Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Diphenhydramine
Drug ID BADD_D00686
Description Diphenhydramine - perhaps known most commonly as its brand name formulation Benadryl - is a first-generation H1 receptor antihistamine that is used extensively for the treatment of seasonal allergies, insect bites and stings, and rashes [L5263, L5266, L5269, F3379]. However, it also has antiemetic, antitussive, hypnotic, and antiparkinson properties [L5269, F3352]. As histamine receptors exist both peripherally and in the central nervous system, diphenhydramine has been shown to cause sedation due to its competitive antagonism of histamine H1 receptors within the central nervous system [L5263, L5266, L5269, F3379, A174541]. While its use in allergy therapy can sometimes fall out of favor due to its sedative effect, diphenhydramine has been repurposed for use within many non-prescription over-the-counter sleep aids and cough-and-cold medications that have been marketed for "night time" use [L5263, L5281, L5287]. Diphenhydramine is also used in combination with [DB14132] as the anti-nausea drug [DB00985] where it is utilized primarily for its antagonism of H1 histamine receptors within the vestibular system [A1540]. Diphenhydramine has also been shown to be implicated in a number of neurotransmitter systems that affect behaviour including dopamine, norepinephrine, serotonin, acetylcholine, and opioid [A1539]. As a result, diphenhydramine is being investigated for its anxiolytic and anti-depressant properties.
Indications and Usage Diphenhydramine is a first-generation histamine H1 receptor antagonist (H1 antihistamine) that is widely available as a non-prescription, over-the-counter (OTC) medication. As an OTC medication, diphenhydramine is typically formulated as tablets and creams indicated for use in treating sneezing, runny nose, itchy/watery eyes, itching of nose or throat, insomnia, pruritis, urticaria, insect bites/stings, allergic rashes, and nausea [L5263, L5266, L5269, F3379, A174541]. Additionally, when the use of oral diphenhydramine is impractical, there are also prescription-only formulations such as diphenhydramine injection products that are effective in adults and pediatric patients (other than premature infants and neonates) for: i) the amelioration of allergic reactions to blood or plasma, in anaphylaxis as an adjunct to epinephrine and other standard measures after acute allergic reaction symptoms have been controlled, and for other uncomplicated allergic conditions of the immediate type when oral therapy is impossible or contraindicated [F3352]; ii) the active treatment of motion sickness [F3352]; and iii) use in parkinsonism when oral therapy is impossible or contraindicated, as follows: parkinsonism in the elderly who are unable to tolerate more potent agents; mild cases of parkinsonism in other age groups, and in other cases of parkinsonism in combination with centrally acting anticholinergic agents [F3352].
Marketing Status approved; investigational
ATC Code D04AA32; R06AA02
DrugBank ID DB01075
KEGG ID D00300
MeSH ID D004155
PubChem ID 3100
TTD Drug ID D01FGR
NDC Product Code 76168-065; 52119-012; 73281-001; 0031-9304; 82179-003
UNII 8GTS82S83M
Synonyms Diphenhydramine | Benzhydramine | Diphenylhydramine | Diphenylhydramin | 2-Diphenylmethoxy-N,N-dimethylethylamine | Benhydramin | Benadryl | Benylin | Diphenhydramine Citrate | Citrate, Diphenhydramine | Diphenhydramine Citrate (1:1) | Diphenhydramine Hydrochloride | Hydrochloride, Diphenhydramine | Dormin | Allerdryl | Dimedrol
Chemical Information
Molecular Formula C17H21NO
CAS Registry Number 58-73-1
SMILES CN(C)CCOC(C1=CC=CC=C1)C2=CC=CC=C2
Chemical Structure
ADRs Induced by Drug
*The priority for ADR severity classification is based on FAERS assessment, followed by the most severe level in CTCAE rating. If neither is available, it will be displayed as 'Not available'.
**The 'Not Available' level is hidden by default and can be restored by clicking on the legend twice..
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Brain injury19.07.03.007; 17.11.01.0030.000269%Not Available
Oropharyngeal pain22.12.03.016; 07.05.05.004--
Acute kidney injury20.01.03.0160.001276%
Hypoxic-ischaemic encephalopathy24.04.06.021; 22.02.02.011; 17.13.02.0060.000873%Not Available
Substance-induced psychotic disorder19.03.01.007; 12.03.01.0530.000269%Not Available
Alopecia areata23.02.02.008; 10.04.02.0110.000134%Not Available
Pupil fixed17.02.11.008; 06.05.03.0120.000940%Not Available
Opsoclonus myoclonus17.13.02.010; 06.05.02.0220.000201%Not Available
Neurogenic shock24.06.02.023; 17.02.10.0250.000134%Not Available
Accidental death12.01.08.040; 08.04.01.0130.000269%Not Available
Visceral congestion24.03.02.0330.000269%Not Available
Skin plaque23.03.03.044--Not Available
Acute lung injury22.01.03.0100.000336%Not Available
Executive dysfunction19.21.02.0100.000134%Not Available
Seizure like phenomena17.12.03.0300.000201%Not Available
Hyporesponsive to stimuli17.02.05.0570.000269%Not Available
Postural tremor17.01.06.0090.000336%Not Available
Oedematous kidney20.01.02.0170.000269%Not Available
Agonal rhythm02.03.02.0290.000269%Not Available
Allergic reaction to excipient10.01.01.0350.000295%Not Available
Brief resolved unexplained event22.11.02.012; 18.04.15.006; 17.02.05.0660.000134%Not Available
Catheter site oedema12.07.02.024; 08.02.02.024--Not Available
Drug effective for unapproved indication12.09.02.001; 08.06.01.0370.000134%Not Available
Drug ineffective for unapproved indication08.06.01.038; 12.09.02.0020.000792%Not Available
Drug use disorder19.07.06.0120.000201%Not Available
Illness08.01.03.091--Not Available
Infusion site bruising24.07.06.030; 23.03.11.034; 08.02.05.022; 12.07.05.0220.000457%Not Available
Malabsorption from injection site12.07.03.071; 08.02.03.0710.000295%Not Available
Mucosal disorder08.01.06.0290.000269%Not Available
Periorbital swelling23.04.01.025; 10.01.05.025; 06.08.03.0320.000295%Not Available
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ADReCS-Target
Drug Name ADR Term Target
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