Is Histex (diphenhydramine) okay to give to a 13-year-old weighing 72.4 pounds?

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Diphenhydramine (Histex) Dosing for a 13-Year-Old Weighing 72.4 Pounds

Yes, diphenhydramine (Histex) is appropriate for a 13-year-old weighing 72.4 pounds (approximately 33 kg), with a recommended dose of 25 mg every 4-6 hours, not exceeding 6 doses in 24 hours. 1

Dosage Recommendations

  • For children 6 to under 12 years of age, the FDA-approved dose is 10 mL (25 mg) 1
  • For children over 12 years of age, the FDA-approved dose is 10 mL (25 mg) to 20 mL (50 mg) 1
  • Since this 13-year-old weighs 72.4 pounds (approximately 33 kg), which is less than 40 kg (88 pounds), the lower end of the dosing range (25 mg) is more appropriate 2
  • Do not exceed 6 doses in 24 hours as per FDA labeling 1
  • Administer every 4 to 6 hours as needed 1

Safety Considerations

  • Diphenhydramine may cause drowsiness, which is more pronounced in children than adults 3
  • Consider administering the dose in the evening if drowsiness occurs to minimize impact on daily activities 3
  • Monitor for potential side effects including:
    • Sedation (most common) 4
    • Central nervous system effects such as dizziness or imbalance 5
    • Paradoxical reactions (particularly in patients with developmental disorders) 4

Toxicity Concerns

  • The toxic threshold for diphenhydramine in children 6 years and older is 7.5 mg/kg or 300 mg (whichever is less) 6
  • For this 13-year-old weighing approximately 33 kg, the toxic threshold would be approximately 247.5 mg 6
  • The recommended dose of 25 mg is well below this toxic threshold and is safe when used as directed 1, 6

Alternative Considerations

  • Second-generation antihistamines (like cetirizine) may be preferable alternatives with fewer sedative effects 7
  • If diphenhydramine is being used for sleep, be aware that it is not recommended for long-term use as a sleep aid 5

Important Precautions

  • Avoid combining with other medications that cause sedation without medical supervision 4
  • Do not exceed the recommended dose, as diphenhydramine toxicity can cause serious adverse effects including cardiac toxicity 7
  • If the child experiences any unusual symptoms such as agitation, hallucinations, abnormal muscle movements, or severe drowsiness, discontinue use and seek medical attention 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Cetirizine Dosage and Safety for Pediatric Patients

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Appropriate PRN Dose of Olanzapine for Adolescents

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Diphenhydramine: Time to Move on?

The journal of allergy and clinical immunology. In practice, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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