It is best to avoid alcohol while taking a Z-Pak, according to Healthline. Azithromycin, the antibiotic in a Z-Pak, is filtered from the body through the liver. Drinking alcohol while taking this medication puts extra stress on the liver and can lead to liver damage.
Drinking alcohol while taking a Z-Pak may also increase the severity of side effects, such as nausea, vomiting and headache, states Healthline. Treatment with a Z-Pak sometimes produces serious side effects, including watery or bloody diarrhea, fast or pounding heartbeats, chest pain, upper stomach pain, and yellowing of the skin or eyes, states Drugs.com. Immediate medical attention is recommended if serious side effects occur.