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(die-fen-HIGH-druh-meen HIGH-droe-KLOR-ide)
40 Winks
Tablets
50 mg
Allergy Medication
Liquid
12.5 mg/5 mL
AllerMax
Tablets
50 mg
AllerMax Allergy and Cough Formula
Liquid
6.25 mg/5 mL
Banophen
Capsules
25 mg
Benadryl
Injection
50 mg/mL
Benadryl Allergy
Capsules, soft-gels
25 mg
Tablets
25 mg
Tablets, chewable
12.5 mg
Liquid
12.5 mg/5 mL
Benadryl Allergy Ultratabs
Tablets
25 mg
Benadryl Dye Free
Liquid
12.5 mg/5 mL
Benadryl Dye Free Allergy Liqui Gels
Capsules, soft gels
25 mg
Bydramine Cough
Syrup
12.5 mg/5 mL
Compoz Gel Caps
Capsules
25 mg
Compoz Nighttime Sleep Aid
Tablets
50 mg
Diphen AF
Liquid
6.25 mg/5 mL
Diphen Cough
Syrup
12.5 mg/5 mL
Diphenhist
Solution
12.5 mg/5 mL
Diphenhist Captabs
Tablets
25 mg
Dormin
Tablets
25 mg
Capsules
25 mg
Genahist
Liquid
12.5 mg/5 mL
Hyrexin-50
Injection
50 mg/mL
Maximum Strength Nytol
Tablets
50 mg
Maximum Strength Sleepinal Capsules and Soft Gels
Capsules
50 mg
Maximum Strength Unisom SleepGels
Capsules
50 mg/mL
Midol PM
Tablets
50 mg
Miles Nervine
Tablets
25 mg
Nighttime Sleep Aid
Tablets
50 mg
Nytol
Tablets
25 mg
Scot-Tussin Allergy DM
Liquid
12.5 mg/5 mL
Siladryl
Elixer
12.5 mg/5 mL
Silphen DM
Syrup
10 mg/5 mL
Sleep-Eze 3
Tablets
25 mg
Sleepwell 2-nite
Tablets
25 mg
Snoozefast
Tablets
50 mg
Sominex
Tablets
25 mg
Tablets
50 mg
Sylphen Cough
Syrup
12.5 mg/5 mL
Tusstat
Syrup
12.5 mg/5 mL
Twilite
Tablets
50 mg
Uni-Bent Cough
Syrup
12.5 mg/5 mL
Wehdryl
Allerdryl
Nytol Extra Strength
PMS-Diphenhydramine
Scheinpharm Diphenhydramine
Antihistamine, Ethanolamine

 Action Competitively antagonizes histamine at H1 receptor sites.

 Indications Symptomatic relief of perennial and seasonal allergic rhinitis, vasomotor rhinitis and allergic conjunctivitis; temporary relief of runny nose and sneezing caused by common cold; relief of allergic and nonallergic pruritic symptoms; treatment of urticaria and angioedema; amelioration of allergic reactions to blood or plasma; adjunct to epinephrine and other standard measures in anaphylaxis; relief of uncomplicated allergic conditions of immediate type when oral therapy is impossible or contraindicated (parenteral form); treatment and prophylactic treatment of motion sickness; nighttime sleep aid; management of parkinsonism (including drug-induced) in elderly who are intolerant of more potent agents, in mild cases in other age groups and in combination with centrally acting anticholinergics; control of cough from colds or allergy (syrup formulations).

 Contraindications Hypersensitivity to antihistamines; narrow-angle glaucoma; stenosing peptic ulcer; symptomatic prostatic hypertrophy; asthmatic attack; bladder neck obstruction; pyloroduodenal obstruction; MAOI therapy; history of sleep apnea; use in newborn or premature infants and in nursing women.

 Route/Dosage

Hypersensitivity Reactions, Type 1/Antiparkinsonism/Motion Sickness Adults: PO 25 to 50 mg q 4 to 6 hr (max, 300 mg/day). IV/IM 10 to 100 mg (rate not exceeding 25 mg/min or deep IM; max, 400 mg/day).

Children (6 to under 12 yr): PO 12.5 to 25 mg q 4 to 6 hr (max, 150 mg). IV/IM 5 mg/kg/day or 150 mg/m2 /day (max, 300 mg divided into 4 doses at a rate not exceeding 25 mg/min or deep IM).

Nighttime Sleep Aid Adults: PO 50 mg at bedtime.

Cough Suppressant (Syrup) Adults: PO 25 mg q 4 hr (max, 150 mg/24 hr).

Children (6 to 12 yr): PO 12.5 mg q 4 hr (max, 75 mg/24 hr).

