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Benadryl vs Atarax
Introduction
For patients dealing with symptoms of allergies such as hives, or conditions like anxiety and insomnia, certain antihistamines can provide relief by blocking the action of histamine in the body. Benadryl (Diphenhydramine) and Atarax/Vistaril (Hydroxyzine) are two such medications often prescribed for these issues. Both interfere with the release or action of histamine—a chemical in your body involved in allergic reactions—thus aiding to alleviate discomfort associated with these conditions. Benadryl is a first-generation antihistamine which can cause more sedation due to its ability to cross into the brain tissue, while Atarax/Vistaril is considered a second-generation antihistamine that tends not to enter the brain and has been shown effective particularly at treating anxiety and tension associated with psychoneuroses.
Benadryl vs Atarax Side By Side
| Attribute | Benadryl | Atarax |
|---|---|---|
| Brand Name | Benadryl | Atarax |
| Contraindications | Should not be taken with monoamine oxidase inhibitors (MAOIs) | Should not be taken with monoamine oxidase inhibitors (MAOIs) |
| Cost | Around $10 for 30 tablets of 25 mg | Approximately $60–$80 for 30 capsules of 25 mg |
| Generic Name | Diphenhydramine | Hydroxyzine |
| Most Serious Side Effect | Signs of an allergic reaction, rapid heartbeat, low blood pressure, severe dry mouth, vision problems, mental changes like hallucinations, confusion, agitation | Signs of an allergic reaction, involuntary motor control loss, confusion or hallucinations, seizures, rapid heart rate with severe headache and chest pain, easy bruising or unusual bleeding |
| Severe Drug Interactions | Monoamine oxidase inhibitors (MAOIs) | Monoamine oxidase inhibitors (MAOIs) |
| Typical Dose | 25–50 mg every 4-6 hours for adults and children over 12 | 25-100 mg/day, divided into three to four doses |
What is Benadryl?
Diphenhydramine (the generic name for Benadryl) was one of the first antihistamines developed and is still widely used today. It was initially approved by the FDA in 1946. Benadryl works by blocking histamine, a substance your body produces during an allergic reaction, effectively "trapping" it and preventing it from triggering allergy symptoms. It's commonly prescribed for the relief of allergies and cold symptoms as well as occasional insomnia.
On the other hand, Hydroxyzine (Atarax) is another type of older antihistamine first approved by the FDA in 1956. Atarax also blocks histamine but has additional anti-anxiety effects due to its slight influence on serotonin and dopamine levels in brain - neurotransmitters associated with mood regulation.
While both medications can cause drowsiness, this side effect tends to be more pronounced with Benadryl than Atarax due to its stronger interaction with central nervous system receptors that regulate wakefulness.
What conditions is Benadryl approved to treat?
Benadryl and Atarax are two medications approved for the treatment of various conditions:
- Allergic reactions such as hay fever, atopic or contact dermatoses, and urticaria (both Benadryl and Atarax)
- Sedation before or after general anesthesia (Atarax)
- Symptomatic relief of anxiety and tension associated with psychoneurosis (Ataray)
- Nausea, vomiting, dizziness due to motion sickness (Benadryl)
Remember that each medication has different side effects and drug interactions. Always consult your healthcare provider before starting any new medication.
How does Benadryl help with these illnesses?
Benadryl works to manage allergies by blocking the actions of histamine, a substance in the body that is involved in many physiological processes such as allergic reactions. It does this by binding to H1 receptors, which are responsible for causing symptoms like inflammation and itchiness. Histamine is a neurotransmitter, a chemical that acts as a messenger within the body, playing an important role in immune responses and triggering symptoms of allergies such as swelling, redness, itching and increased mucus production. Individuals with allergies have hypersensitive immune systems that overreact when exposed to certain substances or allergens. By inhibiting histamine activity through receptor antagonism, Benadryl can mitigate these allergic reactions and help patients manage their symptoms.
