Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Ashwagandha or Withania somnifera is known as Indian ginseng, poison gooseberry, or winter cherry, is a plant product. The roots of Ashwagandha have been used to treat arthritis, constipation, insomnia, etc. It is not known how the Ashwagandha extract interacts with various antibiotics like Azithromycin. Azithromycin has a unique mechanism of action and complex metabolic profile of absorption, assimilation, distribution, metabolites, and excretion just like the other antibiotics. When you take both of these drugs at the same time, it may be a neutral, synergistic, additive, or antagonistic interaction. Since, we don’t have detailed drug-to-drug interaction profile of Ashwagandha with other antibiotics including any drugs, it s an unknown territory to experiment without scientific evidence. I suggest you to not use both of these drugs together with no known risks or benefits until your treating doctor tell you it s totally safe. Yes, Azithromycin, like the other antibiotics had effect in making darker urine. So you don t have to worry, unless there is: 1. Fever 2. Blood clot in urine 3. Dysuria, pain when peeing, etc. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nurul Falah