Children (2 to 6 yr): PO 6.25 mg q 4 hr (max, 25 mg/24 hr).

 Interactions

Alcohol, CNS depressants: May cause additive CNS depression.

MAOIs: May increase anticholinergic effects.

Injectable form is incompatible with dexamethasone sodium phosphate, furosemide, iodipamide meglumine, parenteral barbiturates, and phenytoin.

 Lab Test Interferences

Skin tests: Antihistamines may prevent or diminish otherwise positive reaction to dermal reactivity indicators.

 Adverse Reactions

CARDIOVASCULAR: Orthostatic hypotension; palpitations; bradycardia; tachycardia; reflex tachycardia; extrasystoles; faintness. CNS: Drowsiness (often transient); sedation; dizziness; faintness; disturbed coordination.EENT: Nasal stuffiness; dry mouth, nose and throat; sore throat. GI: Epigastric distress; nausea; vomiting; diarrhea; constipation; change in bowel habits. HEMATOLOGIC: Hemolytic anemia; thrombocytopenia; agranulocytosis. METABOLIC: Increased appetite, weight gain. RESPIRATORY: Thickening of bronchial secretions; chest tightness; wheezing; respiratory depression. OTHER: Hypersensitivity reactions; photosensitivity.

 Precautions

Pregnancy: Category B. Lactation: Excreted in breast milk. Children: Contraindicated in newborn and premature infants. Overdosage may cause hallucinations, convulsions, and death. Antihistamines may diminish mental alertness. In young children drug may produce paradoxical excitation. Use with caution in children younger than 2 yr. Elderly and debilitated patients: Greater risk of dizziness, excessive sedation, syncope, toxic confusional states, and hypotension in patients older than 60 yr. Dosage reduction may be required. Special risk patients: Use with caution in patients predisposed to urinary retention, prostatic hypertrophy, history of bronchial asthma, increased intraocular pressure, hyperthyroidism, cardiovascular disease, or hypertension. Hepatic impairment: Use with caution in patients with cirrhosis or other liver diseases. Hypersensitivity reactions: May occur. Have epinephrine 1:1000 immediately available. Respiratory disease: Generally not recommended to treat lower respiratory tract symptoms including asthma. Sulfites: Some diphenhydramine products may contain sulfites as preservatives and aspartame as sweetener. Avoid in sulfite-allergic patients and in patients with phenylketonuria, respectively.

PATIENT CARE CONSIDERATIONS

 Administration/Storage

  • If patient is prone to excessive salivation
    (eg, postencephalitic patients), administer drug after meals. If mouth dries excessively, administer drug before meals.

  • Syrup formulations are used only for control of cough.
  • If drug is prescribed for motion sickness, administer first dose 30 min prior to exposure to motion.
  • Give IM injection deep in muscle.
  • Do not administer drug for at least 2 days before skin allergy testing.
  • Store in tightly closed containers at room temperature.
  • Store injection formulation in light-resistant container and protect from light.

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies. Be alert for conditions that may place patient at greater risk for adverse effects (eg, bronchial asthma, glaucoma, prostatic hypertrophy).
  • Be prepared to institute supportive treatment (eg, advanced life support) in event of severe adverse reaction or overdose.
  • Observe patient for adverse reactions to medication such as dry mouth, headaches, disorientation, drowsiness, tachycardia, shortness of breath, nausea, skin rash, urinary retention, constipation, or increase in BP.
  • If administering medication to children or elderly, be alert to fact that they are more likely to experience side effects and paradoxical reactions such as excitement, irritability, sleeplessness.
  • Explain that drowsiness may occur at first but will lessen or disappear during long-term therapy.
OVERDOSAGE: SIGNS & SYMPTOMS
  Circulatory collapse; cardiac arrest; respiratory depression or arrest; toxic psychosis; coma; stupor; seizures; ataxia; anxiety; incoherence; hyperactivity; combativeness; anhidrosis; fever; hot, dry, or flushed skin; dry mucous membranes; dysphagia; decreased bowel sounds; dilated and sluggish pupils

 Patient/Family Education

  • Instruct patient not to discontinue long-term therapy without consulting health care provider.
  • Warn patient using topical medication to avoid excessive application to skin eruptions.
  • Instruct patient to report these symptoms to health care provider:
    excessive drowsiness or dry mouth, GI upset, constipation, blurred vision, rash, hives, difficulty breathing, difficulty urinating, confusion, fainting, irregular heart rate.

  • Encourage patient to take sips of water frequently, suck on ice chips or sugarless hard candy, or chew sugarless gum if dry mouth occurs.
  • Instruct patient to avoid intake of alcoholic beverages or other CNS depressants.
  • Advise patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness.

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