Determine whether or not your child has an allergy, and find the trigger. Sometimes it's just a cold. One way to rule out allergies is if your child is running a fever. Avoid the triggers as best you can. If your child still has symptoms, find the right Benadryl product to give your child relief, and carefully read and follow the entire product label before giving the medication.
If symptoms persist, talk to your pediatrician. Here are some simple steps you can take to reduce your child's exposure to allergens, both around the house and while outdoors. Knickknacks collect dust and are hard to clean. Store children's toys, games and stuffed animals in plastic bins to get rid of those dust-collectors.
Lower dosages may be used at advice of prescriber. The FDA recommends that non-prescription products not be used for sedation in children of any age; a Public Health Advisory was issued in January Initially, 25 mg PO 3 times per day; dose may be increased to 50 mg 4 times per day. Topical application of Hantagonists is discouraged because of questionable efficacy and the possibility of sensitivity reactions, especially from prolonged or repeated use. However, diphenhydramine cream and lotion are available for external application, applied 3 to 4 times per day for up to 7 days.
It is advisable to individualize the dosage based upon clinical response and tolerability. Diphenhydramine is a second-line pharmacologic option if the patient is still experiencing persistent symptoms after a trial of nonpharmacologic options and pyridoxine taken alone or in combination with doxylamine.
Maximum doses are indication-specific; do not exceed product labeling. The following are general guidelines:. Safety and efficacy have not been established for PO formulations. OTC use is not recommended. Dosage reduction may be warranted for patients with hepatic impairment; diphenhydramine is extensively metabolized in the liver.
Diphenhydramine is administered intravenously or intramuscularly. Do not use subcutaneously or perivascularly. Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit.
Inject deeply into a large muscle i. External use only; do NOT administer orally or use on mucous membranes. Apply gently to affected area. Topical products may contain camphor; toxic if ingested. Advise patients to use only as directed on product labeling. To decrease the likelihood of an administration route error, store topical preparations separately from oral products and advise patients to do the same.
Use antihistamines such as diphenhydramine with caution in patients with asthma. The anticholinergic activity of H1-antagonists may result in thickened bronchial secretions in the respiratory tract thereby aggravating an acute asthmatic attack or chronic obstructive pulmonary disease COPD.
Although antihistamines should be avoided during an acute asthmatic attack, these anticholinergic effects do not preclude the use of antihistamines in all asthmatic or COPD patients, particularly if the above respiratory symptom is not a primary component of the illness. Because diphenhydramine exhibits a significant amount of anticholinergic activity, the use of an H1-antagonist with less anticholinergic activity is preferable when therapy is indicated. Diphenhydramine should be used cautiously in young children; most non-prescription oral products are labeled only for use in children 6 years and older.
The FDA recommends against the use of diphenhydramine for sedation in pediatric patients of any age. While prescription use of diphenhydramine is approved for the treatment of allergic reactions and other conditions in infants and children as young as 1 month, the drug must be used with caution since a paradoxical CNS stimulation can occur. In general, sedating antihistamines should not be used in neonates due to the possibility of paradoxical CNS stimulation or seizures. There have been a number of cases of respiratory depression, sleep apnea, and SIDS in children receiving phenothiazine antihistamines.
The mechanism of this reaction is not yet known; therefore, sedating antihistamines should be used with extreme caution in children with a family history of SIDS or sleep apnea. In January , the CDC warned caregivers and healthcare providers of the risk for serious injury or fatal overdose from the administration of cough and cold products to children and infants less than 2 years of age. This warning followed an investigation of the deaths of three 3 infants less than 6 months of age that were attributed to the inadvertent inappropriate use of these products.
The symptoms preceding these deaths have not been clearly defined, and there is a lack of conclusive data describing the exact cause of death. The report estimated that 1, children less than 2 years of age were treated in emergency departments during to for adverse events related to cough and cold medications. In October , the FDA Nonprescription Drug Advisory Committee and the Pediatric Advisory Committee recommended that nonprescription cough and cold products containing pseudoephedrine, dextromethorphan, chlorpheniramine, diphenhydramine, brompheniramine, phenylephrine, clemastine, or guaifenesin not be used in children less than 6 years of age.
