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Suggest Remedy For Itchy Hives After Taking Z-pack For Sinus Infection

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Posted on Wed, 24 Jun 2015
Question: i had a sinus infection that wouldn't go away so my dr prescribed a zpack and prednisone. i have never taken antibiotics before but i had taken prednisone and never had a reaction. well after starting the zpack i got super itchy and after ending both medications i broke out in hives all over my body. i took Benadryl and it's been one week since i stopped taking the zpack. i looked online and it looks like it is a common allergy symptom if you are allergic to the zpack which i must be. as the days go on the hives decrease in frequency and size but i asked my dr what to do and she said she is not sure and to just take Benadryl as needed?? should i be taking something else?? i am a little concerned if i am still having a reaction to it.
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Answered by Dr. Bonnie Berger-Durnbaugh (41 minutes later)
Brief Answer:
You can try Zyrtec (cetirizine).

Detailed Answer:
I am sorry you are having this allergic reaction. Hives and itching can be very miserable.

I am thinking that since you were on prednisone at the same time as the Zithromax, the prednisone was probably was masking the allergic reaction you have to azithromycin until you were off of it (the prednisone).

What to do now? It is reassuring that the hives are decreasing in frequency and size. You might want to consider trying over the counter Zyrtec (cetirizine) in place of as needed Benadryl. Zyrtec is also a very effective antihistamine and is one of the best for hives and itching. A benefit of Zyrtec over Benadryl is that it lasts 24 hours, and is less sedating. Brand name Zyrtec can be pricey, so if that is an issue, the generic cetirizine is much less expensive.

I would recommend starting with 1 tablet of 10 mg cetirizine at bedtime. If you tolerate that well but the hives still continue, you can double the dose by taking an additional (1) 10 mg tablet in the morning. If you tend to be sensitive to the side effects of meds, titrate up to that slowly by cutting the second dose in half.

It is not uncommon for allergic reactions to medications to last for a week or more. The main thing is that it appears to be diminishing in intensity.

Another thing that allergist sometimes add on to hive treatment, particularly if the hives or itching are severe, is the stomach medicine Zantac (ranitidine). It is used in these cases because some skin histamine receptors are H2, and Zantac is an H2 blocker. MOST of the histamine receptors in the skin are the standard H1 receptors, so you would want to use a traditional antihistamine like Benadryl or Zyrtec as your main treatment; and if that is not controlling it adequately, then adding Zantac 150 mg twice a day can help.

Prednisone is sometimes used for intractable drug reactions, but would not seem appropriate in your case because the hives seem to be decreasing, and you can still increase your antihistamine regimen, which would be safer than a corticosteroid.

I hope this information helps. Please let me know if I can clarify further or provide additional information.

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3134 Questions

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Suggest Remedy For Itchy Hives After Taking Z-pack For Sinus Infection

Brief Answer: You can try Zyrtec (cetirizine). Detailed Answer: I am sorry you are having this allergic reaction. Hives and itching can be very miserable. I am thinking that since you were on prednisone at the same time as the Zithromax, the prednisone was probably was masking the allergic reaction you have to azithromycin until you were off of it (the prednisone). What to do now? It is reassuring that the hives are decreasing in frequency and size. You might want to consider trying over the counter Zyrtec (cetirizine) in place of as needed Benadryl. Zyrtec is also a very effective antihistamine and is one of the best for hives and itching. A benefit of Zyrtec over Benadryl is that it lasts 24 hours, and is less sedating. Brand name Zyrtec can be pricey, so if that is an issue, the generic cetirizine is much less expensive. I would recommend starting with 1 tablet of 10 mg cetirizine at bedtime. If you tolerate that well but the hives still continue, you can double the dose by taking an additional (1) 10 mg tablet in the morning. If you tend to be sensitive to the side effects of meds, titrate up to that slowly by cutting the second dose in half. It is not uncommon for allergic reactions to medications to last for a week or more. The main thing is that it appears to be diminishing in intensity. Another thing that allergist sometimes add on to hive treatment, particularly if the hives or itching are severe, is the stomach medicine Zantac (ranitidine). It is used in these cases because some skin histamine receptors are H2, and Zantac is an H2 blocker. MOST of the histamine receptors in the skin are the standard H1 receptors, so you would want to use a traditional antihistamine like Benadryl or Zyrtec as your main treatment; and if that is not controlling it adequately, then adding Zantac 150 mg twice a day can help. Prednisone is sometimes used for intractable drug reactions, but would not seem appropriate in your case because the hives seem to be decreasing, and you can still increase your antihistamine regimen, which would be safer than a corticosteroid. I hope this information helps. Please let me know if I can clarify further or provide additional information.