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Peds Calc

Clinical Wisdom

Diphenhydramine Clinical PearlsExpert Tips & Parent Guide

Clinical pearls for safer, smarter diphenhydramine use in kids.

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Essential Clinical Pearls

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Prefer non‑sedating antihistamines for daytime

Prefer non‑sedating antihistamines for daily allergic rhinitis; reserve diphenhydramine for acute hives/itching

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Watch for paradoxical excitation

A subset of children become more restless and agitated—stop and switch agents

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Avoid OTC cold combinations

Avoid multi‑symptom OTC cough/cold combinations in young children

Practice-Changing Updates

Updated 2018

Pediatric Specific

Avoid routine use of sedating antihistamines for cough/cold in young children

Old Practice

Use diphenhydramine for cold symptoms

New Practice

Avoid for cold symptoms; use supportive care

Impact: Fewer adverse effects and safer care