Sounds like 'rox-ZITH-roe-MYE-sin'

Roxithromycin is an antibiotic used to treat different infections caused by bacteria. Find out how to take it safely and possible side effects. Roxithromycin is commonly called Rulide D.

Type of medicine Also called
  • Antibiotic (to treat infections)
  • Macrolide antibiotic 
  • Arrow-Roxithromycin
  • Rulide D

What is roxithromycin?

Roxithromycin is an antibiotic that is used to treat infections such as infections of the chest, tonsils, skin or genitals. It works by killing or stopping the growth of bacteria (bugs). Like all antibiotics, roxithromycin is not effective against infections caused by viruses.

In New Zealand, roxithromycin is available as tablets (150 mg and 300 mg) and dispersible tablets (50 mg). Dispersible tablets dissolve in water and are used in children where smaller doses are used or if swallowing larger tablets is a problem. 


  • The dose of roxithromycin will be different for different people depending on the type of infection and your age.
  • The usual dose in adults is 300 mg once a day OR 150 mg two times a day.
  • The dose for children will depend on their body weight. It is usually given 2 times a day.
  • Your doctor will advise you how long to take roxithromycin for (usually 5 to 10 days).
  • Always take your roxithromycin exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it, and any special instructions.

How to take roxithromycin

  • Tablets: swallow the tablets whole with a glass of water. 
  • Dispersible tablets: remove the correct number of tablets from the foil. If your child is only taking half a tablet at a time, place the remaining half of the tablet back in the foil and cover it up. Add the tablets to a small amount of water (about 1 tablespoon) and wait about 30 or 40 seconds for the tablet to break down into fine granules. (The tablets will not completely dissolve). Stir if necessary. After taking, rinse the container with water and drink this to ensure all roxithromycin dose is swallowed.
  • Timing: Roxithromycin is best taken on an empty stomach, about 15 minutes before food or 3 hours after food. If it makes you feel sick, then take it with food. Take roxithromycin at the same time each day. 
  • Missed dose: If you forget to take your dose, take it as soon as you remember. But, if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose.
  • Alcohol: You can drink alcohol while taking roxithromycin.

It is best to take the antibiotic for the number of days your doctor has told you to. Do not stop taking it, even if you feel your infection has cleared up. Talk to your doctor first.

Precautions – before starting roxithromycin

  • Do you have problems with your liver?
  • Are you pregnant or breastfeeding?
  • Do you have any problems with your heart?
  • Are taking any other medicines? This includes any medicines you are taking which you can buy without a prescription, as well as herbal and complementary medicines.

If so, it’s important that you tell your doctor or pharmacist before you start roxithromycin. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

Note: if you are taking the contraceptive 'pill', the effectiveness of the 'pill' can be reduced if you have a bout of being sick (vomiting) or diarrhoea which lasts for more than 24 hours. If this happens, ask your doctor or pharmacist for advice about contraception over the following few days.

What are the side effects of roxithromycin?

Like all medicines, roxithromycin can cause side effects, but not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects What should I do?
  • Nausea (feeling sick) or vomiting
  • Take roxithromycin with food
  • Diarrhoea (runny poos)
  • This may go away with time
  • Tell your doctor if troublesome
  • Vaginal itching, soreness or discharge (thrush)
Tell your doctor or pharmacist
  • Dizziness
  • Be careful when driving or using tools until you know how this medicine affects you
  • Fainting
  • Changes in your heartbeat (fast or irregular)
  • Tell your doctor immediately or ring HealthLine 0800 611 116 
  • Signs of problems with your liver such as yellowing of the skin or eyes, dark urine, pain in the abdomen
  • Tell your doctor immediately or ring HealthLine 0800 611 116 
  • Allergic reaction such as skin rash, itching, swelling of the lips, face, and mouth or difficulty breathing
  • Tell your doctor immediately or ring HealthLine 0800 611 116 
Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product


Roxithromycin interacts with a number of other medications including warfarin and colchicine, so always check with your doctor or pharmacist before starting roxithromycin or before starting any new medicines, including medicines you can buy without a prescription.

Learn more

Medsafe Consumer Information Sheet  Arrow-Roxithromycin 
New Zealand Formulary Patient Information: roxithromycin


  1. Roxithromycin New Zealand Formulary
  2. Roxithromycin New Zealand Formulary for Children

Clinical resources

Arrow-roxithromycin Medsafe, NZ
Drug-induced qt prolongation and torsades de pointes Medsafe, NZ, 2010
Upfront – antimicrobial resistance in NZ – what is my role in primary care? August, 2013
Antibiotics guide BPAC, NZ, 2013

Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 25 Feb 2019