Diphenhydramine Indications and Dosage
- allergic rhinitis
- common cold
- cough
- drug-induced extrapyramidal symptoms
- insect bites or stings
- insomnia
- motion sickness
- Parkinson’s disease
- parkinsonism
- pruritus
- rhinorrhea
- sneezing
- urticaria
- vertigo
Diphenhydramine Indications and Dosage
For allergic rhinitis, common cold, urticaria, pruritus, or allergic reactions:
- for the prevention and treatment of allergic rhinitis, urticaria, pruritus, or allergic reactions:
Oral dosage:
Adults and adolescents: The recommended dose is 25 - 50 mg PO 3 - 4 times per day, at 4 - 6 hour intervals, as needed. Maximum dose is 300 mg/day.
Elderly: Start at the lowest adult dosage. Elderly patients are more sensitive to anticholinergic effects.
Children > 9.1 kg: The recommended dose is 12.5 - 25 mg PO 3 - 4 times per day, at 4 - 6 hour intervals. Alternatively, give 5 mg/kg/day PO or 150 mg/m2/day PO, in 3 - 4 divided doses. Maximum dose is 300 mg/day.
Children <= 9.1 kg: The recommended dose is 6.25 - 12.5 mg PO 3 - 4 times per day, at 4 - 6 hour intervals. Alternatively, give 5 mg/kg/day PO or 150 mg/m2/day PO, in 3 - 4 divided doses. Maximum dose is 300 mg/day.
Intravenous or intramuscular dosage:
Adults and adolescents: The recommended dose is 10 - 50 mg IM or IV every 4 - 6 hours, as needed. Single doses of 100 mg may be given if required. Maximum daily dose is 400 mg/day.
Elderly: Start at the lowest adult dosage. Elderly patients are more sensitive to anticholinergic effects.
Children: The recommended dose is 5 mg/kg/day IM or IV or 150 mg/m2/day IM or IV, given in 3 - 4 divided doses.
- for self-medication of symptoms associated with allergic rhinitis or the common cold, including rhinorrhea, sneezing, itching of the nose or throat, or itchy/watery eyes:
Oral dosage (tablets or capsules):
Adults and adolescents: The recommended dose is 25 - 50 mg PO every 4 - 6 hours, not to exceed 300 mg in 24 hours.
Elderly: Start at the lowest adult dosage. Elderly patients are more sensitive to anticholinergic effects.
Children 6 - 12 years: The recommended dose is 12.5 - 25 mg PO every 4 - 6 hours, not to exceed 150 mg in 24 hours.
Oral dosage (chewable tablets, e.g., Benadryl® Allergy Chewables 12.5 mg tablet):
Adults and adolescents: The recommended dose is 2 - 4 tablets (25 - 50 mg) PO every 4 - 6 hours, not to exceed 24 tablets (300 mg) in 24 hours.
Elderly: Start at the lowest adult dosage. Elderly patients are more sensitive to anticholinergic effects.
Children 6 - 12 years: The recommended dose is 1 - 2 tablets (12.5 - 25 mg) PO every 4 - 6 hours, not to exceed 12 tablets (150 mg) in 24 hours.
Oral dosage (e.g., diphenhydramine 12.5 mg/5 ml liquids, e.g., Benadryl® Allergy Liquid or Benadryl® Dye-Free Allergy Liquid):
Adults and adolescents: The recommended dose is 2 - 4 teaspoonfuls (25 - 50 mg) PO every 4 - 6 hours, not to exceed 24 teaspoonfuls (300 mg) in 24 hours.
Elderly: Start at the lowest adult dosage. Elderly patients are more sensitive to anticholinergic effects.
Children 6 - 12 years: The recommended dose is 1 - 2 teaspoonfuls (12.5 - 25 mg) PO every 4 - 6 hours, not to exceed 12 teaspoonfuls (150 mg) in 24 hours.
Children < 6 years weighing > 9.1 kg † : Under the direction of a physician, the usual dosage is 12.5 - 25 mg PO 3 - 4 times per day, at 4 - 6 hour intervals. Alternatively, give 5 mg/kg/day PO, in 3 - 4 divided doses. Maximum dose is 150 mg/day.
