Roxithromycin capsules are antibacterial drug preparations for oral administration. It has a good safety profile and serious adverse reactions are rare. However, with the wide application of roxithromycin in clinical practice, more and more patients are experiencing adverse reactions, and the manifestations are diverse. Gastrointestinal adverse reactions caused by roxithromycin are more common, with an incidence of 4.1%, and commonly include nausea (1.3%), abdominal pain (1.2%), and diarrhea (0.8%). In addition, treatment with roxithromycin may result in allergic reactions of varying severity. Most of these allergic reactions are skin and mucosal reactions, such as redness with or without pruritus or purpura redness and swelling, more rarely swelling of the face, tongue or throat, as well as dyspnea and even the possibility of fatal shock. There are also effects on the liver and bile ducts, with some patients experiencing weight loss, epigastric pain, fever, jaundice with mild hepatomegaly, and hepatocellular damage with cholestasis as features of roxithromycin use. Most patients recover spontaneously within a few weeks of stopping the drug. There have also been rare cases in which signs of pancreatitis have been observed during or after treatment with roxithromycin. These signs are reversible once treatment is discontinued. Also, the drug should be discontinued in the event of a severe reaction.