A doctor has raised concerns about the misuse of diphenhydramine, commonly known as Benadryl, for treating food allergies. Dr. Anna Wolfson, an allergist at Massachusetts General Hospital, emphasizes that epinephrine should be the go-to treatment in such situations, rather than relying on diphenhydramine. She observes that patients often mistakenly think the medication can help, but in reality, it can lead to drowsiness, masking the worsening symptoms of an allergic reaction.
“It’s really time to reconsider our approach,” she stated, highlighting that there are safer and more effective alternatives available. Some of her patients, she noted, have experienced impairments in their daily activities due to the effects of diphenhydramine.
Wolfson’s views are supported by recent allergy experts from institutions like Johns Hopkins University and the University of California, San Diego. They suggest that diphenhydramine is outdated and should be removed from both over-the-counter and prescription markets due to its safety concerns.
Approved for use in 1946, diphenhydramine is still widely used in the U.S. for allergies and related symptoms, particularly during summer months. However, the experts warn that it poses risks, especially for children and the elderly, when compared to newer antihistamines.
Dr. James Clark, leading author of a recent review, recommends alternatives like loratadine (Claritin) and cetirizine (Zyrtec), which might provide better relief without the side effects associated with diphenhydramine.
The Consumer Healthcare Products Association acknowledges that while diphenhydramine can offer symptom relief, it is not meant for long-term use, pointing out that users should adhere to dosage instructions and consult healthcare providers with any concerns.
Understanding Diphenhydramine Risks
Diphenhydramine blocks H1 receptors to address allergy symptoms, but this older medication affects the brain in other ways, leading to sedation and cognitive issues. For older adults, the drug’s effects can linger for hours, raising the risk of falls and confusion, with potential links to dementia noted in long-term use.
In children, the risks are pronounced, including cases of overdose and extreme reactions, which have even led to fatalities linked to misuse during challenges on platforms like TikTok.
Dr. Manuela Murray of the University of Texas Medical Branch advises that diphenhydramine should be administered carefully and only for specific situations like allergic reactions or motion sickness. It’s not effective for treating cold symptoms and can actually increase hyperactivity in children.
Dr. Alyssa Kuban, a pediatrician at Texas Children’s Pediatrics, agrees that alternative treatments are often overlooked. She finds many families mistakenly use diphenhydramine for colds, which doesn’t help and can be unsafe. Instead, she suggests using cetirizine for allergy-related conditions.
Murray concurs that for infants, saline drops and suctioning are more suitable alternatives, while older children can benefit from options like loratadine and cetirizine.
A Call for Change
Diphenhydramine is present in over 300 OTC products, often combined with others for cold symptoms. The review’s authors argue that it should be more tightly regulated, with pharmacists directing patients towards safer medications.
The American Pharmacists Association recommends caution with combination products containing diphenhydramine and encourages patients to consult pharmacists for the best treatment options with minimal side effects.
Despite diphenhydramine’s long history of use, the authors highlight that there is no substantial evidence suggesting it is more effective than newer alternatives. Although it may alleviate symptoms like sneezing, its effects on nasal congestion are limited compared to current options, such as oral cetirizine, which offers 24-hour relief.
Surprisingly, diphenhydramine continues to be commonly prescribed in the U.S., with over 1.5 million prescriptions written each year. Experts assert that while it was once beneficial, its current risks and side effects now outweigh any advantages, making it time to say goodbye to diphenhydramine as a reliable medication.
