Azithromycin is a veterinarian-prescribed, off-label antibiotic for cats—not a medicine to start or dose from an online reference. Merck Veterinary Manual lists a general feline reference range of 5–15 mg/kg by mouth every 24 hours, but your veterinarian must choose the dose, formulation, duration, and monitoring for your cat’s diagnosis. Vomiting, reduced appetite, and diarrhea are possible side effects.
What azithromycin is used for in cats
Azithromycin is a macrolide antibiotic. In the United States, it is not labeled for veterinary use, but veterinarians frequently prescribe it off-label by mouth. Depending on the diagnosis, a veterinarian may consider it for selected conditions such as some upper respiratory infections, bartonellosis, cryptosporidiosis, or toxoplasmosis. It is also used with atovaquone and supportive care for cytauxzoonosis, a life-threatening disease. These are examples of veterinary use, not a guarantee that azithromycin will work for an individual cat. Merck Veterinary Manual; VCA Animal Hospitals; Merck Veterinary Manual
Eye and respiratory infections need the right diagnosis
Azithromycin is not a universal treatment for feline eye or respiratory signs. For feline chlamydiosis, Merck names doxycycline as the treatment of choice and says azithromycin does not appear effective. Merck also describes azithromycin as less effective than doxycycline for respiratory disease caused by Chlamydia felis. Eye discharge, sneezing, or congestion can have different causes, so a veterinarian should identify the likely disease before choosing an antibiotic. Merck Veterinary Manual; Merck Veterinary Manual
Azithromycin dosage for cats: reference range, not a home prescription
Merck Veterinary Manual’s 2026 reference table lists azithromycin at 5–15 mg/kg by mouth every 24 hours for cats (off-label). Merck also reports feline oral bioavailability of 59%; that pharmacokinetic figure is not a measure of treatment success or safety. Neither figure tells you what dose your cat should receive. A veterinarian must select the dose and schedule for the specific infection and patient. Merck Veterinary Manual
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Do not calculate a dose from your cat’s weight, give leftover medication, or use human azithromycin without veterinary direction. The correct amount depends on the prescription and product, and an online reference range is not an individualized treatment plan. Veterinary Partner/VIN’s owner guidance warns: “Never administer any drug without your veterinarian’s input.” Veterinary Partner/VIN
How to give a prescribed dose
Use the instructions for the exact formulation dispensed; tablet and liquid directions differ. VCA’s general guidance is:
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- Tablets: Preferably give with food.
- Liquid suspension: Shake before each dose, measure carefully, and preferably give on an empty stomach.
- Missed dose: Give it when remembered, then wait the veterinarian-prescribed interval before the next dose. Do not give two doses at once.
If your cat resists medicine or you are unsure about the product’s food instructions, ask the prescribing clinic or pharmacy rather than changing how you give it. VCA Animal Hospitals
Side effects and when to call the veterinarian
VCA lists vomiting, decreased appetite, and diarrhea as possible side effects. Call your veterinarian if gastrointestinal effects persist for multiple days or become severe. If you suspect an overdose or an adverse reaction, contact the veterinary office immediately. Follow the clinic’s instructions for monitoring and reassessment. VCA Animal Hospitals
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The available owner guidance lists these possible effects but does not establish a general feline adverse-event rate. A listed side effect is a reason to monitor and seek veterinary advice when warranted, not a prediction that it will occur.
Health cautions and other medicines
Tell the veterinarian about your cat’s health history and every prescription drug, nonprescription medicine, vitamin, supplement, and herbal product. VCA advises against azithromycin in animals sensitive to macrolide antibiotics and recommends caution when a cat has:
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- Liver disease
- Certain abnormal heart rhythms
- A history of vomiting
- Pregnancy or nursing, because safety studies are limited
VCA says interactions have not been reported in animals, while noting that interaction information exists in humans. That does not establish that interactions are impossible; the veterinarian needs the full medication and supplement list to assess the situation. VCA Animal Hospitals
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.Storage depends on the formulation
VCA’s listed guidance is to keep tablets in a tightly sealed container protected from light at room temperature below 30°C (86°F). Its guidance says oral suspension may be kept at room temperature for up to 10 days before it should be discarded. Product instructions can differ, so follow the label and the dispensing pharmacy’s directions for your cat’s specific medicine. VCA Animal Hospitals
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