Which Antihistamines Are Safe To Take With Ativan?

In our latest question and answer, the pharmacist discusses which antihistamines are considered safe to take with Ativan (lorazepam).

Question

I am taking Zoloft, Ativan, and famotidine. I’m having really bad allergies but I’ve read that it is not good to mix Benadryl with Ativan. Are there any good alternatives to Benadryl that can be taken with my meds? Also, what is the safest option for antacids based on the meds I’m taking?

Asked by Matt On Oct 25, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Oct 25, 2022
Last updated Oct 25, 2022

Key points

  • Sedating antihistamiens (such as Benadryl) should generally be avoided with Ativan (lorazepam) due to the increased risk of additive side effects (e.g., sedation, dizziness etc...).
  • Non-sedating antihistamines, such as Claritin (loratadine) and Allegra (fexofenadine) are considered safe to take with Ativan.

Answer

You're correct that there is a potential interaction between Benadryl (diphenhydramine) and Ativan (lorazepam). Both drugs can cause sedation, dizziness, and drowsiness, so taking both together can potentiate these effects.

We have actually answered a question in the past regarding this very same combination (which can be found here).

It is important to note that the interaction between Benadryl and Ativan is based on the additive side effects (specifically, their CNS [central nervous system] depressant effects). As there are plenty of antihistamines available over-the-counter that are essentially non-drowsy, you have alternative options.

Antihistamines Safe With Ativan

The safest antihistamines to take with Ativan are the ones that are non-drowsy. This includes most of the second-generation antihistamines, such as:

It should be noted that Claritin and Allegra are 'non-drowsy', and marketed as such, while Zyrtec and Xyzal cause sedation in about 10% of individuals.

As mentioned, you generally want to avoid sedating antihistamines with Ativan, so this would include Benadryl (diphenhydramine), Chlor-Trimeton (chlorpheniramine), and doxylamine (the antihistamine in NyQuil)

Final Words

You also asked about safe antacids with your medications. You are already taking famotidine (generic for Pepcid), so I assume you are asking about fast-acting antacids.

Antacids like Tums (calcium carbonate) and Mylanta (magnesium hydroxide/aluminum hydroxide/simethicone) are safe with your medications.

Some studies suggest antacids may slow the absorption of benzodiazepines (such as lorazepam), making them take longer to work, but this doesn't appear to be clinically significant and I could not find any that specifically noted an interaction with Ativan.

I hope this answer helped and please reach back out anytime!

References

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 11 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Feel free to send him an email at Hello@HelloPharmacist.com! You can also connect with Dr. Brian Staiger on LinkedIn.

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