Paradoxical reactions to diphenhydramine have been documented, in particular among children, and it may cause excitation instead of sedation. Still, non-sedating antihistamines are the preferred alternative. A single bedtime dose after the last feeding of the day may minimize any harmful effects of the medication on the baby and on the milk supply. Large doses or long-term use may affect the baby or reduce breast milk supply, especially when combined with sympathomimetic drugs such as pseudoephedrine or before the establishment of lactation. It is expected that low doses of diphenhydramine taken occasionally will not cause any adverse effects on breastfed infants. ĭiphenhydramine is category B in the FDA Classification of Drug Safety During Pregnancy. Due to its strong anticholinergic effects, diphenhydramine is on the Beers list of drugs to avoid in the elderly. These populations should be treated with second-generation antihistamines such as loratadine, desloratadine, fexofenadine, cetirizine, levocetirizine, and azelastine. Special populations ĭiphenhydramine is not recommended for people older than 60 or children under the age of six, unless a physician is consulted.

Nausea ĭiphenhydramine also has antiemetic properties, which make it useful in treating the nausea that occurs in vertigo and motion sickness. A major systematic review and network meta-analysis of medications for the treatment of insomnia published in 2022 found little evidence to inform the use of diphenhydramine for insomnia.

The American Academy of Sleep Medicine's 2017 clinical practice guidelines recommended against the use of diphenhydramine in the treatment of insomnia due to poor effectiveness and low quality of evidence. The ethics of this use have also been challenged, with the Seattle Children's hospital arguing in a 2009 article that 'Using a medication for your convenience is never an indication for medication in a child.' This has been met with criticism, both by doctors and members of the airline industry, as sedating young passengers may put them at risk if the flight encounters an emergency and they are unable to react to the situation efficiently, and the drug's side effects, especially the chance of a paradoxical reaction, may result in some individuals becoming hyperactive rather than sedated. ĭiphenhydramine has also been used off prescription by parents in an attempt to make their children sleep or remain sedated on long-distance flights. Diphenhydramine has also been used as an anxiolytic. Diphenhydramine can cause minor psychological dependence. The drug is an ingredient in several products sold as sleep aids, either alone or in combination with other ingredients such as acetaminophen (paracetamol) in Tylenol PM or ibuprofen in Advil PM. It is also used to treat acute dystonia including torticollis and oculogyric crisis caused by first generation antipsychotics.īecause of its sedative properties, diphenhydramine is widely used in nonprescription sleep aids for insomnia. Movement disorders ĭiphenhydramine is used to treat akathisia and Parkinson's disease–like extrapyramidal symptoms caused by antipsychotics. These are used to relieve itching and have the advantage of causing fewer systemic effects ( e.g., drowsiness) than oral forms. Topical formulations of diphenhydramine are available, including creams, lotions, gels, and sprays. Ī bottle of topical 'Itch-Stopping Gel' diphenhydramine In 2017, it was the 241st most commonly prescribed medication in the United States, with more than two million prescriptions. It is sold under the brand name Benadryl, among others. ĭiphenhydramine was first made by George Rieveschl and came into commercial use in 1946. This has led to some cases of recreational use and addiction. Diphenhydramine is also a potent anticholinergic, and works as a deliriant at higher than recommended doses as a result. It is a first generation H 1-antihistamine and ethanolamine and works by blocking certain effects of histamine. There is no clear risk of harm when used during pregnancy however, use during breastfeeding is not recommended. Its use is not recommended in young children or the elderly. Ĭommon side effects include sleepiness, poor coordination and an upset stomach. Maximal effect is typically around two hours after a dose, and effects can last for up to seven hours. It is taken by mouth, injected into a vein, injected into a muscle, or applied to the skin. It can also be used for insomnia, symptoms of the common cold, tremor in parkinsonism, and nausea. Diphenhydramine ( DPH) is an antihistamine medication mainly used to treat allergies.

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