Diphenhydramine in overdose can cause significant toxicity. Proper management is crucial because choosing the wrong treatment for certain toxic symptoms could result in fatal cardiac complications. MECHANISM OF TOXIC ACTION IN OVERDOSE
Full Answer
Can You overdose on diphenhydramine?
However, it is likely that toxic diphenhydramine exposures are a result of oral ingestion, given the accessibility of oral diphenhydramine compared to other diphenhydramine formulations. Diphenhydramine overdose or intoxication can be either accidental or intentional.[1]
What are the long-term effects of diphenhydramine abuse?
Abusing diphenhydramine long-term can include effects of: 1 Heart palpitations 2 Inability to think properly due to brain changes 3 Skin rashes 4 Vision changes 5 Physical tremors 6 Vertigo (constant dizziness) 7 Physical dependence
Does diphenhydramine cause tachycardia?
Diphenhydramine can also have negative cardiovascular consequences in the setting of toxicity. ECG changes can be observed, which include the widening of the QRS-complex and tachycardia, possibly caused by the anticholinergic effects of diphenhydramine.
Can you take diphenhydramine without a prescription?
Cold sufferers frequently use diphenhydramine to reduce their symptoms. Diphenhydramine can be possessed without a prescription, but that does not mean there is a shortage of powerful side effects.
What are the long-term effects of overdosing on Benadryl?
Complications such as pneumonia, muscle damage from lying on a hard surface for a long period of time, or brain damage from lack of oxygen may result in permanent disability. Few people actually die from an antihistamine overdose. However, serious heart rhythm disturbances may occur, which can cause death.
Can diphenhydramine cause brain damage?
Long-term use of anticholinergic drugs is associated with increased dementia risk. Potential harm to the brain: Long-term anticholinergic use has been associated with increased dementia risk; diphenhydramine can impair many cognitive functions including memory.
Can diphenhydramine cause Alzheimer's?
Researchers have discovered a significant link between high use of anticholinergic drugs – including popular non-prescription sleep aids and the antihistamine Benadryl (diphenhydramine) – and increased risk of developing dementia and Alzheimer's disease in older people.
Is dementia from Benadryl reversible?
The general view is that medication-caused memory problems is reversible when the medication is stopped, but new evidence is linking long-term use to increased risks of dementia.
Does Benadryl cause permanent memory loss?
The research to date has not definitively proven that Benadryl (as a specific individual medication) raises the risk of developing dementia. However, the class of medications Benadryl belongs to (anticholinergics) does appear to be associated with dementia.
Does diphenhydramine cause brain fog?
Over-the-counter medications such as Benadryl and other antihistamine allergy medications also can lead to temporary brain fog and forgetfulness.
What are the 9 common pills linked to Alzheimer's?
An estimated 47 million people worldwide were living with dementia in 2015, while in the United States around 5.7 million people have Alzheimer dementia, according to the study. Anticholergenic drugs include, but are not limited to, Artane, Bentyl, Oxytrol, Neosol, Symax and Vesicare.
Can you take diphenhydramine long-term?
Taking diphenhydramine over a long period of time can actually predispose people to dementia. You should be careful not to use these types of medicines all the time in order to get good sleep.
What is the best treatment for diphenhydramine toxicity?
The mainstay of therapy of diphenhydramine toxicity is supportive management that addresses the symptomatology of intoxication/overdose. Benzodiazepines (e.g., lorazepam) for seizures or convulsions, physostigmine for acetylcholinesterase inhibition, sodium bicarbonate for ventricular arrhythmia, and VA-ECMO for hemodynamic support can be used for management of the clinical manifestations of diphenhydramine toxicity. There is growing support for the utilization of intravenous lipid emulsion therapy; however, its efficacy in this setting remains controversial. Diphenhydramine is minimally dialyzable, and thus, there is little support for hemodialysis in the management of diphenhydramine toxicity. [6][23][24][25][26][15][27][28]
How long does diphenhydramine last?
For adult patients, the elimination half-life is approximately 9 hours (range: 7 to 12 hours) and approximately 13.5 hours (range: 9 to 18 hours) for elderly patients (range: 9 to 18 hours).[9] . Diphenhydramine is lipophilic and has a relatively large volume of distribution (Vd). Vd can also vary between age groups.
