Azifast Gel

Azifast Gel is an azithromycin gel for acne, made in India by Ipca Laboratories. Each gram contains 20 mg of azithromycin (2% w/w), and it comes in a 20 g tube. It is a skin gel, not an eye product. We sell it as single tubes and in packs of 3, 6 and 12 tubes, from $5.64 a tube in the 12 pack before shipping.

Before you buy, know two things. First, no azithromycin gel for the skin is approved in the US, UK or Canada: the regulators there approve azithromycin only as tablets, liquids, injections and eye drops. Second, the evidence for azithromycin gel in acne is small, and acne guidelines advise against using any antibiotic gel on its own. This page sets out what is known, how it is usually used, and what to pair it with.

Azifast Gel at a glance

Price per tube

Prices below are as of October 2026; the pack selector shows the current price.

Every pack is under the $149 free shipping threshold, so the flat $25 shipping makes a single tube expensive. Per gram with shipping, the gel costs $1.70 in a single tube and $0.39 in the 12 pack ($0.45 and $0.28 before shipping). We cannot tell you how many tubes a course needs: there is no label for this gel that sets an amount per application or a course length, and that depends on the area you treat and your doctor's plan. Buy one or three tubes first, and check how your skin responds before you order more.

What regulators approve, and what the evidence shows

Azithromycin is a well known antibiotic, but almost all of its approvals are for tablets, liquids and injections. In the FDA's drug approval database, every azithromycin product is given by mouth, by injection or into the eye (AzaSite eye drops); none is for the skin. Health Canada's drug database lists azithromycin products for oral, intravenous and eye use only. The UK NHS medicines dictionary lists azithromycin capsules, tablets, oral suspension, an infusion and eye drops, with no gel or cream. So a doctor in those countries cannot prescribe a licensed azithromycin gel; Azifast Gel is an Indian product.

The published trials are small:

• In an Iranian double blind trial, 40 people with mild to moderate acne used azithromycin 2% gel on one side of the face and clindamycin 1% gel on the other, twice a day for 8 weeks. Spots fell on both sides, with no significant difference between the two gels in lesion counts, satisfaction or side effects (Mokhtari 2016, PMID 27169103).
• A US study tested a 2% azithromycin solution, not a gel, once nightly against 2% erythromycin in 20 people with acne for 12 weeks. Both reduced inflamed spots; the authors said larger studies would be needed (McHugh 2004, PMID 15370397).
• A 2026 network meta-analysis of 34 trials of antibiotic gels and lotions used alone found that azithromycin 2% reduced blackheads and whiteheads compared with placebo, but no topical antibiotic improved total lesion counts. The authors concluded that routine use of antibiotics on their own should be limited (Lyu 2026, PMID 42105175).

No trial has tested Azifast Gel itself.

Use it with benzoyl peroxide or a retinoid, not alone

The NICE acne guideline in the UK says: "Do not use the following to treat acne: monotherapy with a topical antibiotic" (recommendation 1.5.11). Its first choice treatments that include a topical antibiotic pair clindamycin with benzoyl peroxide or with tretinoin. The American Academy of Dermatology's 2024 guideline also advises combining topical treatments that work in different ways. Neither guideline names azithromycin gel; their rule covers antibiotic gels in general, and the reason is antibiotic resistance in acne bacteria.

In practice, that means a doctor who prescribes an antibiotic gel will usually add benzoyl peroxide, such as Benzac AC 5% or Persol AC 5% Gel, or a retinoid such as Adaferin (adapalene) or A Ret Gel 0.05% (tretinoin). Do not use it at the same time as an antibiotic taken by mouth for acne, such as doxycycline: NICE advises against combining a topical and an oral antibiotic.

Compared with US options

NADAC is the average price US pharmacies pay, not a retail price; the figures are per gram for generic products in the NADAC week of 21 October 2026. Generic clindamycin 1% gel on its own is priced per millilitre in NADAC, at about $3.63 per mL. If you are in the US and have a prescription, compare cash prices for the US generics at local pharmacies before you order from abroad: they are approved, and the combination gel already contains benzoyl peroxide.

Other acne gels we sell

NICE's first-line list includes fixed combinations of benzoyl peroxide with clindamycin (as in Peroclin) and adapalene with benzoyl peroxide (as in Epiduo). Ask a doctor which suits your acne.

How to apply Azifast Gel

1. Use it only on the skin. The Tata 1mg listing says it is "for external use only".
2. Clean and dry the area, then apply a thin film over the affected skin. Wash your hands afterwards unless your hands are the treated area.
3. Use it as often and for as long as your doctor tells you. Truemeds gives no frequency. Tata 1mg's FAQ says 'usually prescribed once daily', but its other answers are copied from azithromycin tablets, so we do not treat this as a label dose. The one gel trial used it twice a day for 8 weeks; that is a study schedule, not a label dose.
4. Keep it away from the eyes, nose and mouth (Tata 1mg listing). It is not an eye gel; do not put it in or near the eyes.
5. Do not apply it to broken or damaged skin, eczema or sunburned skin (Tata 1mg listing).
6. The Tata 1mg listing says it can make skin more sensitive to sunlight, so limit sun exposure on treated skin.
7. NICE reviews acne treatment at 12 weeks. If your skin has not improved by then, see a doctor rather than continuing the gel.

