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A recent article in the World Allergy Organization Journal aims to discourage the use of prescription and over-the-counter diphenhydramine. Clinical teams from Johns Hopkins University School of Medicine and the Division of Allergy and Immunology, University of California, San Diego, argue that the first-generation antihistamine has risks and should no longer be widely prescribed or made available over-the-counter. There are safer and more effective second-generation alternatives like cetirizine, loratadine, and fexofenadine available that might be considered instead. Diphenhydramine is associated with sedation, drowsiness, psychomotor impairment, and potential risks for those with certain health conditions. Its non-selective action on multiple body systems increases the likelihood of adverse effects, especially in children and older adults. Consumers can buy diphenhydramine in liquid, tablet, capsule, and topical products, including some combination products that are marketed for sleep. Though professional organizations in the United States have not issued formal guidance, Germany, the Netherlands, and Sweden have limited access by requiring a prescription for diphenhydramine.
Say goodbye to an old friend: “We believe that diphenhydramine has reached the end of its life cycle,” the authors write, citing clinical reasons and a comparatively lower risk/benefit ratio. Approved in 1946, it was the first antihistamine given the go-ahead by the Food and Drug Administration.
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