The FDA recommends that if these products are used, labels should be read carefully, caution should be used when administering multiple products, and only measuring devices specifically designed for use with medications should be used.
Parenteral diphenhydramine is typically the parenteral antihistamine of choice in managing acute or severe allergic reactions during pregnancy. The routine use of sedating antihistamines is generally not recommended in the last 2 weeks of pregnancy due to a possible association between these drugs and retrolental fibroplasia in premature neonates.
Non-pharmacologic methods e. Pregnant patients should see their health care professional for a proper diagnosis and for treatment recommendations before taking medications. Diphenhydramine should be administered during pregnancy only when the benefits of therapy outweigh the potential risks to the fetus, and use should be limited to short-term, 'as needed' administration under the prescription of a qualified health-care professional.
The American College of Obstetricians and Gynecologists ACOG and the American College of Allergy, Asthma, and Immunology consider loratadine an acceptable alternative for allergy symptoms in pregnancy, preferably after the first trimester, when first generation antihistamines are usually not tolerated. Diphenhydramine has been used to treat nausea and vomiting during pregnancy, but such use should occur under the advice and supervision of a qualified health care professional.
Topical diphenhydramine use does not carry any particular caution in breast-feeding women; avoid application to the breast area in a lactating woman. Use all forms of oral diphenhydramine with caution in breast-feeding women.
The use of injectable diphenhydramine is contraindicated in breast-feeding due to the higher risks associated with antihistamine use in infants, particularly neonates and premature neonates. Small, single or occasional doses of diphenhydramine, when necessary, would not be expected to cause adverse effects in breast-fed infants. However, larger doses or prolonged use may cause adverse effects in the breast-fed infant or decrease the mother's milk supply, particularly when used in combination with a sympathomimetic such as pseudoephedrine or before lactation is well established.
No reactions were reported as requiring medical attention. In this study, drowsiness was reported in one infant of 12 exposed to diphenhydramine breast-milk.
In general, many first-generation antihistamines are not recommended for use during lactation, since irritability, drowsiness, unusual excitement or other infant effects might be observed. Antihistamines can lower basal prolactin secretion and may interfere with the establishment of lactation.
Consider treatment alternatives when possible. Loratadine may be considered as an alternative for the treatment of allergy symptoms.
Because of its lack of sedation and low milk concentrations, maternal use would not be expected to cause adverse effects in breast-fed babies and loratadine is considered usually compatible with breast-feeding. The British Society for Allergy and Clinical Immunology also recommends loratadine at the lowest dose as a preferred antihistamine in breast-feeding women. Consider the benefits of breast-feeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition.
If a breast-feeding infant experiences an adverse effect related to a maternally ingested drug, healthcare providers are encouraged to report the adverse effect to the FDA. Diphenhydramine should be avoided, if possible, in patients with closed-angle glaucoma and an antihistamine with less anticholinergic effects should be substituted. Increased intraocular pressure may occur from the anticholinergic actions of the drug, precipitating an acute attack of glaucoma.
Other ocular effects resulting from the anticholinergic effects of diphenhydramine include dry eyes or blurred vision. This may be of significance in the elderly and wearers of contact lenses. Diphenhydramine has substantial anticholinergic effects and a worsening of symptoms may be seen in patients with bladder obstruction, GI obstruction or ileus, benign prostatic hypertrophy, or urinary retention. These precautions are most significant when using H1-antagonists from the ethanolamine group such as diphenhydramine.
The elderly are more susceptible to the anticholinergic effects of drugs since there is a decline in endogenous cholinergic activity that occurs with age. Diphenhydramine is extensively metabolized in the liver. Metabolism may be reduced in the presence of hepatic impairment. Those with significant hepatic disease receiving H1-antagonists should be monitored for liver function and side effects.
