Difengidramin (When ATH D04AA32)

When ATH:
D04AA32

Characteristic.

Diphenhydramine hydrochloride - a white crystalline powder bitter taste, It numbs the tongue. Hygroscopic. Soluble in water (1 g 1 ml), alcohol (1 g 2 ml), xloroforme (1 g 2 ml), acetone (1 g 50 ml). Very slightly soluble in benzene, ether. pH 1% aqueous solution is about 5,5.

Pharmacological action.
Antihistamine, antiallergic, holinoliticheskoe, antiemetic, sedation, snotvornoe, mestnoanesteziruyuschee.

Application.

Hives, pollen disease, vasomotor rhinitis, pruritic dermatoses, Acute iridocyclitis, allergic conjunctivitis, angioedema, kapillyarotoksikoz, serum sickness, allergic complications of drug therapy, transfusion of blood and blood liquids; complex therapy of anaphylactic shock, radiation sickness, asthma, gastric ulcer and gastritis hyperacid; colds, sleep disorders, premedication, extensive trauma to the skin and soft tissues (burns, crushing); parkinsonizm, xoreja, sea ​​and air sickness, vomiting, incl. Pregnancy, Meniere's syndrome; Local anesthesia in patients with allergic reactions to local anesthetics history.

The gel: sunburns and burns of I degree, insect bites, hives, itching of various origins, itchy eczema, enable vetryanaya, allergic skin irritation (except pruritus in cholestasis), contact dermatitis, caused by contact with plants.

Contraindications.

Hypersensitivity, lactation, childhood (the neonatal period and the state of prematurity).

Restrictions apply.

Zakrыtougolynaya glaucoma, prostatauxe, stenotic gastric and duodenal ulcers, piloroduodenalynaya obstruction, stenosis of the bladder neck, pregnancy.

Pregnancy and breast-feeding.

Carefully, under strict medical supervision, during pregnancy (adequate and well-controlled studies in pregnant women were not conducted).

Category actions result in FDA - B. (The study of reproduction in animals revealed no risk of adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not done.)

At the time of treatment should stop breastfeeding.

Side effects.

From the nervous system and sensory organs: generalized weakness, fatigue, sedation, decreased attention, dizziness, drowsiness, headache, dystaxia, anxiety, hypererethism (especially in children), irritability, nervousness, insomnia, euphoria, confusion, tremor, neuritis, convulsions, paraesthesia; blurred vision, diplopia, Acute labyrinthitis, noise in ears.

Cardio-vascular system and blood: gipotenziya, heartbeat, tachycardia, arrythmia; agranulocytosis, thrombocytopenia, gemoliticheskaya anemia.

From the digestive tract: dry mouth, numbness of the oral mucosa, anorexia, nausea, epigastric distress, vomiting, diarrhea, constipation.

With the genitourinary system: frequent and / or difficulty in urination, Delay urination, early menstruation.

From the respiratory system: dryness of the nose and throat, nasal congestion, thickening of secretions of the bronchi, tightness in the chest and heavy breathing.

Allergic reactions: - Rashes, hives, anaphylactic shock.

Other: Sweating, chills, photosensitivity.

Cooperation.

Sleeping, sedatives, tranquilizers and alcohol increase (mutually) CNS depression. MAO inhibitors enhance the effects of diphenhydramine holinoliticheskie. In a joint application with psychostimulants marked antagonistic interaction.

Overdose.

Symptoms: dry mouth, labored breathing, stable mydriasis, redness of the face, depression or agitation (more children) CNS, confusion; in children is the development of seizures and death.

Treatment: induction of vomiting, gastric lavage, appointment of activated carbon; symptomatic and supportive therapy for background careful monitoring of breathing and blood pressure levels.

Dosing and Administration.

Inside, / m, I /, rectally, fur gloves, intranasally, in the conjunctival sac. Inside adult — 30-50 mg 1-3 times a day, to prevent motion sickness — for 30-60 minutes prior to travel. Insomnia — 50 mg at bedtime. The maximum single dose - 100 mg, daily - 250 mg. V/m is 10-50 mg, The maximum single dose - 50 mg, daily - 150 mg, in/in drip — 20-50 mg (in 75-100 ml izotoniceski solution of sodium chloride). Children up 1 year-inside, at a dose of 2-5 mg, 2-5 years is 5-15 mg, 6-12 years is 15-30 mg per reception. Rectal suppositories 1-2 times a day (After bowel cleansing). Children under 3 years — suppositories, containing 5 mg diphenhydramine, from 3 to 4 years - 10 mg, from 5 to 7 years - 15 mg, 8-14 years - 20 mg. The course of treatment is 10-15 days. For instillation into the conjunctival sac prepare 0.2-0.5% solutions (better 2% boric acid) and instilled 1-2 drops 2-5 times daily. For the purpose of topical application of the gel is applied to the affected areas of the skin with a thin layer of 3-4 times per day, possibly also manufacture and use of 3-10% of creams or ointments. In rinitah — intranasal, in the shape of sticks on 50 mg.

