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 Z-pack? I was prescribed one and am having some issues sleeping.

Asked by Travis On Nov 01, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Nov 01, 2022
Last updated Mar 28, 2024

Key points

  • There is no known interaction between Benadryl and amoxicillin.

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! 

References

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at [email protected]! You can also connect with Dr. Brian Staiger on LinkedIn.

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