On the other hand, Atarax also blocks H1 receptors but has additional sedative effects due to its ability to penetrate into central nervous system more effectively than Benadryl. This makes it not only useful for treating allergy symptoms but also anxiety or tension associated with psychoneurosis because of its tranquilizing effect on the central nervous system.
What is Atarax?
Atarax is a brand name for hydroxyzine, an antihistamine that functions by blocking the effects of histamine in the body. It also acts as a mild sedative and may be used for its calming effect on the central nervous system. Hydroxyzine was first approved by the FDA in 1956. As Atarax does not operate like typical SSRI antidepressants, it does not inhibit serotonin reuptake. Its lack of action on serotonin means that its side-effect profile is quite different from SSRIs; specifically, it tends to cause drowsiness rather than preventing sleep (a common issue with some SSRIs). The tranquilizing effects can be beneficial in treating conditions like anxiety or tension related to psychoneurosis, especially if patients have struggled with other forms of treatment such as Benadryl.
What conditions is Atarax approved to treat?
Atarax is authorized for the treatment of certain conditions, including:
- Anxiety and tension associated with psychoneurosis
- As a sedative when used as premedication before surgery
- Relief of the pruritus caused by allergic conditions such as chronic urticaria, and atopic and contact dermatoses.
How does Atarax help with these illnesses?
Atarax, also known as hydroxyzine, is an antihistamine which has multiple uses in medicine. It works by blocking histamine receptors in the body, a compound that plays key roles during immune responses. In addition to its antihistaminic action, Atarax exerts anxiolytic effects and can be used for short-term management of anxiety disorders. This makes it particularly useful in situations where allergies are accompanied by stress or anxiety symptoms. Furthermore, Atarax may have beneficial effects on sleep due to its sedative properties; this contrasts with Benadryl (diphenhydramine), another commonly used antihistamine, which often tends to disrupt sleep architecture over time despite causing drowsiness initially. The actions of Atarax on both histaminergic and serotonergic systems might make it more suitable for individuals who do not respond perfectly well to typical first-generation antihistamines such as Benadryl or when combined therapy is required.
How effective are both Benadryl and Atarax?
Both diphenhydramine (Benadryl) and hydroxyzine (Atarax) have well-established histories as effective antihistamines, with the former being approved by the FDA in 1946 and the latter in 1955. As they act on histamine receptors to reduce allergic reactions, they may be prescribed under different circumstances based on patient needs. The effects of Benadryl and Atarax were directly studied; both drugs exhibited comparable efficacy in alleviating allergy symptoms such as itching, sneezing, runny nose, and hives.
A review revealed that Benadryl is effective for immediate relief from allergy symptoms due to its fast onset of action. Despite having a shorter duration of effect compared to some other antihistamines (4-6 hours), it can be used multiple times throughout the day if needed. It's also useful for treating allergic reactions like anaphylaxis or severe skin rashes because of its potent antiallergic properties.
Hydroxyzine was shown in studies to not only relieve allergy symptoms but also exert sedative effects due to its strong affinity towards H1-receptors within the central nervous system. This makes it particularly useful when sleep aid is required during conditions like urticaria or atopic dermatitis where nighttime itchiness can disrupt sleep quality.
While both are first-generation antihistamines known for causing drowsiness compared to their second-generation counterparts, hydroxyzine is sometimes favored over diphenhydramine when a stronger sedating effect is preferred or beneficial for certain patients.
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At what dose is Benadryl typically prescribed?
Oral dosages of Benadryl for adults and children over 12 range from 25–50 mg every 4-6 hours, but studies have indicated that a dose of 25 mg is often sufficient for managing symptoms like hives or hay fever. Children ages six to eleven can be started on a lower dosage, generally around 12.5-25 mg every four to six hours. In either population, if there's no response after the initial dose, it may be increased under medical supervision. It's important that the maximum daily dosage (300mg) not be exceeded in any case.
