Tejal Somvanshi
Doctors are urging patients to stop using the popular allergy medication diphenhydramine, commonly known as Benadryl, citing significant safety concerns that they say outweigh its benefits.
“It’s time to move on. For every single indication that people are using diphenhydramine, there are better drugs that are more effective at treating the symptoms people are trying to treat with fewer side effects,” says Dr. Anna Wolfson, an allergist at Massachusetts General Hospital.
In a review published earlier this year, allergy experts from Johns Hopkins University and the University of California, San Diego called for the complete removal of diphenhydramine from both over-the-counter and prescription markets in the United States, describing it as “outdated, dangerous and eclipsed by safer alternatives.”
First approved in 1946, diphenhydramine appears in over 300 different over-the-counter formulations for allergies, insomnia, and cold symptoms. However, research has highlighted serious risks, particularly for children and older adults.
The medication doesn’t just block allergy-related receptors but affects other parts of the brain as well. This can cause significant drowsiness, cognitive impairment, and in some cases, dangerous cardiac effects. In older adults, the drug can remain in the body for up to 18 hours, leading to prolonged sleepiness, disorientation, and increased fall risk.
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Studies have also found a concerning link between long-term use of diphenhydramine and dementia. A study published in JAMA Internal Medicine found that people who used anticholinergic medications like Benadryl regularly for three years or more had a 54% higher risk of developing dementia compared to those who used them for less than three months.
The risks for children can be even more severe. Pediatric formulations have been linked to accidental overdoses, extreme sedation, and even deaths. The medication gained additional notoriety during the viral “Benadryl Challenge” on TikTok, which resulted in several child hospitalizations and fatalities.
Dr. James Clark of Johns Hopkins University, lead author of the review paper, recommends alternatives: “Patients should trial alternative agents like loratadine, which is Claritin, or cetirizine, which is Zyrtec, or fexofenadine, which is Allegra,” to manage allergy symptoms.
The Consumer Healthcare Products Association, representing the over-the-counter medicine industry, acknowledges the concerns but emphasizes that the side effects are disclosed on product labels and notes that “these products are not intended for long-term use.”
Despite this warning, over 1.5 million prescriptions for diphenhydramine are written annually, not counting untracked over-the-counter purchases.”It used to be a useful drug that helped millions of patients, but today its therapeutic ratio is inferior to second-generation antihistamines due to significantly fewer side effects,” the researchers concluded. “It’s time to say goodbye to diphenhydramine as a public health threat.”
