Drinking alcohol while on azithromycin, or the Z-Pak, can potentially worsen drug side effects, including headache and liver damage.

Azithromycin is an antibiotic that stops the growth of bacteria that can cause infections such as:

It only treats these or other infections if they’re caused bacteria. It doesn’t treat infections caused by a virus or fungus.

Azithromycin comes in oral tablets, oral capsules, oral suspension, eye drops, and an injectable form. You can usually take the oral forms with or without food. But can you also take this drug with your favorite alcoholic beverage?

Azithromycin starts to work quickly, often within the first couple of days after you start taking it. You’ll probably feel well enough to resume your normal activities soon after you start the drug. Still, you may want to hold off from enjoying your favorite cocktails until you finish treatment.

Alcohol doesn’t appear to reduce the effectiveness of azithromycin. A study done on rats published in Alcoholism: Clinical & Experimental Research found that alcohol doesn’t prevent azithromycin from treating the bacterial infection.

That said, drinking alcohol can cause temporary liver damage in some people. This may increase the severity of some of the unpleasant side effects of this drug. Alcohol is also dehydrating. Dehydration can increase the risk of side effects or make them worse if you already have them. These side effects can include:

In rare cases, azithromycin itself can also cause liver damage and result in more severe side effects. It’s a good idea to avoid doing anything that creates extra stress on your liver, such as drinking alcohol, while you take the drug.

Talk with your doctor before taking azithromycin if you take other drugs, including:

  • over-the-counter drugs
  • vitamins
  • supplements
  • herbal remedies

Some drugs interact with azithromycin. These interactions can also be rough on your liver, especially if you’ve had past liver problems. Also, when your liver has to process several different medications at the same time, it may process all of them more slowly. This leads to more of the drugs sticking around in your blood stream, which can increase the risk and intensity of side effects.

It’s important to take all of your antibiotic medication. Keep taking it even if you begin to feel better. This helps ensure that your infection is completely cured and won’t come back. It also prevents you from developing antibiotic-resistant bacteria. As bacteria becomes resistant to treatment, fewer drugs work to treat the infections caused by these bacteria.

Take your medication at the same time each day. This can help ensure you don’t skip a dose. It may be annoying to continue taking those pills or liquid when you’re feeling better, but it’s crucial to complete your treatment to help prevent bacterial resistance.

Azithromycin is generally a safe drug. Drinking moderate amounts of alcohol (three drinks or fewer per day) doesn’t seem to reduce the effectiveness of this drug. However, combining azithromycin with alcohol could intensify your side effects.

Remember, treatment with this drug is not very long. Postponing happy hour until your treatment is complete may just save you a headache or two.