From the Guidelines
The recommended dosing of Diphenhydramine (Benadryl) for pediatric patients is 1 to 2 mg/kg per dose, with a maximum dose of 50 mg IV or oral, as stated in the most recent and highest quality study 1.
Key Considerations
- The dosing should be based on the child's weight, with a maximum dose not to exceed 50 mg per dose.
- The medication can be administered orally or intravenously, with oral liquid being more readily absorbed than tablets.
- Alternative dosing may be considered with a less-sedating second-generation antihistamine.
Administration Guidelines
- Parents should use proper measuring devices rather than household spoons for accuracy.
- Liquid formulations are often easier to administer to younger children, with typical concentrations of 12.5 mg per 5 mL.
- The medication should be used for short-term symptom relief only, and medical attention should be sought if symptoms worsen or persist beyond a few days.
Potential Side Effects
- Drowsiness
- Dry mouth
- Paradoxical excitability in some children
Important Notes
- Benadryl works by blocking histamine receptors to reduce allergy symptoms like itching, sneezing, and runny nose.
- The medication should not be used as a substitute for epinephrine in the treatment of anaphylaxis, as stated in 1 and 1.
- The guidelines for the diagnosis and management of food allergy in the United States, as reported in 1, also support the use of diphenhydramine as an adjunctive treatment for food allergy.
From the FDA Drug Label
Directions • take every 4 to 6 hours, or as directed by a physician• do not take more than 6 doses in 24 hours agedose Adults and children over 12 years of age10 mL (25 mg) to 20 mL (50 mg) Children 6 to under 12 years of age10 mL (25 mg) Children under 6 years of ageDo not use
The recommended dosing of Diphenhydramine (Benadryl) for pediatric patients is:
- Children 6 to under 12 years of age: 10 mL (25 mg) every 4 to 6 hours, not to exceed 6 doses in 24 hours 2
- Children under 6 years of age: Do not use 2
- Children over 12 years of age: same as adults, 10 mL (25 mg) to 20 mL (50 mg) every 4 to 6 hours, not to exceed 6 doses in 24 hours 2
From the Research
Recommended Dosing of Diphenhydramine for Pediatric Patients
The recommended dosing of Diphenhydramine (Benadryl) for pediatric patients is as follows:
- For children less than 6 years of age, the dose should not exceed 7.5 mg/kg 3, 4
- For children 6 years of age and older, the dose should not exceed 7.5 mg/kg or 300 mg, whichever is less 3
- It is essential to consider the patient's age, size, and level of organ maturity when determining the dose, rather than simply administering a "small adult" dose 5, 6
Important Considerations
- Diphenhydramine toxicity can occur with large doses or via the intravenous route, especially in pediatric patients 7
- The American Association of Poison Control Centers (AAPCC) guideline for pediatric diphenhydramine ingestions recommends referral to an emergency department for children who ingest at least 7.5 mg/kg of diphenhydramine 3, 4
- Pediatric patients who experience any changes in behavior, such as agitation, staring spells, or hallucinations, should be referred to an emergency department 3