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)
Influenza like illness08.01.03.0100.000591%
Injection site erythema12.07.03.001; 08.02.03.001; 23.03.06.0150.001666%Not Available
Injection site extravasation12.07.03.002; 08.02.03.0020.000457%Not Available
Injection site mass12.07.03.010; 08.02.03.0090.000752%Not Available
Injection site pain12.07.03.011; 08.02.03.0100.001276%Not Available
Injection site pruritus23.03.12.007; 12.07.03.014; 08.02.03.0130.001370%Not Available
Injection site reaction12.07.03.015; 08.02.03.0140.000913%
Injection site urticaria08.02.03.029; 23.04.02.003; 12.07.03.029; 10.01.06.0030.000457%Not Available
Injection site warmth12.07.03.036; 08.02.03.0360.000134%Not Available
Insomnia19.02.01.002; 17.15.03.002--
Irritability08.01.03.011; 19.04.02.013--
Jaundice23.03.03.030; 09.01.01.004; 01.06.04.0040.000201%Not Available
Joint swelling15.01.02.004--Not Available
Labyrinthitis11.01.05.002; 04.04.03.001--Not Available
Lethargy08.01.01.008; 17.02.04.003; 19.04.04.0040.001209%
Leukocytosis01.02.01.0020.000806%
Lip swelling23.04.01.007; 10.01.05.005; 07.05.04.0050.001477%Not Available
Lividity23.06.05.0090.000134%Not Available
Loss of consciousness17.02.04.0040.002042%Not Available
Malaise08.01.01.003--
Mallory-Weiss syndrome24.07.02.038; 07.12.01.0040.000134%Not Available
Mania19.16.02.002--
Metabolic acidosis14.01.01.0030.003559%Not Available
Migraine24.03.05.003; 17.14.02.0010.000658%Not Available
Mouth ulceration07.05.06.004--Not Available
Mucosal dryness08.01.06.0010.001209%Not Available
Multiple allergies10.01.03.0300.000134%Not Available
Muscle necrosis15.05.05.0070.000201%Not Available
Muscle rigidity17.05.02.005; 15.05.04.0010.000940%Not Available
Muscle twitching15.05.03.0050.000336%Not Available
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ADReCS-Target
Drug Name ADR Term Target
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