What is diphenhydramine used for?
It is most commonly used for the treatment of nausea, vomiting, allergic rhinitis, mild to severe allergic reactions (e.g ., anaphylaxis), and as a mild sleep aid. While used for a wide array of medical indications, ...
What receptors does diphenhydramine bind to?
Diphenhydramine competes against histamine to bind to H1-receptor sites on effector cells in the respiratory tract, blood vessels, gastrointestinal tract, and the CNS. Within the CNS, diphenhydramine can occupy, even at therapeutic doses, H1-receptors in the frontal cortex, temporal cortex, hippocampus, and pons. This can lead to significant sedation and can produce moderate to severe neurological and respiratory signs/symptoms characterized by intoxication and overdose. [1][6]Due to its effects on muscarinic receptors, diphenhydramine can produce anticholinergic effects, such as blurred vision, dry mouth, urinary retention, impotence, tachycardia, and gastrointestinal effects, such as nausea and constipation. [6]
How long does it take to get discharged from a diphenhydramine toxicity test?
Therefore, patients may be considered for discharge if they remain asymptomatic beyond four hours of diphenhydramine oral exposure or eight hours if dermal exposure. However, a patient may be admitted if they display moderate to severe signs of anticholinergic toxicity. Complications. Respiratory failure.
How old is the most likely age to die from diphenhydramine?
In the same study, diphenhydramine ranked among the top 15 drugs most frequently involved in drug overdose deaths in the U.S.[4] Most diphenhydramine intoxication/overdose cases occur in children ages 6 years or younger. [5] Pathophysiology.
Is diphenhydramine a dangerous drug?
While used for a wide array of medical indications, diphenhydramine is also one of the most commonly abused medications in the United States (U.S.). Acute intoxications of diphenhydramine can have severe, potentially fatal consequences if not managed appropriately in a timely manner.[1]
What is the treatment for diphenhydramine overdose?
Common treatment procedures, however, include intravenous therapy, activated charcoal, laxatives, and certain medications for the treatment of symptoms or to counter and reverse the effects of Diphenhydramine overdose.
What happens if you take too much Benadryl?
Someone who is suspected to have taken too much Benadryl may be difficult to wake up or may be hallucinating, having trouble breathing, or having a seizure, among other signs. In case of Benadryl overdose, immediately call the local poison control or health center and get medical attention – tell the emergency team the following information:
What Are The Causes Of Benadryl Overdose?
Benadryl is a widespread medication, and unlike prescription drugs behind the counter, it is easy to get. Diphenhydramine overdose is merely taking more than the recommended amount of the medicine prescribed by a physician.
How to tell if you have taken too much Benadryl?
Someone who is suspected to have taken too much Benadryl may be difficult to wake up or may be hallucinating, having trouble breathing, or having a seizure, among other signs. In case of Benadryl overdose, immediately call the local poison control or health center and get medical attention – tell the emergency team the following information: 1 Patient’s age, weight, and condition 2 How much Diphenhydramine was taken (if known) 3 The time of Benadryl consumption (if known) 4 The health status of the individual
How to prevent OD?
In preventing OD, the most important thing to do is to strictly follow a doctor’s prescription and recommendation. Never take more Diphenhydramine than what is prescribed, and if planning to change the dosage of the drug, consult and seek the advice of a doctor regarding alternatives to Benadryl. It is also crucial to exercise caution and avoid the use of other drugs and substances that might interact with the medication and cause adverse effects. Another thing that should be avoided is self-medicating. Monitoring one’s intake of Benadryl will also be of help to avoid multiple dosages, especially for those who are forgetful.
Can you overdose on Benadryl?
Patients can require Benadryl overdose treatment if it is combined with other medications, which can result in harm ful Diphenhydramine interactions and toxicity. The use of other medications with this antihistamine can cause serious adverse effects. For instance, when an individual mixes alcohol and Benadryl, it can lead to side effects such as impaired motor skills and extreme drowsiness. Side effects that may occur from mixing medications vary in severity, and depending on which drugs are mixed and how much of them are taken, it can cause death. Thus, it must be avoided unless advised by a medical professional.
