Is it ok to drink alcohol while taking z pac (azithromycin) antibiotic?

Within limits, yes: Azithromycin can cause gastrointestinal irritation with abdominal pain, nausea, or cramping, and alcohol could make it worse. For most people, a couple of mixed drinks, wine, or beer aren't likely to be a problem, but go easy. Of course heavy alcohol use impairs the body's ability to fight any infection, so no heavy drinking.