Dosage reduction may be required in these patients. The quinidine-like local anesthetic and anticholinergic effects of first-generation H1-antagonists are responsible for the adverse cardiac effects which have been observed including tachycardia, ECG changes, hypotension, and arrhythmias. Although these cardiovascular effects are uncommon, sedating antihistamines should be used conservatively in patients with cardiac disease or hypertension.
Diphenhydramine can cause drowsiness. Patients receiving diphenhydramine should be advised to avoid driving or operating machinery until the effects of the drug are known. Diphenhydramine has the potential for overdose or poisoning with incorrect use. Serious adverse events, including death, have been reported after the ingestion of large oral doses of diphenhydramine during the "Benadryl Challenge", a social media "challenge" aimed at young people. Taking larger than recommended systemic doses can cause serious heart problems, seizures, coma, and death.
Additionally, numerous reports of adverse events, some severe, have been reported after the accidental exposure via ingestion of topical diphenhydramine gel. Although all forms of diphenhydramine have potential for overdose or poisoning with incorrect use, liquid topical preparations contain a significantly greater concentration of active ingredient. Similarities in topical gel and oral liquid product packaging may contribute to consumer confusion.
Health care practitioners are encouraged to reduce the potential for overdose or poisoning by counseling patients on the route of administration and indication whenever OTC products are recommended and to store all medicine in a secure location. Geriatric patients are more susceptible to the anticholinergic effects of diphenhydramine. The anticholinergic effects of diphenhydramine may be additive with other anticholinergic medications, particularly in the elderly.
Guidelines suggest that clinicians not use diphenhydramine as a treatment for sleep onset and sleep maintenance insomnia, including in elderly adults; chronic use should be avoided. The Beers expert panel considers treatment of acute emergent conditions such as a severe allergic reaction an acceptable use of diphenhydramine in the geriatric patient when necessary. According to the Beers Criteria, first generation sedating antihistamines are considered potentially inappropriate medications PIMs in elderly patients; avoid use as they are highly anticholinergic, there is reduced clearance in advanced age, tolerance develops when used as hypnotics, and there is a greater risk of anticholinergic effects e.
The federal Omnibus Budget Reconciliation Act OBRA regulates medication use in residents of long-term care facilities; cough, cold, and allergy medications should be used only for a limited duration less than 14 days unless there is documented evidence of enduring symptoms that cannot otherwise be alleviated.
First-generation antihistamines have strong anticholinergic properties and are not considered medications of choice in older individuals. If appropriate and effective, topical diphenhydramine may be considered for allergic reactions involving the skin instead of oral diphenhydramine.
Diphenhydramine is considered inappropriate for use as an anxiolytic by the OBRA guidelines. Acarbose: Moderate Sympathomimetic agents and adrenergic agonists tend to increase blood glucose concentrations when administered systemically. Monitor for loss of glycemic control when pseudoephedrine, phenylephrine, and other sympathomimetics are administered to patients taking antidiabetic agents.
Epinephrine and other sympathomimetics, through stimulation of alpha- and beta- receptors, increase hepatic glucose production and glycogenolysis and inhibit insulin secretion. Also, adrenergic medications may decrease glucose uptake by muscle cells. For treatment of cold symptoms, nasal decongestants may be preferable for short term, limited use 1 to 3 days as an alternative to systemic decongestants in patients taking medications for diabetes.
Acebutolol: Minor Close monitoring of blood pressure or the selection of alternative therapeutic agents to the sympathomimetic agent may be needed in patients receiving a beta-blocker. Sympathomimetics, such as amphetamines, phentermine, and decongestants e. Concurrent use increases the risk of unopposed alpha-adrenergic activity.
Increased blood pressure, bradycardia, or heart block may occur due to excessive alpha-adrenergic receptor stimulation. Excessive caffeine ingestion via medicines, supplements or beverages including coffee, green tea, other teas, guarana, colas may contribute to side effects like nervousness, irritability, insomnia, or tremor.