Can you take more diphenhydramine than you are prescribed?
Side effects of Diphenhydramine overdose often cause long-term damage, which can be fatal to patients ingesting it. Never take more Diphenhydramine than what is prescribed, and if planning to change the dosage of the drug, consult and seek the advice of a doctor.
In Summary
More frequently reported side effects include: sedated state and thickening of bronchial secretions. See below for a comprehensive list of adverse effects.
For the Consumer
Sedation, sleepiness, dizziness, disturbed coordination, epigastric distress, thickening of bronchial secretions.
For Healthcare Professionals
Applies to diphenhydramine: compounding powder, injectable solution, oral capsule, oral disintegrating strip, oral liquid, oral tablet, oral tablet chewable, oral tablet disintegrating
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
What Is Diphenhydramine?
Diphenhydramine is a common antihistamine medication that is most likely sitting in your medicine cabinet right now . It is labeled as Benadryl, and it is a popular over-the-counter antihistamine drug that treats various allergens. The drug was created with the intention of combatting the actions of histamine, which is a naturally occurring substance produced by your body as a reaction to allergens like dust, pollen, or animal hair.
How often is diphenhydramine given?
Diphenhydramine is often administered in doses of between 25 to 50 milligrams every four to six hours. Diphenhydramine, Benadryl, may interact with monoamine oxidase inhibitors (MAOIs), over-the-counter cough, cold, allergy, or insomnia medication, anxiety or sleep medicines, antidepressants, or any other medicines that cause drowsiness. The drugs intention is to block the effect of histamine in the body, and it is considered an H1 receptor antagonist.
How long does it take for diphenhydramine to recover?
If the individual survives the first 24 hours, their chances of a full recovery are high.
What is misuse of over the counter medicine?
The misuse of over-the-counter medications is characterized by taking medicine in a dose or a manner other than directed on the package, taking medicine for the effect it causes or mixing over-the-counter medications to create new products.
What is over the counter medication?
Over-the-counter medications are among the most widely used and recognized substances in our pharmacies. They treat everything from the common cold, headaches, chronic pain, and even allergies.
How to treat a drug overdose?
Once the person who has overdosed is in the care of medical professionals, the following steps can be taken to treat the overdose: 1 Administer activated charcoal to avoid further absorption into the body 2 Gastric lavage for the elimination of the drug from the stomach 3 Manage severe symptoms such as reduce heart rate and control breathing difficulty 4 Relieve respiratory distress with an artificial respirator 5 Administer laxatives to eliminate the drug from the body 6 Administer fluids intravenously
When did Pfizer buy diphenhydramine?
The drug was so effective in early testing that global drug giant Pfizer bought it in 1946. In two decades, diphenhydramine was found to inhibit the reuptake of the neurotransmitter serotonin. Diphenhydramine played a significant role in developing the drug fluoxetine (Prozac), which is a selective reuptake inhibitor.
What are the side effects of diphenhydramine?
Liver problems, etc. In certain people, a paradoxical reaction to diphenhydramine is possible, meaning that the drug causes different symptoms than the intended ones. Certain studies also show that a prolonged use of diphenhydramine increases the risk of dementia and Alzheimer’s disease.
What are the symptoms of diphenhydramine overdose?
Overdose symptoms with diphenhydramine include: Drowsiness, Difficulties breathing, Irregular heartbeat, Widened pupils, Seizures, etc. If the above signs are noticed, emergency medical help is required as these are serious symptoms which can lead to death if left unattended.
How Can the Diphenhydramine Abuse Be Treated?
In cases when people abuse with diphenhydramine, medical professionals suggest that the best way is to quit taking it slowly over one or two weeks. However, the exact time is individual, depending on the duration of abuse, the doses consumed, the person's general health, other diseases, etc.
Can you abuse diphenhydramine?
When it comes to medication abuse, people often think that medication abuse is possible only with those prescribed by a doctor. However, diphenhydramine abuse is also very common, perhaps due to the fact that it is more easily obtained.
Does chlorpheniramine have a sedating effect?
