Benadryl-D

• It is used to treat nose stuffiness.
• It is used to ease allergy signs.

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Applies to diphenhydramine / pseudoephedrine: oral liquid, oral tablet, oral tablet disintegrating

Nervous system

The CNS depressant effect of diphenhydramine parallels its plasma concentrations. The plasma concentration threshold for sedation is 30 to 42 ng/mL, and to cause mental impairment is 58 to 74 ng/mL. Patients should be warned against driving while taking diphenhydramine, and should avoid concomitant ingestion of alcohol.

Dystonic reactions to diphenhydramine have been accompanied by dizziness, mental confusion, rigidity, lip and tongue protrusion, trismus, torticollis, and swallowing difficulties. These reactions generally resolve spontaneously. Toxic encephalopathy has been reported in a child with chicken pox treated generously with topical diphenhydramine.

Delirium has been reported in elderly patients with mild dementia following small oral doses of diphenhydramine.[Ref]

Central nervous system (CNS) depression commonly occurs with diphenhydramine administration, resulting in drowsiness and sedation in nearly all patients treated. Motor skills may be impaired. Dystonic reactions have been reported after single doses of diphenhydramine.

Pseudoephedrine produces nervous system stimulation, resulting in tremor, anxiety, and nervousness. Insomnia is reported in up to 30% of pseudoephedrine-treated patients. Headache may also occur in patients receiving pseudoephedrine.[Ref]

Cardiovascular

Cardiovascular effects of diphenhydramine may include hypotension, tachycardia, and palpitations.

Cardiovascular adverse effects more commonly may be associated with pseudoephedrine. Pseudoephedrine generally causes a significant rise in heart rate. Hypertension and arrhythmias may be problematic in susceptible patients.[Ref]

Pseudoephedrine causes vasoconstriction which generally does not produce hypertension, but may be problematic for patients with pre-existing hypertension. Arrhythmias may be produced in predisposed patients. Rarely, pseudoephedrine has been reported to cause coronary artery spasm and chest pain.[Ref]

Hypersensitivity

Hypersensitivity reactions may occur with diphenhydramine, generally resulting in rash, pruritus and eczema. Photosensitivity reactions have also been reported with diphenhydramine.

Hypersensitivity reactions to pseudoephedrine may also occur. Fixed drug eruptions secondary to pseudoephedrine have been reported.[Ref]

Most commonly, hypersensitivity to diphenhydramine manifests itself in patients receiving systemic drug after being sensitized to it by topical application. Sensitization with systemic administration has also been reported.[Ref]

Gastrointestinal

Gastrointestinal tract adverse effects of diphenhydramine are mild, and may include nausea, dry mouth, and constipation.

Gastrointestinal adverse effects of pseudoephedrine may include anorexia and gastric irritation in approximately 5% of patients. Dry mouth, nose, or throat may occur in up to 15% of patients.[Ref]

Ocular

Ocular affects of diphenhydramine may include blurred vision, diplopia, and dry eyes due to its anticholinergic effect.[Ref]

Genitourinary

The genitourinary tract may be adversely affected due to the anticholinergic effects of diphenhydramine, resulting in urinary retention and dysuria.[Ref]

Hematologic

Hematologic adverse effects such as hemolytic anemia, thrombocytopenia, and agranulocytosis may be rarely caused by antihistamines.[Ref]

Some side effects of Benadryl Allergy Sinus may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

6 years to 12 years:
5 mL liquid (12.5 mg-30 mg/5 mL) or 1 disintegrating tablet (12.5 mg-30 mg) orally every 4 to 6 hours as needed. Maximum recommended daily dose 20 mL or 4 tablets.

13 years or older:
2 tablets (25 mg-30 mg) or disintegrating tablets (12.5 mg-30 mg) or 10 mL liquid (12.5 mg-30 mg/5 mL) orally every 4 to 6 hours as needed. Maximum recommended daily dose is 8 tablets or 40 mL.
-or-
1 tablet (25 mg-60 mg) every 4 to 6 hours as needed. Maximum recommended daily dose is 4 tablets.

6 years to 12 years:
5 mL liquid (12.5 mg-30 mg/5 mL) or 1 disintegrating tablet (12.5 mg-30 mg) orally every 4 to 6 hours as needed. Maximum recommended daily dose 20 mL or 4 tablets.

13 years or older:
2 tablets (25 mg-30 mg) or disintegrating tablets (12.5 mg-30 mg) or 10 mL liquid (12.5 mg-30 mg/5 mL) orally every 4 to 6 hours as needed. Maximum recommended daily dose is 8 tablets or 40 mL.
-or-
1 tablet (25 mg-60 mg) every 4 to 6 hours as needed. Maximum recommended daily dose is 4 tablets.

Data not available

The FDA has not approved use of over-the-counter cough and cold medications to children aged less than 2 years, and proper dosing for children in this age group has not been studied. Clinicians should be aware of the risk for serious illness or fatal overdose from administration of cough and cold medications to children aged less than 2 years. Clinicians should be certain that caregivers understand 1) the importance of administering cough and cold medications only as directed and 2) the risk for overdose if they administer additional medications that might contain the same ingredient.