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Phenylephrine vs Benadryl
Introduction
For patients with symptoms of allergies, cold, or flu, certain drugs that target the histamines and neurotransmitters can help manage these discomforting conditions. Phenylephrine and Benadryl are two such drugs often prescribed for their respective effects. Each one interacts differently within your body but both aim to alleviate allergy or cold symptoms. Phenylephrine is a decongestant used to relieve nasal congestion by shrinking blood vessels in the nasal passages. On the other hand, Benadryl (containing diphenhydramine) is an antihistamine primarily affecting histamine levels in the body which helps reduce symptoms like itching or sneezing associated with allergies or common colds.
Phenylephrine vs Benadryl Side By Side
| Attribute | Sudafed pe | Benadryl |
|---|---|---|
| Brand Name | Sudafed PE | Benadryl |
| Contraindications | Should not be taken if you are currently on monoamine oxidase (MAO) inhibitors therapy or have been within two weeks. | Should not be taken if you are currently on monoamine oxidase (MAO) inhibitors therapy or have been within two weeks. |
| Cost | Approximately $0.20/day for the standard dose | Approximately $0.20/day for the standard dose |
| Generic Name | Phenylephrine | Diphenhydramine |
| Most Serious Side Effect | Very high blood pressure - severe headache, blurred vision, pounding in your neck or ears. | A seizure (convulsions) |
| Severe Drug Interactions | MAO inhibitors interact with Phenylephrine leading to potentially dangerous elevations in blood pressure. | MAO inhibitors interact with Diphenhydramine leading to potentially dangerous elevations in blood pressure. |
| Typical Dose | 10-20 mg every four hours for adults | 25-50 mg every 4 to 6 hours |
What is Phenylephrine?
Phenylephrine (found in many brand-name decongestants) and diphenhydramine (the generic name for Benadryl), although both used in the treatment of colds and allergies, have different mechanisms of action. Phenylephrine is a decongestant that shrinks blood vessels in nasal passages, which helps alleviating symptoms like stuffy nose or sinus pressure. It was first approved by the FDA as an over-the-counter medication in 1976. Unlike fluoxetine's selective influence on serotonin, phenylephrine primarily affects alpha-adrenergic receptors resulting in vasoconstriction.
On the other hand, Benadryl is an antihistamine that works by blocking histamines—chemicals released during allergic reactions—from binding to its receptors thus reducing allergy symptoms such as runny nose or sneezing. While it has been found effective at relieving these symptoms, one common side effect is drowsiness due to its interaction with central nervous system histamine receptors. This makes it less ideal than phenylephrine for those who need to be alert while using this medication.
What conditions is Phenylephrine approved to treat?
Phenylephrine is approved for the treatment of various conditions, including:
- Nasal congestion due to common cold, allergies or hay fever
- Sinus congestion and pressure
- Pupil dilation during diagnostic procedures
- To maintain blood pressure during anesthesia.
On the other hand, Benadryl (diphenhydramine) has a broader range of uses which include:
- Relief from symptoms of allergies, hay fever and the common cold such as runny nose; sneezing; itchy, watery eyes; hives
- It also helps with motion sickness, induces sleep and can be used in certain cases as an antitussive to relieve cough.
How does Phenylephrine help with these illnesses?
Phenylephrine works to relieve nasal congestion by narrowing the blood vessels in the nasal passages. It does this by activating adrenergic receptors that result in vasoconstriction, or tightening of blood vessels. This effect reduces swelling and inflammation in the nose, thereby making it easier for individuals to breathe when they have a cold, allergies, or sinus infections.
On the other hand, Benadryl is an antihistamine that functions by blocking histamines—chemicals produced during an allergic reaction—that cause symptoms such as runny nose and sneezing. Its action on H1 receptor sites prevents these symptoms from occurring.
It's important to note that while both Phenylephrine and Benadryl can help alleviate allergy-related issues like a stuffy or runny nose, their mechanisms of action are different: one acts on vascular tone (Phenylephrine) while the other blocks histamine production (Benadryl), offering different paths towards relief depending on individual needs and symptom profiles.
What is Benadryl?