Chlorpheniramine, commonly known as Chlor-Trimeton. According to the National Institute of Health, the second or third generations of antihistamines have no sedating effects or only a very little sedating effect, due to the fact that these medications of a newer generation have a limited penetration into the brain.
Can you mix diphenhydramine with alcohol?
People sometimes even mix diphenhydramine medication intentionally with other substances such as alcohol, muscle relaxants, benzodiazepines, MAOI’s, opiates, etc. These substances, when combined together, have adverse reactions, but the user often seeks for these effects.
Is Benadryl a topical or over the counter medication?
Diphenhydramine, commonly known as Benadryl, is an over-the-counter medication used for the treatment of common cold, allergies, insomnia, hay fever, etc. As a topical medication, it can be used for the treatment of minor cuts, burns, itchiness, etc. When it comes to medication abuse, people often think that medication abuse is possible only ...
How Dangerous Is Diphenhydramine Abuse?
Like alcohol, diphenhydramine poses a special kind of problem — it is widely available by purchase at stores that are open sometimes 24-hours per day. Its availability is a cause for concern, and those with pre-existing drug addictions are more vulnerable to abusing it than others. Diphenhydramine is not considered an effective intoxicant, and taking more than the recommended dose will likely lead to an overdose or uncomfortable side effects rather than euphoria.
What to do if someone overdoses on diphenhydramine?
If you believe that someone has overdosed on diphenhydramine, it is imperative to seek emergency medical attention. You must call 911 immediately to get them the help they need. Risking someone’s life to see if they will be OK is not worth it, and if you see something say something.
What is the generic name for Benadryl?
What Is Diphenhydramine? Diphenhydramine is the generic name for the popular over-the-counter antihistamine drug Benadryl. The sole objective of antihistamines is to combat the actions of histamine, a substance produced by the body in response to the presence of allergens such as pollen, dust, or animal hair.
How does diphenhydramine work?
Diphenhydramine is considered an H1 receptor antagonist, and it works by blocking the effect of histamine in the body. The chemical reactions that diphenhydramine trigger in the body can cause other potentially significant sedative side effects on the central nervous system (CNS).
How much diphenhydramine can cause euphoria?
When too much is consumed, it will lead to an overdose. Taking more than 25 mg (milligrams) of di phenhydramine can be extremely dangerous and is more likely to cause harm than produce euphoria. Symptoms of a diphenhydramine overdose include: Extremely dry eyes. Dilated pupils.
What is the drug Benadryl?
Overdose Symptoms. Signs of Abuse. Dangers. Road To Recovery. Diphenhydramine is sold under the brand name Benadryl, a medication you’ve likely heard of or consumed at some point in your life. When the drug is used as prescribed, the chances of becoming addicted to its active ingredients are very slim.
When was diphenhydramine first used?
In 1943, a professor at the University of Cincinnati named George Rieveschl discovered diphenhydramine, and shortly after, in 1946, Pfizer purchased it, and the U.S. Food and Drug Administration approved it as the first prescription antihistamine. A couple of decades later in the 1960s, diphenhydramine was found to inhibit the reuptake ...
What happens if you drink too much Benadryl?
If someone drinks too much Benadryl®, beware of a Diphenhydramine overdose because it can cause significant toxicity. Proper management is crucial because choosing the wrong treatment for certain toxic symptoms could result in fatal cardiac complications.
What are the symptoms of anticholinergic drugs?
These include tachycardia, dry flushed skin, dry mucous membranes, thick secretions, mydriasis, urinary retention, and quiet bowel. Ingested drugs may be more slowly absorbed, resulting in a delayed time to peak and longer course of toxicity than otherwise expected. Elevated body temperature due to impaired heat dissipation is possible, especially in warm ambient environment.
What is the best treatment for central anticholinergic delirium?
Central anticholinergic delirium usually responds to benzodiazepines. Some physicians use the reversible cholinesterase inhibitor, physostigmine, as an antagonist of central and peripheral anticholinergic toxicity. Physostigmine is not recommended for diphenhydramine toxicity by the Missouri Poison Center since it can precipitate seizures and worsen cardiac toxicity.
What is the DPH?
Diphenhydramine is a first generation H 1 -histamine receptor antagonist with prominent sedative and anticholinergic effects. DPH crosses the blood brain barrier, accounting for the central anticholinergic syndrome of agitation, combativeness, delirium and hallucinations.
