Diphenhydramine
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| ID | DRUG-DIPHENHYDRAMINE |
|---|---|
| Тип | Препарат |
| Синоніми | BenadrylDimedrolДифенгідрамін |
| Статус | переглянуто 2026-04-27 | очікує клінічного підпису |
| Хвороби | Не вказано |
| Джерела | SRC-NCCN-BCELL-2025 SRC-NCCN-MM-2025 |
Дані про препарат
| Клас | First-generation H1 antihistamine (ethanolamine class); also moderate anticholinergic, sedative-hypnotic, antiemetic, mild α1-blocker |
|---|---|
| Механізм дії | Competitive reversible H1 receptor antagonist that blocks histamine- mediated vasodilation, increased capillary permeability, smooth- muscle contraction, sensory nerve stimulation, and pruritus. Lipophilic — readily crosses the blood-brain barrier producing significant sedation. Additional actions: muscarinic antagonism (anticholinergic — dry mouth, urinary retention, mydriasis, constipation, confusion in elderly), modest α1-adrenergic antagonism (mild orthostatic hypotension), and 5-HT-antagonist / D2-antagonist effects contributing to antiemetic and antimotion- sickness activity. In oncology supportive care, used as: (1) premedication for chemotherapy infusion reactions (paclitaxel, carboplatin retreatment, rituximab, monoclonal antibodies); (2) adjunct treatment of mild-to-moderate hypersensitivity / infusion reactions (mainstay of pruritus, urticaria, mild bronchospasm — but NOT a s... |
| Типове дозування | PREMEDICATION (paclitaxel, rituximab, etc.): 25-50 mg IV 30 min before infusion (paired with H2 antagonist + dexamethasone). ACUTE INFUSION REACTION / mild anaphylaxis adjunct: 25-50 mg IV push, may repeat every 4-6 h (max 400 mg/day adult). Acute extrapyramidal reaction: 25-50 mg IV/IM push, repeat in 15-30 min if no response. Allergic urticaria / pruritus: 25-50 mg PO every 4-6 h, max 300 mg/day. Pediatric: 1 mg/kg IV/PO q6h (max 50 mg per dose, 300 mg/day). Geriatric (≥65 yrs): use cautiously — start 25 mg, increased fall and confusion risk; consider non- sedating second-generation H1 (cetirizine, loratadine) for non-emergency indications. Renal impairment: extended dosing interval (q9h... |
| Зареєстровано в Україні | True |
| Відшкодовується НСЗУ | True |
| Остання перевірка для України | 2026-04-27 |
Нотатки
Foundation H1 antihistamine for chemotherapy infusion-reaction premedication (especially paclitaxel — Cremophor vehicle reactions — and rituximab / other monoclonal antibodies). Standard premedication package: dexamethasone 20 mg IV + diphenhydramine 25-50 mg IV + H2 antagonist (famotidine 20 mg IV) given 30 min before chemo. Also first adjunct for ACTIVE infusion reactions (urticaria, pruritus, mild bronchospasm, mild flushing) — but ESCALATE TO EPINEPHRINE if hypotension, severe bronchospasm, upper airway edema, or no response to antihistamine + steroid + fluids within 10-15 min. CRITICAL: diphenhydramine is NEVER a substitute for epinephrine in anaphylaxis — the leading cause of preventable fatal anaphylaxis is using antihistamine alone. Beers-list inappropriate in elderly (≥65 yrs) for routine use due to anticholinergic delirium and fall risk — substitute non-sedating second-generation H1 for chronic indications. Extrapyramidal reaction rescue: 25-50 mg IV reverses metoclopramide / promethazine acute dystonia within 5-10 min. Ukraine: cheap, ubiquitous.
Де використовується
У YAML-корпусі не знайдено зворотних посилань.