Acetaminophen; Caffeine: Moderate CNS-stimulating actions of caffeine can be additive with other CNS stimulants or psychostimulants like phenylephrine; caffeine should be avoided or used cautiously. Acetaminophen; Caffeine; Dihydrocodeine: Moderate CNS-stimulating actions of caffeine can be additive with other CNS stimulants or psychostimulants like phenylephrine; caffeine should be avoided or used cautiously.
Moderate Concomitant use of opioid agonists with diphenhydramine may cause excessive sedation and somnolence. Limit the use of opioid pain medication with diphenhydramine to only patients for whom alternative treatment options are inadequate. If concurrent use is necessary, use the lowest effective doses and minimum treatment durations needed to achieve the desired clinical effect.
Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine: Moderate CNS-stimulating actions of caffeine can be additive with other CNS stimulants or psychostimulants like phenylephrine; caffeine should be avoided or used cautiously. Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide: Moderate CNS-stimulating actions of caffeine can be additive with other CNS stimulants or psychostimulants like phenylephrine; caffeine should be avoided or used cautiously.
Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine: Major Pseudoephedrine can potentiate the effects and increase the toxicity of other sympathomimetics by adding to their sympathomimetic activity. Although no data are available, pseudoephedrine should be used cautiously in patients using significant quantities of other sympathomimetics. Acetaminophen; Codeine: Moderate Concomitant use of opioid agonists with diphenhydramine may cause excessive sedation and somnolence.
Acetaminophen; Dextromethorphan; Guaifenesin; Pseudoephedrine: Major Pseudoephedrine can potentiate the effects and increase the toxicity of other sympathomimetics by adding to their sympathomimetic activity.
Acetaminophen; Dextromethorphan; Pseudoephedrine: Major Pseudoephedrine can potentiate the effects and increase the toxicity of other sympathomimetics by adding to their sympathomimetic activity.
Acetaminophen; Dichloralphenazone; Isometheptene: Moderate Additive CNS depression may occur if dichloralphenazone is used concomitantly with any of the sedating H1 blockers. Use caution with this combination. Dosage reduction of one or both agents may be necessary. Acetaminophen; Hydrocodone: Moderate Concomitant use of opioid agonists with diphenhydramine may cause excessive sedation and somnolence. Acetaminophen; Oxycodone: Moderate Concomitant use of opioid agonists with diphenhydramine may cause excessive sedation and somnolence.
Coadministration of pentazocine with sedating H1-blockers may result in additive respiratory and CNS depression and anticholinergic effects, such as urinary retention and constipation. Acetaminophen; Propoxyphene: Moderate Concomitant use of opioid agonists with diphenhydramine may cause excessive sedation and somnolence.
Acetaminophen; Pseudoephedrine: Major Pseudoephedrine can potentiate the effects and increase the toxicity of other sympathomimetics by adding to their sympathomimetic activity. Aclidinium; Formoterol: Moderate Caution and close observation should be used when formoterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Acrivastine; Pseudoephedrine: Major Pseudoephedrine can potentiate the effects and increase the toxicity of other sympathomimetics by adding to their sympathomimetic activity.
Albiglutide: Moderate Sympathomimetic agents and adrenergic agonists tend to increase blood glucose concentrations when administered systemically. Albuterol: Moderate Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects.
Therefore, psychotropic pharmacodynamic interactions could occur following concomitant administration of drugs with significant CNS activity. Use with caution. Alfentanil: Moderate Concomitant use of opioid agonists with diphenhydramine may cause excessive sedation and somnolence.
Aliskiren; Amlodipine: Moderate Phenylephrine's cardiovascular effects may reduce the antihypertensive effects of calcium-channel blockers. Well-controlled hypertensive patients receiving decongestant sympathomimetics at recommended doses do not appear to be at high risk for significant elevations in blood pressure; however, increased blood pressure especially systolic hypertension has been reported in some patients.
Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ: Moderate Phenylephrine's cardiovascular effects may reduce the antihypertensive effects of calcium-channel blockers. Moderate The cardiovascular effects of sympathomimetics may reduce the antihypertensive effects produced by diuretics.
