Context:

Experts are advocating for the phasing out of Benadryl, a popular first-generation antihistamine, due to its significant side effects and potential for harm compared to newer alternatives like Claritin and Zyrtec. Benadryl, known for causing drowsiness and other adverse effects such as cardiac issues and cognitive impairment, might not pass modern clinical trials for over-the-counter approval. Despite its affordability and rapid onset in acute allergic reactions, safer second-generation antihistamines are recommended for regular use, especially for chronic allergies and in vulnerable populations like the elderly. The risks associated with Benadryl, including impaired driving and potential for abuse, further support the call for its reduced availability. While Benadryl still has specific applications, such as short-term use before procedures where sedation is desired, the consensus is to prioritize alternatives with fewer side effects for general allergy management.

Dive Deeper:

• Diphenhydramine, marketed as Benadryl, has been a staple for treating various allergy symptoms but is now under scrutiny due to its side effects and the availability of safer alternatives. It is an older, first-generation antihistamine that can cause drowsiness and other adverse effects by blocking H1 receptors and crossing the blood-brain barrier.

• The drug also affects sodium channels and blocks acetylcholine, leading to potential cardiac issues and other side effects like dry mouth, blurry vision, constipation, and elevated heart rates. These significant risks have prompted the development of second-generation antihistamines such as Claritin and Zyrtec, which offer similar effectiveness with fewer side effects.

• A recent paper published in the World Allergy Organization Journal argues for the discontinuation of Benadryl due to its adverse reactions and potential for abuse, such as the incidents linked to the TikTok 'Benadryl Challenge.' The paper suggests that if Benadryl were to undergo clinical trials today, it would likely not be approved for over-the-counter use.

• Clinical experts recommend second-generation antihistamines for conditions like rhinitis and hives due to their longer-lasting effects and reduced side effects, making them more suitable for chronic allergy sufferers and particularly safer for the elderly.

• Despite its drawbacks, Benadryl retains some utility in specific scenarios, such as when a rapid onset of action is needed during acute allergic reactions or when short-term drowsiness is beneficial, as before medical procedures. However, the general advice is to opt for newer antihistamines for everyday allergy management.