Atarax is typically prescribed at an oral dosage ranging between 10 -100 mg/day in adults divided into several doses throughout the day depending on what condition it is being used to treat; however, starting with a smaller dose (like 10mg) might be enough for mild cases of anxiety or itching due to allergies. For children under six years old: the total daily amount must not exceed 50mg divided into several doses and should only be administered under medical supervision.
At what dose is Atarax typically prescribed?
Atarax treatment typically begins with a dosage of 25-100 mg/day, divided into three to four doses throughout the day. The dose can be increased up to 600 mg/day for short-term administration in cases where severe anxiety is present. It's crucial to space the doses evenly apart during waking hours and not exceed the recommended maximum dosage. If no significant improvement in symptoms is noted after several weeks at this higher dosage, then further consultation with your healthcare provider would be necessary before any changes or adjustments are made to your regimen.
What are the most common side effects for Benadryl?
Common side effects of Benadryl and Atarax include:
- Sleepiness/drowsiness
- Dizziness
- Dry mouth, throat, and nose (may lead to a sore throat)
- Nausea or vomiting
- Constipation
- Loss of appetite
- Headache or feeling nervous
- Blurred vision -Ringing in your ears
More severe but less common side effects can include mood changes like restlessness, irritability or confusion; difficulty urinating; tremors; and an irregular heartbeat. In rare cases, you may experience rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, or trouble breathing. If any of these occur, it's essential to seek medical attention quickly.
Are there any potential serious side effects for Benadryl?
While both Benadryl and Atarax are antihistamines used to treat symptoms of allergies, they may cause different side effects. Here are some rare but potential adverse reactions you should be aware of:
- Signs of an allergic reaction: hives, difficulty breathing, swelling in your face or throat
- Rapid heartbeat or palpitations that lead to chest discomfort
- Low blood pressure which might result in dizziness or feeling faint
- Severe dry mouth leading to difficulties swallowing
- Vision problems such as blurred vision or eye pain; these could indicate increased eye pressure
- Mental changes like hallucinations, confusion, agitation.
It's important to note that elderly patients may experience more serious side effects like memory loss and decreased mental alertness. If any unusual reaction occurs after taking either medication, it is crucial that medical help is sought immediately.
What are the most common side effects for Atarax?
When comparing Benadryl to Atarax, it's important to note the potential side effects of Atarax:
- Dry mouth or throat
- Dizziness, headache
- Feeling nervous or irritable
- Blurred vision
- Ringing in your ears or difficulty hearing
- Sleep problems (insomnia)
- Nausea, loss of appetite, upset stomach
- Skin rash -Increased urination -Lack of coordination, tremors -Fast heartbeat and chest discomfort.
These side effects may be bothersome but are usually not serious. However, if you experience symptoms like confusion, seizures or irregular heartbeats while on Atarax therapy, seek immediate medical attention as these could indicate a serious reaction.
Are there any potential serious side effects for Atarax?
While Atarax is generally safe for use, it's important to be aware of potential severe side effects:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Involuntary motor control loss or muscle tremor
- Confusion or hallucinations
- Seizures (convulsions)
- Rapid heart rate combined with a severe headache and chest pain
- Easy bruising or unusual bleeding
If you experience any of these symptoms while using Atarax, seek immediate medical attention. It's crucial to remain informed about the medications we take and how they can potentially affect our health.
Contraindications for Benadryl and Atarax?
Both Benadryl and Atarax, like most antihistamines, may exacerbate symptoms of dry mouth in some people. If you notice your dry mouth worsening, or an increase in dizziness, confusion, or difficulty urinating after taking these medications, please seek immediate medical attention.
Neither Benadryl nor Atarax should be taken if you are currently using medications classified as monoamine oxidase inhibitors (MAOIs). Always inform your healthcare provider about any medications you're taking; MAOIs will require a period of approximately two weeks to clear from the system to prevent harmful interactions with Benadryl and Atarax.
How much do Benadryl and Atarax cost?
For the brand name versions of these drugs:
- The price for 30 tablets of Benadryl (25 mg) averages around $10, which works out to about $0.33/day, based on a typical dose.
