Diphenhydramine - instructions for use, dose, side effects, contraindications

The H1 blocker is a first-generation histamine receptor. The effect on the central nervous system is due to the blockade of H3 - histamine and m-cholinergic receptors of the brain. Removes spasm of smooth muscles (direct action), reduces permeability of capillaries, prevents and weakens allergic reactions, has local anesthetic, antiemetic, sedative effects, has a hypnotic effect. Antagonism with histamine manifests itself in a greater degree in relation to local vascular reactions in inflammation and allergies than in systemic, ie. lowering blood pressure. However, with parenteral administration, patients with circulating blood volume deficiency may reduce blood pressure and increase the existing hypotension, due to ganglion blocking action.In people with local brain damage and epilepsy activates (even in low doses) epileptic discharges on the electroencephalogram and can provoke an epileptic attack. The action develops within a few minutes, lasting up to 12 hours.

Pharmacokinetics:

After intravenous and intramuscular injection is widely distributed in the body. The highest concentration is found in the lungs, spleen, kidneys, liver, brain, muscles. Penetrates through the blood-brain barrier (BBB). It binds to plasma proteins by 98-99%. Metabolized mainly in the liver, in part - in the lungs and kidneys. It is excreted from the tissues after 6 hours. The half-life period is 4-10 hours. Within a day it is completely excreted by the kidneys in the form of metabolites conjugated with glucuronic acid. Essential amounts are excreted in milk and can cause sedation in infants (a paradoxical reaction characterized by excessive excitability may be observed).

Indications:Anaphylactic and anaphylactoid reactions (in complex therapy); Quincke's edema, serum sickness, other acute allergic conditions (in complex therapy and in cases when the use of a tablet form is impossible).

Contraindications:

Hypersensitivity, lactation, angle-closure glaucoma, prostatic hyperplasia, stenosing peptic ulcer of stomach and duodenum, stenosis of the neck of the bladder, bronchial asthma, epilepsy, children under 7 months.

Carefully:In view of the presence of atropine-like effect in diphenhydramine, caution should be used in patients with recent history of respiratory diseases (including asthma), increased intraocular pressure, hyperthyroidism, cardiovascular disease, hypotension. Use with caution diphenhydramine at the age of 60 years and older, because of the high probability of developing dizziness, sedation and hypotension.

Pregnancy and lactation:

The use of diphenhydramine in pregnancy is possible only under the strict supervision of a doctor in the event that the intended benefit to the mother exceeds the potential risk to the fetus.

For the duration of treatment, breastfeeding should be discontinued.

Dosing and Administration:

Intravenous and intramuscular.

For adults and children over 14 years old - 1-5 ml of 1% solution (10-50 mg) 1-3 times a day; the maximum daily dose is 200 mg.

For children aged 7 months to 12 months, 0.3-0.5 ml (3-5 mg), 1 to 3 years - 0.5-1 ml (5-10 mg), 4 up to 6 years - 1-1,5 ml (10-15 mg), from 7 to 14 years - 1,5-3 ml (15-30 mg) if necessary every 6-8 hours.

Side effects:

Allergic reactions:

urticaria, photosensitivity, skin rash, itching.

From the nervous system:

drowsiness, general weakness, decreased speed of psychomotor reactions, impaired coordination and rapid reaction, a sense of fatigue. In some cases, excitation (especially in children), insomnia, irritability, euphoria, dizziness, tremor.

From the digestive tract:

feelings of dry mouth, upset of the functions of the gastrointestinal tract (discomfort in the epigastrium, nausea, vomiting, loss of appetite) are possible.

From the cardiovascular system:

decrease in arterial pressure, tachycardia, extrasystole.

From the urinary system:

disturbances of urination.

From the respiratory system:

dryness of the mucous membrane of the nose and throat, nasal congestion, thickening of bronchial secretions, tightness in the chest and shortness of breath.

From the hematopoiesis:

hemolytic anemia, thrombocytopenia, agranulocytosis.

Overdose:

Symptoms:

oppression or excitation (especially in children) of the central nervous system, including depression, confusion; dilated pupils, dry mouth, disorders of the functions of the gastrointestinal tract.

Treatment:

there is no specific antidote. Supportive measures include monitoring blood pressure, drugs that increase blood pressure, oxygen, introduction of plasma-substituting fluids intravenously.

Can not use epinephrine and analeptics.

Interaction:Potentsiruet action of alcohol and drugs, depressing the central nervous system (neuroleptics, tranquilizers, sedatives and hypnotics, anticonvulsant drugs, anesthesia drugs). Inhibitors of monoamine oxidase (MAO) increase the anticholinergic activity of diphenhydramine. Enhances the anticholinergic effects of drugs with m-cholinoblocking activity. In general, with psychostimulants, an antagonistic interaction is noted. Reduces the effectiveness of apomorphine as an emetic in the treatment of poisoning.

Special instructions:

Do not administer subcutaneously due to irritant effect.

During the treatment period, alcohol and ultraviolet radiation should be avoided.

The antiemetic effect of diphenhydramine can hamper the diagnosis of appendicitis and the recognition of symptoms of an overdose (it is necessary to inform the doctor about the use of this drug).

Impact on the ability to drive a car and work with machinery.

During the treatment period, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Effect on the ability to drive transp. cf. and fur:During the treatment period, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Form release / dosage:Solution for intravenous and intramuscular injection 10 mg / ml.

Packaging:

1 ml per ampoule of neutral glass.

For 10 ampoules, together with the instructions for use and the ampoule scarifier, are placed in a box of cardboard box.

By 5 or 10 ampoules per contour mesh box made of PVC film or polyethylene terephthalate tape and aluminum foil or paper with polyethylene coating or without foil or without paper.

Pl 1 or 2 contoured cell packs with instructions for use and a knife for opening ampoules or a scarifier ampullum are placed in a pack of cardboard. When you pack the ampoules with a break ring or break point, the ampoule opener or ampoule scaper does not insert.

Storage conditions:

In the dark place at a temperature of no higher than 25 ° C.

Keep out of the reach of children.

Shelf life:4 years. Do not use after the expiration date stated on the package.

Terms of leave from pharmacies:On prescription

Registration number:LS-000034

Date of registration:07.07.2010

Manufacturer: & nbsp

NOVOSIBHIMFARM, OJSC Russia

Information update date: & nbsp02.02.2016

Illustrated instructions

Instructions

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