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).

Question

Can you take Benadryl with a Zpack? I was prescribed one and am having some issues sleeping.

Asked by Travis On Feb 13, 2018

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Feb 18, 2018

There are no drug interactions between Benadryl (diphenhydramine) and a Z-Pak (azithromycin). Benadryl may help with some of the symptoms associated with both allergies and infection, such as runny nose, sneezing, and itching of the nose, throat, or eyes. We will discuss more about these two drugs 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), and Phenergan (promethazine), among others. 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) and are much less sedating. These antihistamines are generally only used for 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. 

About the Pharmacist

Dr. Kevin Davis Pharm.D

Dr. Kevin Davis is a licensed pharmacist with experience in retail and hospital pharmacy. He graduated from the University of Florida with a Doctor of Pharmacy degree in 2015 and a Master of Healthcare Administration degree from Adventist University in 2017. He is also a Board Certified Pharmacotherapy Specialist since 2016.

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