Well-controlled hypertensive patients receiving decongestant sympathomimetics at recommended doses do not appear at high risk for significant elevations in blood pressure, however, increased blood pressure has been reported in some patients. Aliskiren; Hydrochlorothiazide, HCTZ: Moderate The cardiovascular effects of sympathomimetics may reduce the antihypertensive effects produced by diuretics. Alogliptin; Metformin: Moderate Sympathomimetic agents and adrenergic agonists tend to increase blood glucose concentrations when administered systemically.
Alogliptin; Pioglitazone: Moderate Sympathomimetic agents and adrenergic agonists tend to increase blood glucose concentrations when administered systemically.
Alpha-blockers: Major Sympathomimetics can antagonize the effects of antihypertensives such as alpha-blockers when administered concomitantly. Alpha-glucosidase Inhibitors: Moderate Sympathomimetic agents and adrenergic agonists tend to increase blood glucose concentrations when administered systemically.
Alprazolam: Moderate The therapeutic effect of phenylephrine may be decreased in patients receiving benzodiazepines. Monitor patients for decreased pressor effect if these agents are administered concomitantly.
Amantadine: Moderate Medications with significant anticholinergic activity may potentiate the anticholinergic effects of amantadine, and may increase the risk of antimuscarinic-related side effects. Additive drowsiness may also occur. Ambenonium Chloride: Moderate The therapeutic benefits of ambenonium may be diminished when coadministered with drugs known to exhibit anticholinergic properties including sedating H1-blockers.
When concurrent use cannot be avoided, monitor the patient for reduced ambenonium efficacy. Ambrisentan: Major Sympathomimetics can antagonize the effects of vasodilators when administered concomitantly. Patients should be monitored for reduced efficacy if taking ambrisentan with a sympathomimetic.
Amikacin: Minor Diphenhydramine may mask vestibular symptoms e. Antiemetics block the histamine or acetylcholine response that causes nausea due to vestibular emetic stimuli such as motion. Amiloride: Moderate The cardiovascular effects of sympathomimetics may reduce the antihypertensive effects produced by diuretics. Amiloride; Hydrochlorothiazide, HCTZ: Moderate The cardiovascular effects of sympathomimetics may reduce the antihypertensive effects produced by diuretics.
Aminoglycosides: Minor Diphenhydramine may mask vestibular symptoms e. Amiodarone: Moderate Use phenylephrine with caution in patients receiving amiodarone. Amiodarone possesses alpha-adrenergic blocking properties and can directly counteract the effects of phenylephrine. Phenylephrine also can block the effects of amiodarone. Monitor patients for decreased pressor effect and decreased amiodarone activity if these agents are administered concomitantly.
Amlodipine: Moderate Phenylephrine's cardiovascular effects may reduce the antihypertensive effects of calcium-channel blockers. Amlodipine; Atorvastatin: Moderate Phenylephrine's cardiovascular effects may reduce the antihypertensive effects of calcium-channel blockers.
Amlodipine; Benazepril: Moderate Phenylephrine's cardiovascular effects may reduce the antihypertensive effects of calcium-channel blockers. Amlodipine; Celecoxib: Moderate A dosage adjustment may be warranted for diphenhydramine if coadministered with celecoxib due to the potential for celecoxib to enhance the exposure and toxicity of diphenhydramine.
Moderate Phenylephrine's cardiovascular effects may reduce the antihypertensive effects of calcium-channel blockers. Amlodipine; Olmesartan: Moderate Phenylephrine's cardiovascular effects may reduce the antihypertensive effects of calcium-channel blockers. Amlodipine; Valsartan: Moderate Phenylephrine's cardiovascular effects may reduce the antihypertensive effects of calcium-channel blockers.
Amlodipine; Valsartan; Hydrochlorothiazide, HCTZ: Moderate Phenylephrine's cardiovascular effects may reduce the antihypertensive effects of calcium-channel blockers. Amobarbital: Major Because diphenhydramine can cause pronounced sedation, an enhanced CNS depressant effect may occur when it is combined with other CNS depressants including anxiolytics, sedatives, and hypnotics, such as barbiturates.
