Have you heard parents say, "Just give them some Benadryl®" when they refer to helping kids relax, calm down, sleep, etc.? Well, I can tell you I get many questions about this, so I thought it would help to list some common questions and answers about this drug. Diphenhydramine, brand name Benadryl®, is one of the oldest and most frequently used over-the-counter medications for children. Diphenhydramine, an anti-histamine, counteracts the effects of histamine throughout the body, which include itching, runny nose, sneezing and hives. It is not a very selective medication and has other unintended side effects, which often confuse parents. Here are some examples of common questions:
Can Benadryl make my child sleepy? Yes, one of the main side effects is sedation. This can make many children very drowsy, to the point of falling asleep. In addition, sedation can cause lingering confusion and significantly impair gross motor and even affect learning abilities. This can be a big problem when it comes to school performance.
My child becomes hyperactive with Benadryl®. Is this normal? Hyperactivity occurs in roughly 10-15% of children as sort of an opposite effect. The only way to know if your child will react this way is by giving it to them. Tip: Do not give them Benadryl® for the first time right before you board a plane or get in a car for a long road trip!
I often use Benadryl® to help my child go to sleep at night. Is this ok? Not really. If your child is having difficulty sleeping, it is very important to discuss possible reasons with their doctor. Sleep aids, in general, are not effective as they don’t address the underlying problem causing insomnia. Now, if your child is itching so much from eczema or other causes then Benadryl® may be helpful to calm this down so they can rest.
I use Benadryl® for my child’s seasonal allergies. Is there a better option? Absolutely. Newer 2nd generation over-the-counter antihistamines such as loratadine, cetirizine, and fexofenadine (Claritin®, Zyrtec®, and Allegra®) last much longer (18-24 hours compared with 4-6 hours for Benadryl®) and have much fewer side effects, most notably sedation.
My child’s runny nose got better after taking Benadryl®. Does this mean they have allergies? Not at all. This is a prime example of how the side effects of Benadryl® can improve symptoms. Benadryl® can dry out secretions and mucous membranes. This can create problems not only in the eyes, nose and throat but throughout the rest of the body as well. Improvement in a runny nose during a cold is not due to the anti-histamine properties of the medication. In general, Benadryl® is not an effective medication to use during upper respiratory infections due to short duration of action and unfavorable side effect profile.
Can my child become tolerant to Benadryl®? Yes and no. If used excessively, the effectiveness may wear off over time. However, many other reasons for lack of efficacy exist, including using too low of a dose for their weight or using it to treat symptoms that it has no benefit towards.
Should I give Benadryl® for treatment of an allergic reaction? First line treatment of any severe, rapidly progressive allergic reaction (anaphylaxis) is self-injectable epinephrine. This is prescribed for children who have known food allergies or history of anaphylaxis and is not necessary for everyone to have. However, for mild symptoms such as rash or localized swelling without any breathing problems or other symptoms, Benadryl® can be very effective at reducing symptoms.
This is, by no means, a comprehensive list of indications for use or possible side effects but hopefully will answer some of your questions. As always, please talk to your child’s doctor if you have any questions regarding Benadryl® or any other medications. If you have specific questions about your child's allergies, contact the Nationwide Children's Hospital Allergy and Immunology Department.