Jan asked
Can you take Sudafed with Dymista nasal spray? I want to take Sudafed during the day and then Benadryl at night to sleep...is this OK? Was using Nasonex for a couple of weeks and it was not working for post nasal drip. Thank you for your help.
At a glance
- Sudafed and Dymista can safely be used together (absent of any patient-specific contraindications).
Answer
There are no known drug interactions between Sudafed (pseudoephedrine) and Dymista (azelastine/fluticasone). They are considered safe to take together.
Sudafed With Dymista
The two products contain three different active ingredients between them:
- Pseudoephedrine (from Sudafed)
- Azelastine (from Dymista)
- Fluticasone (from Dymista)
All there active ingredients are in different classes of medication and work in separate ways.
Pseudoephedrine
Pseudoephedrine is used to treat both nasal and sinus congestion. It is indicated for use in adults and children 4 years of age and older.
It works to relieve congestion by acting on alpha-adrenergic receptors. This action constricts blood vessels (i.e. vasoconstriction), which helps to shrink swollen nasal membranes and increase airflow.
Azelastine
Azelastine is classified as an antihistamine (similar to Claritin). It, however, is only available in nasal preparations and not in oral dosage forms.
In addition to blocking histamine receptors, which helps to relieve symptoms commonly associated with allergies, it also is a mast cell stabilizer. Mast cell stabilizers prevent the release of histamine.
Fluticasone
Fluticasone is a corticosteroid and is used for a variety of indications. As a nasal decongestant, it helps to reduce the allergic response our body has to allergens. It affects many different types of cells in our bodies, including:
- Mast cells
- Eosinophils
The overall effect is a reduction in symptoms, such as:
- Runny nose
- postnasal drip
- Sneezing
- Congestion
- Sneezing
Can They Be Used Together?
Yes, they can all be used together as there are no known drug interactions between any of the three ingredients listed above (pseudoephedrine, azelastine, fluticasone).
In fact, your doctor may recommend the use of them all initially, until your symptoms begin to improve. Dymista, while effective, often takes at least a few days for the full effects to be realized. Sudafed, on the other hand, works quickly and should help to provide more immediate relief.
In general, Sudafed should be used only intermittently (i.e. not every day), while Dymista is more of maintenance medication, and daily use is necessary for optimal effectiveness.
Additional Information
You mentioned wanting to take Benadryl (diphenhydramine) at night so I wanted to touch on that too. Benadryl is safe to take with Sudafed, but you may want to avoid it if you are taking Dymista as well.
Since Dymista already contains an antihistamine (azelastine), taking Benadryl too would be considered a 'therapeutic duplication', and there may be an increased risk of side effects, like dry mouth and dry eyes.
Taking Benadryl while on Dymista once in a while shouldn't be much of an issue, but it would be prudent to avoid continuous use of both.
References
- Elsevier ClinicalKey: Dymista Monograph (Accessed 2/13/19)
- Elsevier ClinicalKey: Sudafed Monograph (Accessed 2/13/19)
- Azelastine nasal spray for the treatment of allergic and nonallergic rhinitis. PubMed
- Clinical Practice Guideline: Allergic Rhinitis. SAGE Journals
