 states and same day appointments are available every 15 minutes.

  • See a doctor, get treatment and a prescription at your local pharmacy.

  • Use your health insurance just like you normally would to see your doctor.


Will Z-Pack Cure my Cold?

Many people go to their doctors and ask for Z-Pack to cure their cold. The problem is that the common cold is caused by a virus rather than bacteria. Z-Pack is an antibiotic, which means it is not effective against the common cold since it only treats bacterial infections.

Side Effects of Z-Pack

Like all medications, Z-Pack does carry a risk of side effects, including:

  • Diarrhea
  • Upset stomach
  • Abdominal pain
  • Nausea
  • Vomiting
  • Gas
  • Eye problems
  • Hearing changes
  • Muscle weakness
  • Trouble swallowing or speaking
  • Signs of liver problems (like unusual tiredness, severe stomach/abdominal pain, yellowing eyes/skin, persistent nausea/vomiting, dark urine)
  • Dizziness
  • Fainting
  • Fast or irregular heartbeat
  • Clostridium difficile-associated diarrhea (a severe intestinal condition)
  • Yeast infection
  • Oral thrush
  • Chest pain
  • Swelling of the ankles or feet
  • Seizures
  • Low white blood cell count (usually discovered in blood tests, but if you have symptoms, they may include tiredness, weakness, shortness of breath, or infections that do not go away)
  • Fluid build-up between the lungs and the chest wall (symptoms may include chest pain or heaviness, and difficulty breathing)

Considerations and Precautions of Z-Pack

While Z-Pack works effectively when treating the correct type of bacteria, it isn’t right for every infection. You should always take into account potential medication interactions, past medical history, or potential complications with any existing medical concerns.

Z-Pack Interactions

Z-Pack may have interactions with certain medications. Always tell your doctor about all medications (including over-the-counter), vitamins, supplements, and other drugs that you take to help prevent complications. Avoid Z-Pack if you take any of the following:

  • BCG live (Theracrys)
  • Dronedarone (Multaq)
  • Pimozide (Orap)
  • Amiodarone (Cordarone, Pacerone, or Nextarone)
  • Live typhoid vaccine (Vivotif)
  • Digoxin (Lanoxin)
  • Quinidine
  • Blood thinners like enoxaparin (Lovenox), fondaparinux (Arixta), heparin, warfarin (Coumadin or Jantoven)
  • Medications used to prevent blood clots: bivalirudin (Angiomax), antithrombin III (Thrombin), dalteparin (Fragmin)

Other Z-Pack Considerations

Z-Pack isn’t right for everybody. Make sure to tell your doctor if you:

  • Are allergic to other antibiotics (such as clarithromycin, erythromycin, telithromycin)
  • Have kidney disease
  • Have liver disease
  • Have myasthenia gravis (a muscle disease)
  • Or any of your immediate family members have certain heart problems (slow heartbeat, heart failure, QT prolongation in the EKG)
  • Take diuretics (“water pills”)
  • Have conditions such as severe sweating, diarrhea, or vomiting
  • Are pregnant or breastfeeding
  • Have had or currently have a form of jaundice known as cholestatic jaundice, in which bile backs up into the liver and causes a yellowing of the skin, eyes, or nails

Reports reveal that some patients using azithromycin have had liver-related side effects such as jaundice, abnormal liver function test, hepatitis, hepatic necrosis, liver failure and in some cases even death. Therefore it should be discontinued immediately if signs or symptoms of hepatitis occur.

  • Book on our free mobile app or website.

    Our doctors operate in all 50 states and same day appointments are available every 15 minutes.

  • See a doctor, get treatment and a prescription at your local pharmacy.

  • Use your health insurance just like you normally would to see your doctor.


Is There an Increased Cardiovascular Risk with Z-Pack?

According to a 2012 study in the New England Journal of Medicine, azithromycin, the generic name for Z-Pack, may increase the risk of cardiovascular deaths, especially among patients with a high baseline risk of cardiovascular disease. As a result of this study, the US Food and Drug Administration (FDA) issued a warning about potential cardiac problems with Z-Pack in March 2013.

