Jenni asked
Can I take Diphenhydramine and Melatonin and Zolpidiem together?
Answer
Benadryl (diphenhydramine), Ambien (zolpidem), and melatonin are not recommended to be taken together due to additive sedation and additive CNS depression. The resulting side effects could be dangerous.
Two or more of these medications should only be taken together under the recommendation and supervision of your doctor. Taking all three medications together will increase the risk of:
- Dizziness
- Drowsiness
- Dry mouth
- Dry eyes
- Constipation
- Respiratory depression
Of particular note are Benaryl and Ambien. Both depress the central nervous system and there have been reports of respiratory depression on the combustion. This could lead to labored and shallow breathing which can be extremely dangerous, especially in certain individuals taking other CNS depressants such as opioids.
Below is some additional information on each medication.
Benadryl (Diphenhydramine)
Benadryl is a sedating antihistamine, used most commonly for the treatment of allergic reactions, seasonal allergies, symptoms associated with the common cold and insomnia. Benadryl may be taken without regard to meals. Commonly reported side effects associated with taking Benadryl include but are not limited to:
- Drowsiness
- Dizziness
- Fatigue
- Dry mouth
- Constipation
Ambien (Zolpidem)
Ambien (Zolpidem) is a sedative hypnotic medication and is available as an immediate release tablet (Ambien) and as an extended release tablet (Ambien CR). Ambien acts on the GABA receptors which leads to the desired sedative effects in treating insomnia.
Ambien and Ambien CR should both be taken on an empty stomach right before bedtime as the average onset of action for both the immediate and extended release tablets is 30 minutes The onset can vary between individuals and may be delayed if the medication is taken with food. You should take the lowest effective dose of Ambien as taking higher than needed doses can result in increased risks of side effects. Side effects of Ambien include but are not limited to:
- Anxiety
- Drowsiness
- Headache
- Depression
- Unusual thoughts
- Grogginess
- Dry mouth
- Constipation
- Irregular heart rate
Melatonin
Melatonin is a naturally produced hormone that helps to regulate our circadian rhythm as well as the sleep wake cycle. Although taking melatonin can help with making the body feel tired as a rise of melatonin levels generally indicates to our body that it is time to sleep it is not as effective as other treatments for short term insomnia.
It is more effective in populations that have decreased melatonin production such as the elderly as well as populations that may have a disruption to the normal sleep wake cycle such as shift workers or individuals suffering from jet lag. Common side effects associated with taking melatonin include but are not limited to:
- Drowsiness
- Headache
- Stomach cramps
Additional Information
If you are still having problems sleeping after having been prescribed Ambien, it is important to speak to your doctor. You may need a dose or medication change, or be re-evaluated as to the cause of your insomnia. It generally is not recommended to add more sleeping medications on top of it (e.g. Benadryl) if it isn't working well.