Children < 6 years weighing <= 9.1 kg † : Under the direction of a physician, the usual dosage is 6.25 - 12.5 mg PO 3 - 4 times per day, at 4 - 6 hour intervals. Alternatively, give 5 mg/kg/day PO, in 3 - 4 divided doses. Maximum dose is 150 mg/day.
For the prevention and treatment of motion sickness or vertigo:
Oral dosage:
Adults and adolescents: For self medication, the recommended dose is 25 - 50 mg PO every 4 - 6 hours as needed, not to exceed 300 mg in 24 hours.
Elderly: Start at the lowest adult dosage. Elderly patients are more sensitive to anticholinergic effects.
Children 6 - 12 years: For self-medication, the recommended dose is 12.5 - 25 mg PO every 4 - 6 hours, not to exceed 150 mg in 24 hours.
Intravenous or intramuscular doasge:
Adults and adolescents: Initially, 10 mg IV or IM, then 20 - 50 mg every 2 - 3 hours, PRN.
Elderly: Start at the lowest adult dosage. Elderly patients are more sensitive to anticholinergic effects.
Children 6 - 12 years: 1 - 1.5 mg/kg IV or IM every 6 hours, not to exceed 300 mg/day.
For the treatment of cough caused by minor throat and bronchial irritation:
Oral dosage:
Adults and adolescents: For self-medication, the recommended dose is 25 mg PO every 4 - 6 hours, not to exceed 150 mg in 24 hours.
Elderly: Start at the lowest adult dosage. Elderly patients are more sensitive to anticholinergic effects.
Children age 6 - 12 years: For self-medication, the recommended dose is 12.5 mg PO every 4 - 6 hours. Maximum dosage is 75 mg/day.
Children age 2 - 6 years: Under the direction of a physician, the usual dose is 6.25 mg PO every 4 - 6 hours. Maximum dosage is 37.5 mg/day.
For the treatment of insomnia:
Oral dosage:
Adults and adolescents: The recommended dose is 50 mg PO at bedtime.
Elderly: Start at the lowest adult dosage. Elderly patients are more sensitive to anticholinergic effects.
Children 2 - 12 years: Doses of 1 mg/kg (max: 50 mg) PO 30 minutes before bedtime have been given.
For the treatment of parkinsonism or Parkinson’s disease:
Oral dosage:
Adults: Initially, 25 mg PO three times per day; dose may be increased to 50 mg four times per day.
Elderly: Start at the lowest adult dosage. Elderly patients are more sensitive to anticholinergic effects.
Intravenous or intramuscular dosage:
Adults: The recommended dose is 10 - 50 mg IV or IM.
Elderly: Start at the lowest adult dosage. Elderly patients are more sensitive to anticholinergic effects.
For the treatment of drug-induced extrapyramidal symptoms:
Intravenous or intramuscular dosage:
Adults: The recommended dose is 10 - 50 mg IV or IM.
Elderly: Start at the lowest adult dosage. Elderly patients are more sensitive to anticholinergic effects.
For the treatment of local reactions to insect bites or stings, or allergic dermatitis due to poison ivy/oak/sumac:
Topical dosage:
Adults, including the elderly: Topical application of H1-antagonists 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 three to four times per day for up to 7 days.
Maximum Dosage Limits:
- Adults: 300 mg/day PO; 400 mg/day IV or IM.
- Elderly: Start at the lowest adult dosage. Elderly are more sensitive to anticholinergic effects.
- Adolescents 13 - 18 years: 300 mg/day PO; 400 mg/day IV or IM.
- Children 6 - 12 years: 300 mg/day PO, IV or IM for prescription use (max. 150 mg/day PO for OTC use).
- Children 2 - 6 years: 150 mg/day PO for OTC use.
Patients with hepatic impairment:
Dosage reduction may be warranted for patients with hepatic impairment; diphenhydramine is extensively metabolized in the liver.
Patients with renal impairment:
No dosage adjustments are needed.
[ Last revised: 6/15/2004 11:00:00 AM ]
Related entries
Syndicate
|