The study found that Z-Pack could prolong the QT interval (abnormal heart rhythm) and cause other cardiovascular events, which may in turn result in potential cardiac related complications in certain patients.

A 2016 study in the Canadian Medical Association Journal contradicted the 2012 study, arguing that among older adults without long-QT syndrome, the risk of death is no greater for Z-Pack than it is for other antibiotics.

That is to say, as long as you don’t have long-QT syndrome, Z-Pack does not increase your risk of cardiac problems.

About the QT Interval

So, what is the QT interval and how does Z-Pack affect it?

The QT interval is a measurement/reading made on an electrocardiogram (ECG). According to Practical Clinical Skills:

“The QT interval represents the time of ventricular activity including both depolarization and repolarization. It is measured from the beginning of the QRS complex to the end of the T wave. Normally, the QT interval is 0.36 to 0.44 seconds (9-11 boxes). The QT interval will vary with patient gender, age and heart rate. Another guideline is that normal QT Intervals is less than half of the R-R Interval for heart rates below 100 bpm.” This is for the clinician to interpret not the layman patient.”

What does this mean for you? A long QT interval increases the risk of a dangerous arrhythmia called ventricular tachycardia. So, people with a longer QT interval are already at risk of cardiac problems, and Z-Pack can further increase this risk.

Long QT Syndrome

Long QT syndrome is typically genetic, although it can also be caused by certain medications, imbalances of the body’s salts and minerals (electrolyte abnormalities), and medical conditions.

According to the Mayo Clinic:

“Long QT syndrome (LQTS) is a heart rhythm condition that can potentially cause fast, chaotic heartbeats. These rapid heartbeats might trigger a sudden fainting spell or seizure. In some cases, the heart can beat erratically for so long that it causes sudden death.”

Since Z-Pack can increase the QT interval, it can increase the risk of sudden death in people with Long QT syndrome. The most recent studies indicate that Z-Pack does not increase cardiac risk in people without long QT syndrome.

How Quickly Does Z-Pack Work?

A Z-Pack typically takes 5 full days to work. If you begin to feel relief from your symptoms, do not stop taking your Z-Pack so as to avoid antibiotic resistance.

About Antibiotic-Resistant Bacteria

Ever since the invention of penicillin, antibiotics have been used to treat a wide variety of infections. The problem is that taking an antibiotic for an infection that cannot be treated by it specifically can lead to the bacteria becoming resistant to the medications that were designed to kill them.

According to a recent clinical trial, 224 healthy subjects were given macrolide antibiotics and the result was the development of macrolide-resistant bacteria.

Read: Everything You Need to Know About Antibiotic Resistant Bacteria

According to the CDC, at least 2 million people each year in the United States become infected with antibiotic-resistant bacteria, and at least 23,000 of those people die directly as a result. Many more people die indirectly.

To help prevent the rapid increase of antibiotic-resistant bacteria, you should always take the full course of antibiotics prescribed to you by your doctor and you should never take an antibiotic for an illness that is caused by a virus, such as a cold or the flu. Your doctor may run tests to find out the cause of your infection before giving you antibiotics for this reason.

Make an appointment today to get Z-Pack online! Just click here today to make an appointment to speak to one of our experienced doctors. 

Read More About Getting A Z-Pack Prescription Online


PlushCare is dedicated to providing you with accurate and trustworthy health information. Macrolide antibiotics and the risk of ventricular arrhythmia in older adults. Accessed on November 4, 2020.,clarithromycin%2C%20erythromycin%2C%20and%20roxithromycin. Azithromycin and the risk of cardiovascular death. Accessed on November 4, 2020. Antibiotic / Antimicrobial Resistance (AR / AMR). Accessed on November 4, 2020.

Most PlushCare articles are reviewed by M.D.s, Ph.Ds, N.P.s, nutritionists and other healthcare professionals. Click here to learn more and meet some of the professionals behind our blog. The PlushCare blog, or any linked materials are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. For more information click here.

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