Diphenhydramine Administration Guidelines

Adult and Pediatric Dosing

For acute hypersensitivity reactions in adults and children, the American Academy of Allergy, Asthma, and Immunology recommends 25-50 mg of diphenhydramine administered parenterally (IV push) 1, 2
For treatment of dystonic reactions in adults, 25-50 mg of diphenhydramine can be administered IV, as suggested by the American Academy of Pediatrics 3
For acute hypersensitivity reactions in children, the American Academy of Allergy, Asthma, and Immunology recommends 1-2 mg/kg per dose of diphenhydramine 1, 2

Rapid IV administration of diphenhydramine may precipitate seizures in some patients, according to the American Academy of Pediatrics 4
Diphenhydramine can cause sedation and respiratory suppression, especially when combined with other sedative agents, as warned by the American Academy of Pediatrics 4
In patients with allergic reactions, diphenhydramine should be considered second-line therapy to epinephrine and should never be administered alone in the treatment of anaphylaxis, as recommended by the American Academy of Allergy, Asthma, and Immunology 5, 6

Using diphenhydramine as first-line treatment for anaphylaxis instead of epinephrine is not recommended by the American Academy of Allergy, Asthma, and Immunology 5, 6
Failing to monitor patients for respiratory depression, especially when combined with other sedatives, is a concern highlighted by the American Academy of Pediatrics 4