Side effects

There is no regulator approved label for azithromycin gel, so there is no side effect table to quote. The Indian listings name skin reactions where the gel is applied: burning, irritation, itching and redness (Truemeds), and also dryness, scaling and changes in skin colour (Apollo Pharmacy). In the split face trial, the frequency of side effects did not differ significantly between azithromycin gel and clindamycin gel. If irritation is troublesome, stop and speak to a doctor.

When to stop and get help

• Signs of a serious allergic reaction, such as swelling of the face, lips, tongue or throat, difficulty breathing, or widespread hives: get urgent medical help. The US Zithromax label (tablets and oral suspension, taken by mouth) warns of serious, including fatal, allergic and skin reactions with azithromycin; no equivalent label exists for the gel, so treat this as general safety advice.
• Blistering, peeling or a spreading rash beyond the area you treated: stop using it and see a doctor promptly.
• Severe burning or swelling where you applied it: stop using it and speak to a doctor.

Who should not use Azifast Gel

• Anyone allergic to azithromycin or any ingredient of the gel. The US Zithromax label (tablets and oral suspension, taken by mouth) says azithromycin is contraindicated in people with known hypersensitivity to azithromycin, erythromycin, any macrolide or ketolide drug; if you have reacted to any of these antibiotics, do not use this gel.
• On broken or damaged skin, eczema or sunburned skin (Tata 1mg listing: "should not be applied" and "should not be used").

Talk to a doctor first if you are pregnant or breastfeeding, or before using it on a child: no label covers azithromycin gel in these groups. Tell your doctor about other acne products you use. Keep it out of reach of children.

Prescription and legal status

Azifast Gel is a prescription medicine in India. It is not licensed by the FDA, the MHRA, the TGA or Health Canada, and in the US the FDA says personal importation of unapproved medicines is illegal in most circumstances. Every azithromycin medicine in those countries is prescription only: the US Zithromax label is "Rx only", Health Canada lists all its azithromycin products as prescription, azithromycin is a prescription-only medicine (POM) in the UK, and in Australia it is Schedule 4, Prescription Only Medicine. See a doctor before you start, and check the rules where you live.

Buying genuine Azifast Gel

The MHRA warns: "Any medicine not authorised for sale in the UK can be unsafe or ineffective and there is no way of knowing what is in them." It advises UK buyers: "Only use UK-registered pharmacies, including online pharmacies displaying the official green cross logo". That warning covers Azifast Gel, which is not authorised in the UK. When your order arrives, check that the carton and tube name Ipca and Azifast, show azithromycin 2%, a batch number and an expiry date, and that the tube is sealed. These checks cannot prove a tube is genuine, because counterfeiters copy packaging. If a tube causes unusual symptoms, stop using it, seek medical advice, and report it to your medicines regulator (the MHRA Yellow Card scheme in the UK, FDA MedWatch in the US, the TGA in Australia or Health Canada) as well as to us. Store it below 25 °C with the cap closed.

Delivery

We ship Azifast Gel to the US, UK, Australia and Canada in plain packaging with tracking. Standard delivery takes 7 to 14 business days to most countries. Shipping costs a flat $25 on orders under $149 and is free from $149. See our shipping page and refund policy.

Related guides

• Topical antibiotics for acne
• Doxycycline for acne: why it never works alone
• Antibiotic resistance: when antibiotics do not work
• Adapalene vs tretinoin: what the head to head trials show
• Azithromycin dosage (tablets): why a five day course keeps working

Sources

• Indian listings for Azifast Gel 20 g (composition, maker, pack, prescription status, storage, directions, warnings): Tata 1mg, Truemeds and Apollo Pharmacy, checked 20 October 2026.
• Mokhtari F, et al. Comparison effect of azithromycin gel 2% with clindamycin gel 1% in patients with acne. Adv Biomed Res 2016. PMID 27169103.
• McHugh RC, et al. A topical azithromycin preparation for the treatment of acne vulgaris and rosacea. J Dermatolog Treat 2004. PMID 15370397.
• Lyu et al. Topical antibiotic monotherapy only provides mild benefit for patients with acne vulgaris: a systematic review and network meta-analysis. Clin Drug Investig 2026. PMID 42105175.
• National Institute for Health and Care Excellence. Acne vulgaris: management (NG198), recommendations 1.5.11 and 1.5.12. NICE
• Reynolds RV, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol 2024. PMID 38300170.
• ZITHROMAX (azithromycin) US prescribing information, sections 4.1 and 5.1, Pfizer, DailyMed setid db52b91e-79f7-4cc1-9564-f2eee8e31c45, July 2026.
• FDA Drugs@FDA (openFDA) azithromycin products by route; Health Canada Drug Product Database, azithromycin (route and schedule); NHS dictionary of medicines and devices, azithromycin; Teva UK azithromycin capsules (legal category POM); healthdirect Australia, Zithromax (Schedule 4). Checked 20 October 2026.
• Centers for Medicare and Medicaid Services. National Average Drug Acquisition Cost (NADAC), erythromycin 2% gel, clindamycin 1% with benzoyl peroxide 5% gel and clindamycin phosphate 1% gel, week of 21 October 2026. data.medicaid.gov
• MHRA. 20 million illegal erectile dysfunction pills seized as MHRA warns against risky online buys, 13 February 2026. GOV.UK.
• US Food and Drug Administration. Personal Importation. FDA

This page is for information and is not medical advice. Azifast Gel is a prescription medicine in India; talk to a doctor or pharmacist before using it.