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Diphenhydramine, widely known as Benadryl, should no longer be used for the vast majority of seasonal allergies or common skin reactions because safer and more effective alternatives exist on the market. That is the assessment of the Ordre des pharmaciens du Québec (OPQ).
A Push for Provincial Restrictions
Jean-François Desgagnés, a pharmacist and president of the OPQ, supports provincial efforts to restrict access to the medication. He notes that healthcare providers now have access to superior treatments that carry fewer risks for patients.
Public health scrutiny over over-the-counter diphenhydramine sales intensified following a fatal overdose in December 2023, when an 18-year-old died from acute diphenhydramine intoxication. In response to the tragedy, the Bureau du coroner recommended moving Benadryl and related diphenhydramine products behind pharmacy counters to subject purchases to direct professional oversight.
Rising Exposure Cases and Social Media Misuse
Data from the Poison Control Centre of Québec (Centre antipoison du Québec) show that exposure cases reached 603 in 2024. That figure includes 301 intentional acts, representing a 10% increase over a three-year period.
Health professionals also point to social media trends involving the misuse of large quantities of the drug combined with alcohol to achieve euphoric effects.
Severe Risks for Vulnerable Populations
Medical experts emphasize that diphenhydramine carries significant side effects, particularly for vulnerable populations.
According to the OPQ, common adverse reactions include heavy somnolence that can trigger dangerous falls, confusion, impaired driving, blurred vision, dizziness, dry mouth, cardiac irregularities, and severe neurological symptoms. High doses can induce hallucinations and life-threatening respiratory depression. These risks amplify when the drug is combined with alcohol, opioids, sedatives, or anticholinergic medications.
Older adults face heightened danger from fall-related injuries, while infants must never receive the medication due to an extreme risk of fatal accidental overdose. Furthermore, clinicians contraindicate Benadryl for individuals managing heart disease, glaucoma, urinary retention, or an enlarged prostate.
Safer Alternatives on the Market
To replace first-generation antihistamines like Benadryl, health authorities recommend second- or third-generation over-the-counter options. Medications such as loratadine (Claritin), fexofenadine (Allegra), and cetirizine (Reactine) offer longer-lasting symptom relief of up to 24 hours with significantly less drowsiness.
In addition to standard shelf items, pharmacists in Quebec hold the authority to prescribe certain behind-the-counter antihistamines directly to patients seeking relief for allergy symptoms or localized skin reactions, according to the OPQ.
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