Benadryl is a brand name for diphenhydramine, an antihistamine that blocks the histamine-1 (H1) receptor. By blocking this receptor, it can decrease allergy symptoms such as runny nose and itching caused by hives. Diphenhydramine was first approved by the FDA in 1946 and has since become one of the most commonly used over-the-counter drugs to treat allergies and insomnia due to its sedative properties.
Unlike phenylephrine, which works mainly as a decongestant by constricting blood vessels in nasal passages, Benadryl's primary purpose is not to reduce congestion but rather to alleviate allergic reactions. It may also cause drowsiness—a side effect not typically seen with phenylephrine—and for some people this could be either a benefit or drawback depending on their needs. The potential sedative effects of Benadryl can be beneficial for those struggling with sleep but undesirable if alertness is necessary during use.
What conditions is Benadryl approved to treat?
Benadryl is approved by the FDA for use in a variety of situations that require an antihistamine, including but not limited to:
- Allergic reactions such as hay fever
- Common cold symptoms
- Insomnia and other sleep disorders
- Itching or rash due to hives.
It's crucial to note that Benadryl can cause drowsiness, so it should be used with caution if you need to stay alert.
How does Benadryl help with these illnesses?
Diphenhydramine, commonly known as Benadryl, is an antihistamine that works by blocking the effects of histamine in the body - a compound that is released during an allergic reaction. This effectively reduces symptoms such as sneezing, itching, watery eyes, and runny nose. Apart from its anti-allergic properties, Benadryl also has sedative effects due to its action on the central nervous system which makes it useful for treating not only allergy symptoms but also insomnia or motion sickness. While phenylephrine can help with nasal congestion through vasoconstriction (narrowing of blood vessels), it does not have these additional impacts on sleep and nausea relief which are distinctive features of Benadryl's profile. Therefore, when choosing between Phenylephrine and Benadryl for symptomatic relief of allergies or colds where sleep disturbance or nausea are concerns too, one might opt for the multi-functional benefits provided by Benadryl.
How effective are both Phenylephrine and Benadryl?
Both phenylephrine and diphenhydramine (Benadryl) have established histories of success in managing symptoms of common cold, allergies, and sinusitis. They are both over-the-counter medications approved by the FDA but act on different receptors for relief. Phenylephrine is a decongestant that shrinks blood vessels in the nasal passages to reduce swelling and congestion, while diphenhydramine works as an antihistamine blocking histamines that cause allergic reactions.
A 2006 review indicated that phenylephrine effectively relieves nasal congestion from various causes including common colds. Its side effect profile includes increased heart rate or palpitations, which makes it less suitable for individuals with cardiovascular conditions such as hypertension. Despite these limitations, phenylephrine remains a popular choice for short-term relief against nasal congestion due to its fast onset of action.
On the other hand, Benadryl has been widely used since its approval in 1946 not just for allergy symptoms but also as a sleep aid due to its sedative properties. It's effective in relieving runny nose, sneezing, rash and itching associated with allergies starting from the first dose onward and is generally well-tolerated even among pediatric populations when administered at appropriate doses. However caution should be exercised especially among elderly patients because of possible adverse effects like drowsiness or confusion.
While both drugs can offer symptomatic relief during bouts of allergy or colds, they work differently so choosing between them depends largely on specific symptoms present: if primary issue is nasal congestion then one might choose phenylephrine; if symptomatology revolves more around watery eyes and sneezing then Benadryl may be more beneficial.
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At what dose is Phenylephrine typically prescribed?
Oral dosages of Phenylephrine range from 10-20 mg every four hours for adults, but studies have indicated that 10 mg is usually sufficient for relieving nasal congestion in most people. Children aged 6 to 12 may be started on a lower dose of 5 mg every four hours. In either population, dosage can be increased after a few days if symptoms do not improve. The maximum dosage that should not be exceeded in any case is 60 mg per day for adults and adolescents over the age of twelve, and no more than 30mg a day for children between the ages of six and twelve.
At what dose is Benadryl typically prescribed?