Amoxapine: Major Concomitant use of amoxapine with sympathomimetics should be avoided whenever possible; use with caution when concurrent use cannot be avoided.
One drug information reference suggests that cyclic antidepressants potentiate the pharmacologic effects of direct-acting sympathomimetics, but decrease the pressor response to indirect-acting sympathomimetics, however, the data are not consistent.
Moderate Additive anticholinergic effects may be seen when amoxapine is used concomitantly with drugs are known to possess relatively significant antimuscarinic properties, including sedating H1-blockers. Antimuscarinic effects might be seen not only on GI smooth muscle, but also on bladder function, the eye, and temperature Additive sedation may also occur. Amphetamine: Moderate Amphetamines may pharmacodynamically counteract the sedative properties of some antihistamines, such as the sedating H1-blockers i.
This effect may be clinically important if a patient is receiving an antihistamine agent for treatment of insomnia. Alternatively, if a patient is receiving an amphetamine for treatment of narcolepsy, the combination with a sedating antihistamine may reverse the action of the amphetamine. Details Children's Benadryl Dye-Free Allergy Liquid effectively gives your child relief from a runny nose, sneezing, itchy nose, itchy throat, and itchy, watery eyes.
Temporarily relieves these symptoms due to hay fever or other upper respiratory allergies. Children's Benadryl Dye-Free Allergy Liquid brings fast relief to common allergies Dye-free liquid with an antihistamine that works when you need it most Temporarily relieves these symptoms due to hay fever or other upper respiratory allergies: runny nose; sneezing; itchy watery eyes; and itching of the nose or throat Alcohol and sugar free formula hour dose Use only as directed Bubble Gum flavored 4 oz Manufacturer McNeil PPC Fort Washington PA Indications Uses: Temporarily relieves these symptoms due to hay fever or other upper respiratory allergies: runny nose; sneezing; itchy, watery eyes; itching of the nose or throat.
Directions Directions: Find right dose on chart below. Warnings Warnings: Do not use: to make a child sleepy; with any other product containing diphenhydramine, even one used on skin. Show More of the previous text visually. Take our survey. Always follow your doctor's instructions about how and when to take montelukast. Most people take montelukast once a day in the evening to prevent asthma or allergy symptoms. However, if exercise makes your asthma worse, your doctor might tell you to take montelukast 2 hours before you exercise.
Never take more than 1 dose a day. Swallow tablets whole with water, juice or milk. Do not chew these tablets. It's important to take chewable tablets at least 1 hour before food, or 2 hours after food. This is so the medicine is absorbed into your body properly. Chewable tablets can be chewed or sucked.
You or your child can have a drink of water or squash afterwards. Montelukast granules come in a sachet with 4mg of granules inside one dose. They can be put directly on your child's tongue. You can also mix the granules with a spoonful of cold, soft food, such as yoghurt or ice-cream. Make sure your child takes the whole dose immediately or within 15 minutes. It's important to not dissolve the granules in a drink.
You can give your child a drink afterwards. If you or your child misses a dose of montelukast, skip the missed dose and take your next dose the following day at the usual time. If you forget doses often, it may help to set an alarm to remind you. You could also ask a pharmacist for advice on other ways to help you remember to take your medicine. Go to If you need to go to hospital, do not drive yourself. Get someone else to drive you or call for an ambulance.
Take the montelukast packet or leaflet inside it plus any remaining medicine with you. Like all medicines, montelukast can cause side effects, although not everyone gets them. Talk to a pharmacist or doctor if these side effects bother you or do not go away:.
It is possible to have a serious allergic reaction anaphylaxis to montelukast. You could be having a serious allergic reaction and may need immediate treatment in hospital. These are not all the side effects of montelukast. For a full list see the leaflet inside your medicines packet. You can report any suspected side effect to the UK safety scheme. It's important for you and your baby to stay well when you're pregnant.
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