Precautions.

Not recommended for s / c administration. Since diphenhydramine has atropinopodobnye action, care should be taken to use it: in patients with a recent history of respiratory disease (including asthma), increased intraocular pressure, hyperthyroidism, diseases of the cardiovascular system, gipotenzii. Antihistamine drugs can reduce mental alertness as well as in adults, and children, and cause agitation and hallucinations, convulsions and death in infants and children, especially in overdose. To use caution in age 60 and older, tk. more likely to develop dizziness, sedation and hypotension. During treatment, diphenhydramine should avoid sun exposure. Should not be used during the drivers of vehicles and people, skills relate to the high concentration of attention. During treatment should avoid alcohol.

Cooperation

Active substanceDescription of interaction
AzelastinFMR: synergism. Increases (mutually) effect, reduced the rate of psychomotor reactions and amplified deprimatsiya; concurrent use is not recommended.
AlprazolamFMR: synergism. Strengthens (mutually) CNS depression.
Aminosalicylic acidFKV. Against the background of diphenhydramine slightly reduced absorption.
BuspironeFMR: synergism. Strengthens (mutually) CNS depression, can enhance the hypnotic effect.
HaloperidolFMR: synergism. Strengthens (mutually) CNS depression (can enhance the hypnotic effect).
GidroksizinFMR: synergism. Strengthens (mutually) CNS depression, can enhance the hypnotic effect.
DocetaxelDo not change (mutually) effect; permissible combined use.
DroperidolFMR: synergism. Strengthens (mutually) CNS depression (can enhance the hypnotic effect).
ZolpidemFMR: synergism. Strengthens (mutually) CNS depression.
QuetiapineFMR. Strengthens (mutually) CNS depression (can enhance the hypnotic effect).
KetamineFMR. Strengthens (mutually) CNS depression.
KlozapynFMR. Strengthens (mutually) CNS depression (can enhance the hypnotic effect).
CodeineFMR: synergism. Enhances CNS depression and enhances the hypnotic effect.
LorazepamFMR: synergism. Strengthens (mutually) CNS depression, can enhance the hypnotic effect.
MetoprololAgainst the background of diphenhydramine (reduces the activity of the cytochrome P450 isoenzyme CYP2D6) significantly reduced the rate of biotransformation.
MidazolamFMR: synergism. Strengthens (mutually) CNS depression.
MoclobemideFMR: synergism. Prolongs and intensifies the effect of anticholinergic.
Morphine sulfateFMR: synergism. Enhances CNS depression and enhances the hypnotic effect.
OxazepamFMR: synergism. Strengthens (mutually) CNS depression, can enhance the hypnotic effect.
OlanzapineFMR. Strengthens (mutually) CNS depression (can enhance the hypnotic effect).
PerfenazynFMR: synergism. Strengthens (mutually) CNS depression (can enhance the hypnotic effect).
ProcarbazineFMR: synergism. Prolongs and intensifies the effects of anticholinergic.
PropofolFMR: synergism. Strengthens (mutually) CNS depression.
RisperidoneFMR: synergism. Strengthens (mutually) CNS depression (can enhance the hypnotic effect).
SelegilineFMR: synergism. Prolongs and intensifies the effects of anticholinergic.
TioridazinFMR: synergism. Strengthens (mutually) CNS depression (can enhance the hypnotic effect).
TrifluoperazineFMR: synergism. Strengthens (mutually) CNS depression (can enhance the hypnotic effect).
PhenobarbitalFMR: synergism. Strengthens (mutually) CNS depression.
FentanylFMR: synergism. Enhances CNS depression and enhances the hypnotic effect.
FlufenazinFMR: synergism. Strengthens (mutually) CNS depression (can enhance the hypnotic effect).
XlordiazepoksidFMR: synergism. Strengthens (mutually) CNS depression, can enhance the hypnotic effect.
ChlorpromazineFMR: synergism. Strengthens (mutually) CNS depression (can enhance the hypnotic effect).
ChlorprothixeneFMR: synergism. Strengthens (mutually) CNS depression (can enhance the hypnotic effect).
EthanolFMR: synergism. Strengthens (mutually) CNS depression (can enhance the hypnotic effect).

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