- The price for 30 capsules of Atarax (25 mg) is approximately $60–$80, translating to about $2-$3/day.
Thus, if you are taking standard dosages, then brand-name Benadryl is less expensive on a per-day treatment basis than Atarax. However, cost should not be the primary consideration in determining which medication is right for you.
Regarding generic versions of these medications:
-
Diphenhydramine (generic version of Benadryl), available in packs from 24 up to several hundreds or even thousand pills with strengths ranging from 12.5mg up to maximum over-the-counter strength at 50mg per pill; costs can start as low as under a penny per pill and go up depending on the quantity and dosage required.
-
Hydroxyzine hydrochloride or hydroxyzine pamoate (generic names for Atarax), typically packed in bottles ranging from 15 capsules up through quantities exceeding hundred(s). Costs average between ~$0.20 - ~$1+/pill depending upon size/quantity purchased.
Again, it's important that your choice be guided by effectiveness and potential side effects rather than cost alone.
Popularity of Benadryl and Atarax
Diphenhydramine, in generic form as well as brand names such as Benadryl, was estimated to have been used by about 6 million people in the US in 2020. Diphenhydramine accounted for just over 20% of antihistamine use in the US. However, it appears to be among the most-common “first-generation” antihistamines (those that can cause drowsiness). The usage of diphenhydramine has been generally increasing since 2013.
Hydroxyzine, including brand versions such as Atarax and Vistaril, was prescribed to approximately 4 million people in the USA in 2020. In the US, hydroxyzine accounts for nearly 15% of prescriptions for sedating antihistamines; these are often used not only for allergies but also anxiety and insomnia. The prevalence of hydroxyzine has been relatively steady over the last decade.
Conclusion
Both Benadryl (diphenhydramine) and Atarax (hydroxyzine) have long-standing records of usage in patients with allergies, anxiety, and sleep disorders. They are both antihistamines backed by numerous clinical trials indicating their effectiveness over placebo treatments. Due to their differing pharmacokinetics, they may be prescribed under different circumstances or even used together subject to careful consideration by a physician as they can potentiate each other's sedative effects.
Benadryl is considered a first-line treatment option for acute allergic reactions due to its rapid onset of action. It's also commonly used for insomnia due to its drowsiness side effect. Conversely, Atarax would usually be considered as an adjuvant therapy or when there is a need to avoid the common side-effects such as dry mouth associated with Benadryl or in cases where longer duration of action is desirable.
Both drugs are available in generic form which represents significant cost savings especially for patients who must pay out of pocket. Both Benadryl and Atarax may require dose adjustments based on individual response and tolerance.
The side effect profile between these two drugs leans towards more sedation with Atarax compared to that observed with Benadryl at therapeutic doses. For both drugs, users should closely monitor their responses especially when starting treatment and seek medical help immediately if they notice any serious adverse events like difficulty breathing or swelling of the face/lips.
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Refrences
- GOETZ, D., JACOBSON, J., MURNANE, J., REID, M., REPPERGER, D., GOODYEAR, C., & MARTIN, M. (1989, September). Prolongation of simple and choice reaction times in a double-blind comparison of twice-daily hydroxyzine versus terfenadine. Journal of Allergy and Clinical Immunology. Elsevier BV.http://doi.org/10.1016/0091-6749(89)90414-4
- Gelotte, C. K., Zimmerman, B. A., & Thompson, G. A. (2017, October 2). Single‐Dose Pharmacokinetic Study of Diphenhydramine HCl in Children and Adolescents. Clinical Pharmacology in Drug Development. Wiley.http://doi.org/10.1002/cpdd.391
- Wolfson, A. R., Wong, D., Abrams, E. M., Waserman, S., & Sussman, G. L. (2022, December). Diphenhydramine: Time to Move on?. The Journal of Allergy and Clinical Immunology: In Practice. Elsevier BV.http://doi.org/10.1016/j.jaip.2022.07.018