Re: Warning about Benadryl use in the elderly

[Guest guest]

Count me in on this topic. I am " only " 65 but have never

been able to tolerate Benadryl at any dose. When I began my

IVig infusions they were given at an infusion center 100

miles from home. The orders specified 50 mg of benadryl pre

treatment. I tried to refuse, to no avail. I finally got

them to give me half, 25 mg, or so they said. Apparently

they didn't trust me to swallow the pill/s so they pumped it

into my iv line. I was barely conscious within half an

hour. Even after four hours of infusion I was unable to

move unassisted. I tried helplessly to refuse, discuss,

cajole, beg, etc, but got nowhere. I had told them that I

was already taking allegra twice a day, and felt that

benadryl was not appropriate for me. In addition, I am 5'

1 " and only about 125 lbs, since they argued they 'give that

dose to everyone'..... apparently regardless of age, or body

mass, OR ability to tolerate it.

The days after the infusion I would have horrible migraine

type headaches, nausea, light sensitivity etc... the

infusion center would call to see how I was and when I

reported these headaches I was told calmly, " oh that's the

benadryl hangover " Imagine that. They even have a name

for that.

We've had other posters claim the same experience. I'd love

to know why there is not an alternate drug, or if this is

truly necessary. Apparently the doctors are aware of this,

but no one deals with it, or discusses it with the patients.

I now have my infusions at home, with my own nurse, and we

don't do benadryl at all. I've begun to experience sever

fatigue after the infusion, and I called the doctor to ask

if we should slow the infusion, or dilute. His first

thought was that my nurse was sneaking benadryl into my

infusion line. I assured him that this was NOT happening.

However he told me that this is common practice, so beware.

Since we keep saying most of us are 'older' why isn't there

an option or alternative drug?????? Please, since most of

us meet up with this one way or another, can anyone offer

some help?

thanks, be well, beth fillman

[Guest guest]

I get a huge reaction to Benadryl as soon as it starts it

scares me every time! I learned pretty quickly to ask my

nurse to run the Iv drip very slowly and THAT helps a lot!

[Guest guest]

I'm 65 and have had benedryl every time I've had Rituxan

which is a total of 12 times over the past 4 years,

including having last year when I had FCR. I've had no

reaction to the benedryl. Like it's been said before, we're

all individuals and each is an individual case. Get to know

your body and how it reacts to specific dx. Don't

anticipate a reaction because of someone else.

[Guest guest]

I am 72 and take benadryl before Rituxan

without any problems at all.

Maureen

[Guest guest]

Dear All,

I am 79 and had benadryl before rituxan 6 times in the past

year with tolerable reactions. It makes me very sleepy for

a short period and causes " restless legs " . Along with

Zantac IV and the other usual antinausea meds, it made it

possible to get the Rituxan into my body, albeit it slowly.

Anne

[Guest guest]

The use of Benadryl (diphenhydramine) and Tylenol

(acetaminophen) are standard prior to receiving rituximab

and ofatumumab. For ofatumumab, receiving hydrocortisone is

also part of the pre-meds. These are important for

decreasing the likelihood of having a reaction that can be

very severe. There are certainly many ways to adjust this

regimen to fit patients. I sometimes use Claritin

(loratidine) in place of Benadryl if a patient has trouble

with Benadryl and has no problem tolerating the infusion.

Rick Furman

> I get a huge reaction to Benadryl as soon as it starts it

> scares me every time! I learned pretty quickly to ask my

> nurse to run the Iv drip very slowly and THAT helps a lot!

[Guest guest]

So did I, five years ago when I was 68, and had my series of

six weekly Rituxan infusions. No problem at all.

Norma Oxley

In a message dated 4/25/2011 7:02:25 P.M. Eastern Maureen writes:

I am 72 and take benadryl before Rituxan without any problems at all.

[Guest guest]

I've posted on this before. Here are excerpts from the

story from a couple of years ago.