What is the term for the inhibition of muscarinic receptors in the CNS?
Anticholinergic Toxicity. “Mad as a hatter”: Inhibition of muscarinic receptors in the CNS leads to delirium, agitation, combativeness, confusion, restlessness, hallucinations, ataxia, tremor, seizures. Peripheral Anticholinergic Toxicity. “Dry as a bone”: Inhibition of muscarinic receptors in the sweat glands and salivary glands.
How to treat wide QRS?
Treatment for wide QRS includes sodium bicarbonate by bolus followed by continuous infusion. Prolonged QT interval may occur due to concurrent block of potassium channels which delays repolarization, although this is less common than wide QRS.
Can Benadryl be used for hallucinations?
Unfortunately, the diphenhydramine (DPH) found in Benadryl® can also be abused recreationally for delirium and hallucinosis, particularly by teenagers and young adults. It is cheap and easy to obtain. It is also being used more often in suicidal gestures.
What is Diphenhydramine?
According to the National Center for Biotechnology Information, diphenhydramine, which is available as an over-the-counter medication, is a first-generation antihistamine that is used in a variety of conditions to treat and prevent dystonias, insomnia, pruritus, urticaria, vertigo, and motion sickness. It also possesses local anesthetic properties for patients with allergies to other, more commonly used local anesthetics; however, this is an off-label use of the medication. Additional off-label use is for the treatment of oral mucositis. [1] Medications that contain diphenhydramine can also be used to prevent nausea and vomiting, as well as dizziness caused by motion sickness.
How does diphenhydramine work?
Diphenhydramine works by blocking a substance that your body produces naturally during an allergic reaction called histamine. Histamine is a chemical released by white blood cells into the bloodstream in an attempt for the immune system to defend itself against an allergen. Pollen, mold, and different foods can cause these allergic reactions. This drug works to alleviate any discomfort caused by these symptoms while also acting as a sleep aid.
How old was the girl who died from diphenhydramine?
One study, in particular, reviewed a massive diphenhydramine overdose resulting in the death of a 14-year-old girl. She experienced seizures, hemodynamic compromise (abnormal or unstable blood pressure), and problems with cardiac conduction (irregular heartbeats) after ingesting 7.5g of diphenhydramine, the largest overdosage documented.
Is diphenhydramine an over the counter medication?
According to the National Center for Biotechnology Information, diphenhydra mine, which is available as an over-the-counter medication, is a first-generation antihistamine that is used in a variety of conditions to treat and prevent dystonias, insomnia, pruritus, urticaria, vertigo, and motion sickness. It also possesses local anesthetic properties for patients with allergies to other, more commonly used local anesthetics; however, this is an off-label use of the medication. Additional off-label use is for the treatment of oral mucositis. [1] Medications that contain diphenhydramine can also be used to prevent nausea and vomiting, as well as dizziness caused by motion sickness.
Can you get pregnant while taking diphenhydramine?
Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking diphenhydramine , call your doctor.
Is diphenhydramine a liquid?
Diphenhydramine comes as a tablet, a rapidly disintegrating (dissolving) tablet, a capsule, a liquid-filled capsule, a dissolving strip, powder, and a liquid to take by mouth.
Can diphenhydramine cause sleepiness?
This medication will relieve the symptoms of these conditions but will not treat the cause of the symptoms or speed recovery. Diphenhydramine should not be used to cause sleepiness in children. This drug is in a class of medications called antihistamines. It works by blocking the action of histamine, a substance in the body that causes allergic symptoms. [2]
in Summary
For The Consumer
- Applies to diphenhydramine: oral capsules and tablets, parenteral injection Side effects include: Sedation, sleepiness, dizziness, disturbed coordination, epigastric distress, thickening of bronchial secretions.
For Healthcare Professionals
- Applies to diphenhydramine: compounding powder, injectable solution, oral capsule, oral disintegrating strip, oral liquid, oral tablet, oral tablet chewable, oral tablet disintegrating
Frequently Asked Questions
Further Information
- Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Some side effects may not be reported. You may report them to the FDA. Medical Disclaimer