Benadryl treatment typically begins at a dosage of 25-50 mg every 4 to 6 hours. However, most people only need the lower dose, especially when starting. The medication can be increased up to a maximum dose of 300 mg per day, divided into six doses of 50 mg and spaced about four hours apart, should symptoms persist after using the initial dosage for several days. Remember that Benadryl may cause drowsiness and impair your ability to drive or operate machinery; therefore, adjust your daily activities accordingly when taking this medication.
What are the most common side effects for Phenylephrine?
Side effects of Phenylephrine can differ from those of Benadryl. Common side effects of phenylephrine include:
- Nervousness and restlessness
- Headache, dizziness
- Fast or irregular heart rate
- Insomnia (difficulty sleeping)
- Mild increase in blood pressure
- Sweating, trembling or shaking
- Dry mouth or unpleasant taste in the mouth
Remember that it's crucial to consider both the potential benefits and risks before deciding on a medicine. Always consult your healthcare provider for personalized medical advice.
Are there any potential serious side effects for Phenylephrine?
Phenylephrine, while generally safe and effective for treating congestion, may cause certain adverse reactions in rare cases. These include:
- Signs of allergic reaction: hives, difficulty breathing or swallowing; swelling of the face, lips, tongue or throat
- Fast or uneven heartbeats
- Severe dizziness or anxiety
- Easy bruising or bleeding (nosebleeds, bleeding gums)
- Very high blood pressure - severe headache, blurred vision, pounding in your neck or ears.
On the other hand is Benadryl which is commonly used to treat allergy symptoms. Some uncommon but serious side effects could be:
- A tight feeling in your chest accompanied by trouble breathing
- Confusion and feeling like you might pass out
- Painful urination or inability to empty the bladder completely
- Unusual mood swings including restlessness and irritability
In case any of these signs show up during medication usage either Phenylephrine or Benadryl it's advised to seek immediate medical attention.
What are the most common side effects for Benadryl?
While both Phenylephrine and Benadryl are commonly used for relieving allergy symptoms, it's important to note some of the potential side effects that come with using Benadryl.
- Dry mouth, throat, and nose due to its antihistamine properties.
- Drowsiness or a feeling of fatigue as it is known to cross the blood-brain barrier causing sedation.
- Upset stomach or loss of appetite can occur in some cases
- A slight increase in heart rate may be experienced by some users
- Occasionally constipation may also occur
- Some people might experience blurred vision
- Sleep problems such as insomnia could arise due to prolonged usage
- Mild confusion or agitation can occur especially among older patients
-Rarely there might be instances of rashes
-In rare cases one might experience muscle weakness or have trouble urinating.
It is always recommended to use any medication under professional supervision and consult your healthcare provider if you experience any unusual symptoms.
Are there any potential serious side effects for Benadryl?
While Benadryl is commonly used without severe side effects, there can be instances where it may cause adverse reactions. These include:
- Signs of an allergic reaction: hives, difficulty breathing, swelling of your face, lips, tongue or throat
- Confusion, feeling like you might pass out
- Tightness in the chest or throat; trouble swallowing
- Unusual changes in mood or behavior
- Painful urination or difficulty urinating
- Fast or pounding heartbeat
- A seizure (convulsions)
In case any of these potential side effects are experienced after taking Benadryl, medical attention should immediately be sought.
Contraindications for Phenylephrine and Benadryl?
Both Phenylephrine and Benadryl, similar to many other decongestant and antihistamine medications, might cause certain adverse effects in some individuals. If you experience severe reactions such as difficulty breathing or swelling of the face, lips, tongue or throat after taking these medicines, it's crucial to seek immediate medical attention.
Phenylephrine or Benadryl should not be taken if you are currently on monoamine oxidase (MAO) inhibitors therapy or have been within two weeks. MAO inhibitors interact with these drugs leading to potentially dangerous elevations in blood pressure. Always inform your healthcare provider about all the medications that you are taking; MAOIs will require a period of about 2 weeks to clear from your system before starting phenylephrine or Benadryl to prevent harmful interactions.
How much do Phenylephrine and Benadryl cost?
For the brand-name versions of these drugs:
- The price of a 72-tablet pack of Sudafed PE (Phenylephrine, 10 mg) averages around $15, which works out to approximately $0.20/day for the standard dose.
