(This article first appeared 13 November 2018.)
My husband and I were camp cooks this past summer, and one of the girls, who had no known allergies, fell ill after eating some candy-coated sunflower seeds the campers were given as they were heading out on a hike. She returned to camp and was attended to by our camp nurse and EMT. Of course, the medics had epinephrine but most choose to avoid using it if possible. In this case, the girl was given several doses of Benadryl to stop the anaphylactic reaction. She has since tested positive for numerous food allergies and must carry an epi-pen at all times.
Anyone can have a reaction to anything at anytime.
It is for this reason that some physicians believe the most important drug a layperson can carry in an emergency kit is Benadryl, or diphenhydramine. Pain relievers may be used more frequently, but Benadryl can save a life. It is not a substitute for epinephrine, but it can work in mild to moderate anaphylaxis and it can buy you some time. It is the most commonly used antihistamine for addressing acute allergic reactions in emergency rooms.
The above example and Benadryl's common use as an allergy remedy are reason enough to stock and carry Benadryl. However, there are many other uses as well.
OTHER ALTERNATIVE USES
Sleep aid. The most frequent use of Benadryl is for treating allergies and runny noses, but it is also widely sold as a sleep aid.
- Tylenol PM contains acetaminophen and 25 mg (one regular pink pill) of diphenhydramine.
- Advil PM is ibuprofen and 25-38 mg of diphenhydramine.
- Vicks' ZzzQuil is merely 50 mg of diphenhydramine.
Nausea, anxiety, Parkinson's. Physicians also use diphenhydramine in treating nausea due to motion sickness, vertigo, and other illnesses. It can be used in the treatment of mild anxiety and mood swings in addition to some symptoms associated with Parkinson's.
Anesthetic. Benadryl is marketed in lotions and sprays for topical pain relief from:
- rashes, insect bites and stings;
- contact dermatitis due to poison oak, poison ivy, and poison sumac;
- hives and eczema.
Injectable. Benadryl also finds application as an injectable or local anesthetic, especially for individuals allergic to lidocaine.
Dogs. And finally, veterinarians also sometimes suggest diphenhydramine tablets to help dogs with allergies or anxiety.
FORMS OF BENADRYL
Tablets and capsules are the most common and least expensive. Tablets have the longest shelf life and can be split in half if necessary. Capsules are a little faster acting than tablets. They can be opened and sprinkled over food or mixed in liquid for individuals who have difficulty swallowing pills. The powder inside the capsules can also be mixed with saline or dextrose for an injectable anesthetic, with cream for a topical anesthetic, or with water for a topical spray or paste. Unfortunately, unless the capsules are well-protected and stored properly, they can melt together and become an unusable mess. This is more likely to happen in areas with high humidity.
Syrups have a much shorter shelf life, not much beyond the use-by date on the packaging. But they get into the bloodstream faster and are easier for children to swallow.
Chewables and rapid melts are a compromise between the solid and liquid forms. Their great advantages are that they get into the bloodstream faster and store better than liquids. They are the best choice for first aid kits when getting into the bloodstream quickly is critical. While they are relatively expensive, bear in mind that you don't need very many.
Spray, lotion, and gel forms of diphenhydramine for topical use don’t cause as much drowsiness as the oral forms do. Because they are liquid, lotions and sprays have a shorter shelf life. But these topical forms grant almost immediate relief, quite the blessing in taming the urge to scratch. The topical forms not only treat insect stings and bites, rashes, and poison oak, poison ivy, and poison sumac, but they also help with the itching that occurs during the healing of minor burns (including sunburns), cuts, and scrapes. Diphenhydramine powder from capsules can also be used to make your own lotion or spray by simply mixing with lotion or water. Combine the powder and a small amount of water to make a paste that can be applied in and around the edges of a wound to numb it prior to cleaning and closure.
Injectable diphenhydramine acts faster than any of the other forms. This is absolutely critical when it is used as an adjunct in treating anaphylaxis. It is also used as a local anesthetic, especially in individuals allergic to lidocaine. Unfortunately, the injectable is only available for purchase by licensed health care providers. But, you can mix it yourself! This is only for a grid-down situation, and you should only do this under a physician’s guidance. Having the supplies on hand will be critical, and in addition to having diphenhydramine powder from capsules, you will also want sterile saline or dextrose solutions and syringes.
An adult dosage of Benadryl is one or two pills for a total of 25-50 mg. Children 6-12 years are prescribed one 25 mg tablet. Prescription strength Benadryl is 75 mg. A physician should be consulted before using oral diphenhydramine products in children under the age of six years. Topical lotions and sprays may be used in children two years and older.
CONTRAINDICATIONS AND CAUTIONS:
Benadryl is not recommended for use in people over the age of 60 without a physician’s care. It is especially contraindicated for those with enlarged prostate and hypertension. Because it is excreted in breast milk, it should not be used by nursing mothers (and it can also dry up the milk supply). Drug screens may produce false positive results for methadone use in people who have recently taken diphenhydramine. A typical 50 mg dose can create impairment equivalent to a .10 blood alcohol level, which is why each bottle contains a warning about driving and operating heavy machinery. In some children, Benadryl can have a paradoxical effect, where instead of having a sedating side effect, the side effect is stimulating. This is particularly true with children who have ADHD. Diphenhydramine may interact with other medications, so a drug reference should be consulted before medication is administered.
The cheapest places to get Benadryl or diphenhydramine are Amazon and Sam's Club, at least if you are buying in quantity. You can get a little bottle of 30 or so pills at the grocery store for about five dollars, or you can go to Sam's and get 600 pills for $4.48, or Amazon and get 400 pills for $6.09. For less than two cents per pill, you can get a nice supply of a wonder drug.
I think we have about 2,500 tablets and capsules right now. Am I really going to need that many? I sure hope not! If things get that bad, even for my large family, I think we’d rather be dead. It just seems like a good idea to have extra for sharing or bartering.
Links to related posts:
OTC pain relievers
Cough and cold remedies
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