Can You Take Benadryl With A Z-Pak (Azithromycin)?
In our latest question and answer, the pharmacist discusses whether or not Benadryl (diphenhydramine) can be safely taken with a Z-Pak (azithromycin).
Can you take Benadryl with a Z-pack? I was prescribed one and am having some issues sleeping.
Nov 01, 2022- Benadryl and Z-Pak have no drug interactions and are safe to take together.
- Benadryl may help relieve some infection-related symptoms like runny nose, sneezing, and itching.
- Benadryl is more likely to cause drowsiness and sedation compared to other antihistamines.
Answer
There are no drug interactions between Benadryl (diphenhydramine) and a Z-Pak (azithromycin). They are considered safe to combine.
Benadryl may actually help with some of the symptoms associated with an infection, such as runny nose, sneezing, and itching of the nose, throat, or eyes.
I discuss these two drugs in additional detail below.
Information About Benadryl
Benadryl is a first-generation antihistamine. Antihistamines are widely used for self-care of allergy symptoms including runny nose, watery eyes, sneezing, and itching of the nose, throat, or eyes. Benadryl may also be used for symptoms of the common cold, allergic reactions, occasional insomnia, and more.
Because Benadryl is a first-generation antihistamine, it is more likely to cause sedation and drowsiness.
Other first-generation antihistamines include:
- Dramamine (dimenhydrinate)
- Chlor-Trimeton (chlorpheniramine)
- Tavist (clemastine)
- Phenergan (promethazine)
These medications cross the blood-brain barrier and have CNS effects like drowsiness and dizziness.
First-generation antihistamines can also cause urinary retention, GI upset, and blurry vision. The first generation antihistamines are also listed as medications to avoid in elderly adults by the Beers Criteria due to the increased risk of confusion, dry mouth, and drowsiness.
Second-generation antihistamines include Claritin (loratadine), Cetirizine (Zyrtec), and Allegra (fexofenadine) which are much less sedating. These antihistamines are generally only used for the treatment of allergy symptoms, whereas Benadryl can be used for a variety of reasons including allergies, insect bites, poison ivy, sleep, and motion sickness.
Information About The Z-Pak
A Z-pak consists of six tablets of azithromycin 250 mg. Usually, two tablets are prescribed on the first day of therapy, followed by one tablet for the following four days.
Azithromycin is a macrolide antibiotic that can treat a variety of infections including bronchitis, sinus infections, ear infections, skin infections, sexually transmitted infections, and more. Azithromycin can cover several types of bacteria but is not effective in treating the flu, the common cold, or other viral infections.
Like most antibiotics, azithromycin may cause diarrhea, nausea, vomiting, and abdominal pain. Macrolides are more likely to cause these types of side effects, but azithromycin is one of the more tolerable drugs in the class.
Another concern with azithromycin is that it can cause QT prolongation in patients with a past medical history related to the heart. Drug interactions can also be a concern so always check each new medication prior to starting a new therapy.
Final Words
Thanks for your question and reach back out anytime!
Glossary — Terms in This Answer
- Antihistamine
- A medication that blocks histamine, a chemical in your body that causes allergy symptoms like itching and sneezing.
- Blood-brain barrier
- A protective barrier that controls which substances can pass from your bloodstream into your brain.
- CNS effects
- Effects on the central nervous system (brain and spinal cord) such as drowsiness or dizziness.
- Macrolide antibiotic
- A type of antibiotic that works by stopping bacteria from making proteins needed for survival.
- QT prolongation
- A change in the heart's electrical activity that can be dangerous and increase the risk of abnormal heart rhythms.
- Beers Criteria
- A list of medications that should generally be avoided in elderly adults because they pose higher risks of side effects in that population.
- Urinary retention
- A condition where the body has difficulty emptying the bladder completely.
- GI upset
- Stomach or digestive system discomfort such as nausea or pain.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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