- The price for a box containing 24 tablets of Benadryl (Diphenhydramine, 25 mg), is roughly $5, leading to an average daily cost of about $0.20.
This means that if you are taking the recommended dose for either medication, they both come with similar costs per day. As always, remember that cost should not be your only consideration when deciding on a medication - effectiveness and side effects matter too.
As for their generic counterparts:
- Generic Phenylephrine is available in packs from as few as 18 up to more than 100 tablets with prices ranging from approximately $2-$10 depending on quantity and retailer.
- Generic Diphenhydramine can typically be found in packs ranging from about 24 to over 600 capsules or tablets at prices between roughly $4-$20 again contingent on dosage amount and vendor choice.
Hence it's clear that opting for generic versions can provide significant savings without compromising efficacy.
Popularity of Phenylephrine and Benadryl
Phenylephrine, available in generic form and under brand names such as Sudafed PE, is a popular decongestant estimated to have been used by approximately 8 million people in the US in 2020. Phenylephrine accounted for nearly 20% of over-the-counter cold relief medication use. It's worth noting that phenylephrine has been on the market since the early 1950s and its use has remained relatively steady over time.
In contrast, diphenhydramine (commonly known under the brand name Benadryl) is an antihistamine used for allergies and common cold symptoms. In 2020, it was estimated that around 10 million Americans had taken diphenhydramine. This accounts for just under a quarter of all antihistamine usage across America during this period. The use of diphenhydramine has also remained mostly constant over recent years due to its effectiveness against allergy symptoms and sleep disturbances.
Conclusion
Both Phenylephrine and Benadryl (diphenhydramine) have a long history of use in treating symptoms related to allergies, colds, and sinus congestion. These two drugs are backed by extensive clinical studies indicating their efficacy over placebo treatments. However, they operate via different mechanisms of action: Phenylephrine is a decongestant that shrinks blood vessels in the nasal passages for easier breathing while Benadryl acts as an antihistamine blocking histamine production to reduce allergy symptoms.
In some cases, these medications can be used together but only under close medical supervision due to possible drug interactions. Both drugs are available in generic form which offers cost savings especially for those without insurance coverage. It's also worth noting that both may require time before their effects become noticeable.
The side effect profile is similar between the two; however each has its unique considerations. Phenylephrine may cause nervousness or restlessness while one common side effect of Benadryl is drowsiness which might disrupt daily activities if not anticipated. As with any medication, patients should monitor how they feel after starting treatment closely and seek immediate medical attention if adverse reactions occur.
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Refrences
- Horak, F., Zieglmayer, P., Zieglmayer, R., Lemell, P., Yao, R., Staudinger, H., & Danzig, M. (2009, February). A placebo-controlled study of the nasal decongestant effect of phenylephrine and pseudoephedrine in the Vienna Challenge Chamber. Annals of Allergy, Asthma & Immunology. Elsevier BV.http://doi.org/10.1016/s1081-1206(10)60240-2
- Meltzer, E. O., Ratner, P. H., & McGraw, T. (2016, January). Phenylephrine hydrochloride modified-release tablets for nasal congestion: a randomized, placebo-controlled trial in allergic rhinitis patients. Annals of Allergy, Asthma & Immunology. Elsevier BV.http://doi.org/10.1016/j.anai.2015.10.022
- Picon, P. D., Costa, M. B., da Veiga Picon, R., Fendt, L. C. C., Suksteris, M. L., Saccilotto, I. C., … Schmidt, L. F. C. (2013, November 22). Symptomatic treatment of the common cold with a fixed-dose combination of paracetamol, chlorphenamine and phenylephrine: a randomized, placebo-controlled trial. BMC Infectious Diseases. Springer Science and Business Media LLC.http://doi.org/10.1186/1471-2334-13-556
- 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
- Kollar, C., Schneider, H., Waksman, J., & Krusinska, E. (2007, June). Meta-analysis of the efficacy of a single dose of phenylephrine 10 mg compared with placebo in adults with acute nasal congestion due to the common cold. Clinical Therapeutics. Elsevier BV.http://doi.org/10.1016/j.clinthera.2007.05.021