Taking NyQuil WIth Azithromycin (Z-Pak)
In our latest question and answer, the pharmacist discusses whether or not it is safe to take NyQuil and azithromycin (Z-Pak) together.
I started with my first dose of Azithromycin today, two 250mg around 6 hours ago. Can I take Nyquil tonight before bed?
Answered by Dr. Brian Staiger, PharmD
Medical Content Reviewed By HelloPharmacist Staff
Last updated Jun 07, 2023
- There is no known interaction between azithromycin (the antibiotic contained in a Z-Pak) and the drugs contained in NyQuil.
There is no known drug interaction between azithromycin (Z-Pak) and Nyquil (acetaminophen, dextromethorphan, and doxylamine). They can be safely taken together.
'NyQuil Severe', which contains one additional ingredient when compared to the 'original' NyQuil, is also safe to take with a Z-Pak.
Below, I discuss each medication in more detail
Information About The Z-Pak
A Z-pak consists of six tablets of azithromycin 250 mg. Most commonly, it is prescribed to be taken as follows:
- Take two tablets (500mg) by mouth on the first day of therapy
- Take one tablet (250mg) by mouth for the following four days
Azithromycin, the antibiotic in the Z-Pak, 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 (a type of arrhythmia) 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.
Information About Nyquil
Nyquil comes in a variety of formulations and contains several different ingredients. Nyquil Cold & Flu contains the following:
- Acetaminophen (pain relief, fever reducer)
- Dextromethorphan (cough suppressant)
- Doxylamine (antihistamine)
'NyQuil Severe' adds on a nasal decongestant, phenylephrine.
Acetaminophen is an analgesic that can be taken for a wide variety of acute and chronic pain ailments. Acetaminophen has a half-life of 2-3 hours. About 85-98% of the drug gets absorbed and it reaches peak concentrations within 30-60 minutes.
Typically, acetaminophen can start working within 15 minutes. Acetaminophen can have negative impacts on the liver, especially at higher doses for an extended period of time.
Dextromethorphan (commonly referred to as DM on many over-the-counter products) is a cough suppressant that reduces the urge to cough. It is best to prevent a bothersome dry cough or a cough that doesn’t involve mucus from the lower respiratory system.
Doxylamine is a first-generation antihistamine that is more likely to cause sedation and drowsiness as compared to second-generation antihistamines (i.e., loratadine, cetirizine).
Other first-generation antihistamines include Benadryl (diphenhydramine), Dramamine (dimenhydrinate), Chlor-Trimeton (chlorpheniramine), Tavist (clemastine), and Phenergan (promethazine), among others.
NyQuil often represents a good medication choice for those suffering from a variety of symptoms that may come about from an infection, such as a fever, body aches, congestion, and a cough.
As mentioned, NyQuil (and NyQuil Severe) are safe to take with azithromycin.
Thanks for your question!
- Dr. Brian Staiger, PharmD
- 6024 views
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