From the FDA Drug Label
Adults and children 12 years of age and over: 2 teaspoonful (10 mL) every 4 to 6 hours, not to exceed 12 teaspoonfuls in a 24 hours Children 6 to under 12 years of age: 1 teaspoonful (5 mL) every 4 to 6 hours, not to exceed 6 teaspoonfuls in 24 hours Children under 6 years of age: Consult a doctor. The recommended dose of Avil (pheniramine) for a bt reaction in pediatric patients is as follows:
- For children 12 years and older: 2 teaspoonfuls (10 mL) every 4 to 6 hours, not to exceed 12 teaspoonfuls in 24 hours
- For children 6 to under 12 years: 1 teaspoonful (5 mL) every 4 to 6 hours, not to exceed 6 teaspoonfuls in 24 hours
- For children under 6 years: Consult a doctor 1
From the Research
For pediatric patients experiencing a blood transfusion (BT) reaction, diphenhydramine (Avil) can be administered at a dose of 1-2 mg/kg/dose, with a maximum single dose of 50 mg. This medication should be given slowly intravenously over 5 minutes or intramuscularly if IV access is not available. The dosing may be repeated every 6 hours as needed based on symptoms. When administering Avil for transfusion reactions, it's essential to simultaneously stop the transfusion immediately, maintain IV access with normal saline, monitor vital signs frequently, and notify the blood bank. Diphenhydramine works by blocking histamine H1 receptors, which helps reduce allergic symptoms like urticaria, pruritus, and angioedema that can occur during transfusion reactions. For severe reactions with hypotension or respiratory distress, additional medications such as epinephrine, corticosteroids, and bronchodilators may be necessary, and oxygen support should be provided as needed. Always adjust the dose based on the child's weight and clinical response, as there is no specific evidence provided in the given studies 2, 3, 4, 5, 6 regarding the use of Avil in pediatric BT reactions. However, the general principles of treating allergic reactions and the safety profile of diphenhydramine support its use in this context. It's crucial to prioritize the patient's safety and adjust treatment according to their response and clinical condition. In the absence of specific guidelines for Avil dosing in pediatric BT reactions, the provided dose range is based on general pediatric dosing recommendations for diphenhydramine. The most recent and highest quality study regarding pediatric treatment does not directly address Avil dosing for BT reactions, but studies like 3 emphasize the importance of evidence-based treatment protocols in pediatric care. Given the lack of direct evidence, the recommendation is based on standard pediatric pharmacotherapy principles and the known safety profile of diphenhydramine.