You may want to reconsider to reach the antihistamine Benadryl at the first sign of sneezing, itching or hives. Although this familiar pink pill is a must for the medicine cabin for decades, some experts now say that it is time to let go of Benadryl for good.
With the advent of more recent antihistamines in the past two decades, Benadryl is no longer an over-the-counter go-to for regular allergy treatment, explains Sarah Taylor-Black, MD, allergist and clinical immunologist at Dartmouth Hitchcock Medical Center to Hanover, New Hampshire. “We certainly do not recommend Benadryl for chronic daily use,” she says.
Rupture with diphenhydramine would have effects beyond Benadryl – antihistamine is in more than 300 drug formulations, including sleep aid and cold and flu treatments.
But other doctors and public health experts think that it is an excessive reaction, and that Benadryl is always a useful and affordable drug – when used appropriately.
How Benadryl works
Benadryl was the first prescription antihistamine approved by the US Food and Drug Administration (FDA), in 1946, and was considered an antihistamine of “first generation”. It works by blocking histamine, a chemical that the immune system releases during allergic reactions, to help alleviate symptoms such as sneezing, aqueous eyes or itching.
But unlike new allergies drugs, Benadryl also crosses the blood-brain barrier and enters the central nervous system.
“This causes side effects that do not occur as much with the new” second generation “drugs,” explains Michael Steiner, MD, MPH, chief pediatrician at UNC Children’s Hospital in Chapel Hill, North Carolina, which was not involved in the recent review.
The more recent antihistamines such as ketirizine (Zyrtec), loratadine (claritine) and fexofenadine (allegra) are just as effective as diphenhydramine but have fewer side effects, are less sedating and lasts up to 24 hours, explains Dr. Taylor-Black. “Benadryl is only effective for 4 to 6 hours,” she says.
Is it time to retire Benadryl?
Some experts argue that Benadryl has survived its usefulness – and could now do more harm than good.
Their reasons include:
- Significant side effects: Benadryl causes drowsiness, delayed reaction time and confusion. A small study even revealed that diphenhydramine has altered driving more than alcohol. “It is particularly dangerous in people over 65,”, due to the risk that these side effects can lead to accidental falls, explains Stefanie Ferreri, Pharmd, professor at UNESHELMAN School of Pharmacy, also in Chapel Hill, who was not involved in the journal either.
- Cognitive risks: Benadryl blocks acetylcholine, a neurotransmitter that plays an important role in movement, memory and digestion, among other functions. Studies have linked anticholinergic drugs like Benadryl to a cognitive decline and an increased risk of dementia with long -term use.
- Linked to poor quality sleep: Although Diphenhydramine facilitates sleep, it has drawbacks. There is evidence that this can reduce the quality of a person’s sleep and the more you take it, the less effective it becomes. It can also make you feel groggy the next day. “The chronic use of Diphenhydramine for sleep is not a good idea and has side effects,” said Dr. Steiner. This is the case with any sleep medication; Long-term use comes with side effects, he says.
- Has been approved using obsolete standards: Diphenhydramine was approved almost 80 years ago, before the FDA requires rigorous safety tests. Some countries, including Canada and the United Kingdom, now require a prescription for higher dose diphenhydramine forms.
When is it acceptable to use Benadryl?
While some experts call at the end of its use of routine, others say that Benadryl has its place in the right situations.
Benadryl can always be useful for:
- Emergency allergic reactions: It is important to note that it is prudent to give a dose of Benadryl immediately after an allergic reaction to an insect bite or to food, explains Taylor-Black. “Its fast-acting sedating properties can be useful in these acute situations, although epinephrine is always the first treatment of anaphylaxis,” she said a serious allergic reaction which can include swelling of the throat.
- Occasional use in children: For children with allergic disorders who need drugs daily, Benadryl is not the best choice due to side effects, says Steiner. “But when used appropriately, it is safe and effective for short-term use in children and is generally very well tolerated,” he said.
- Relief of short -term nocturnal itching: The drug can be useful for children with eczema (a chronic condition linked to allergies) who find it difficult to sleep. “If a child cannot sleep and scratches all night, Benadryl for a few weeks is a situation where the advantages probably prevail over the disadvantages – but you don’t want someone to take it daily,” said Taylor -Black.
- Relief of low -cost symptoms: “A good thing about Diphenhydramine is that compared to some of the new drugs, it is very inexpensive, which should be taken into consideration,” explains Steiner. Although Benadryl has side effects and should be used with care, it has more than 80 years of data to support its use, he adds.
Over -the -counter drugs may include risks
Steiner says that people should keep in mind that “over -the -counter” does not mean that a drug is without risk. “To become over the counter, drugs must be in a certain safety and risk profile, but that does not mean that all over-the-counter medicines are safe for use in any condition and in any circumstance,” he said.
“There is a reason why it was used as an ingredient of confidence in a wide range of over -the -counter drugs for decades: when used as indicated, these drugs offer well -established therapeutic advantages for common health conditions such as allergies, common cold, transport evil, minor skin irritations and occasional disturbance.”
The CHPA stresses that the current side effects of Bendryl, such as drowsiness or dry mouth, are also well established, clearly disclosed on the label of facts of drugs, and widely recognized by health professionals and consumers.
“It is important to emphasize that these products are not intended for long -term use. Like all drugs, responsible use is essential, and consumers must always follow the instructions and warnings on the labels of the facts of drugs and consult health care providers if they have questions, “the statement said.
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