It is generally not recommended to drink alcohol while taking a Z-Pak (azithromycin), although there are no documented direct interactions between them. Drinking a small amount of alcohol (one or two glasses) is likely safe, but consuming larger quantities can worsen side effects of azithromycin such as nausea, diarrhea, vomiting, abdominal pain, headache, and fatigue. Alcohol can also hinder the body's ability to fight infection, cause dehydration, and disrupt sleep. For best safety, it is advised to avoid alcohol during the treatment and to wait at least 72 hours after finishing the antibiotic before drinking alcohol again. In summary, occasional small amounts of alcohol may be tolerated, but it is better to avoid drinking while on a Z-Pak to ensure optimal effectiveness and reduce side effects.