(Note that taking benadryl for more than 90 days triples the

risk of Alzheimer's!)

Benadryl Could Harm Brain

THURSDAY, June 4 (HealthDay News) — Older people taking

common over-the-counter drugs for pain, cold symptoms or

help with sleep may increase their risk for cognitive

impairment, including delirium, University of Indiana

researchers report.

These drugs include Benadryl, Dramamine, Excedrin PM, Nytol,

Sominex, Tylenol PM and Unisom.

All of these over-the-counter (OTC) drugs contain benadryl

(diphenhydramine), a molecule that blocks the

neurotransmitter acetylcholine. Acetylcholine is essential

for normal functioning of the central and peripheral nervous

systems, the researchers explained.

<snip>

His group analyzed data from 27 prior studies on the

relationship between anticholinergic effects and brain

function, as well as looking into anecdotal data. The team

found a consistent link between anticholinergic effects and

cognitive impairment in older adults.

“Any OTC medication with the term ‘PM’ will indicate the

presence of benadryl, which is bad for the brain,” Boustani

concluded.

He noted that the effects of benadryl can add up, so the

more medications you take that contain benadryl the worse it

may be for cognition. “There is a relationship with the

number of medications and the burden on your aging brain,”

the researcher said.

<snip>

In addition, taking these medications for 90 days or more

may triple your risk of developing Alzheimer’s disease,

Boustani said.

Given the risks, older adults should look for drugs that

don’t contain benadryl, he said.

The report is published in the May 2009 online issue of the

Journal of Clinical Interventions in Aging.

<snip>

“These findings don’t surprise me at all,” said.

“People tend not to think of their OTC medications as

medication, but any medication that has anticholinergic

effects can affect people’s cognition.”

<snip>

For more information on benadryl, visit the U.S. National

Library of Medicine.

Last Updated: June 05, 2009

[Guest guest]

Hmmmm. I wonder if this correlation between extended use of

Benadryl might partially explain chemo-brain…. I know not

everyone experiences it, and my mental functioning has

improved, but three years after undergoing treatment with

FR, I’m neither delirious or delusional but still not

mentally as capable as I was beforehand.

Regards to all,

Karni

[Guest guest]

Friends,

I take one Claritin (loratidine) tablet with

rituximab. No sedation at all.

[Guest guest]

Since Claritin has been suggested as an alternate, would

Allegra also be a suitable substitute for Benadryl. If

not, and Claritin is used instead, then should Allegra

be stopped for the period that Claritin is needed?

thanks, beth fillman

[Guest guest]

I am 60 and take benedryl before my antibody infusions. The

last two times my blood pressure dropped so low they had to

call the doctor. This is strange to me also that the doctor

wouldn't know this.

[Guest guest]

Beth,

I know of no interaction of Allegra with rituximab, but I haven't

checked a data base. I would stick to one antihistamine at a time

[Guest guest]

By antibody infusion do you mean IVIG? I am offered 25 mg of

Benedryl (one tablet) and one tylenol before IVIG infusions.

I usually opt to not take either when the infusion starts

and only take the tylenol if I feel a headache - always

minor - coming. IV Benedryl hits much harder because it's

going right into the blood stream. With rituxan I was given

50 MG of IV Benedryl which really knocked me out and

patients receiving it that way were not allowed to leave the

treatment room for 6 hours unless they could prove they had

a driver to get them home. I usually waited 7 or 8 hours

before driving.

I'm surprised that if your blood pressure dropped so low the

first time that the doctor wouldn't have thought through

what could have caused it and made some changes before you

went through the same experience again.

Pat

On 4/27/11, JAMKL4@... <JAMKL4@...> wrote:

> I am 60 and take benedryl before my antibody infusions. The

> last two times my blood pressure dropped so low they had to

> call the doctor. This is strange to me also that the doctor

> wouldn't know this.

>