AND ON THE SEACOAST, 95 AND 101 ARE DELAY FREE. THIS CAN BE A TOUGH TIME OF YEAR FOR A LOT OF FOLKS. WITH SO MANY THINGS IN BLOOM AND CAUSING THE SEASONAL ALLERGIES TO KICK IN, WE ARE JOINED LIVE TODAY BY DOCTOR SARA TAYLOR BLACK, AN ALLERGY AND IMMUNOLOGY SPECIALIST AT DARTMOUTH HEALTH. SO DOCTOR, THANKS FOR JOINING US. CAN YOU TELL US ANYTHING? DO WE GET GOOD DATA ABOUT THIS, ABOUT THE SEVERITY OF THIS ALLERGY SEASON COMPARED TO, SAY, PREVIOUS YEARS? YEAH, I WOULD SAY THERE ISN’T GREAT RELIABLE DATA COMPARING YEAR TO YEAR FROM LOCATION TO LOCATION. BUT DEFINITELY LATE LATE APRIL TO THE END OF MAY TENDS TO BE THAT WORST TIME OF YEAR FOR ALLERGIES. KEEP IN MIND, IT’S ALWAYS GOING TO BE WORSE WHEN IT’S A SUNNY, BEAUTIFUL DAY, WHICH IS SAD, RIGHT? IT’S LIKE, OH, IT’S GORGEOUS. THE PALM IS GOING TO BE TERRIBLE. AND THEN THE RAINIER DAYS BRING THE POLLEN COUNTS DOWN AND IT’S HELPFUL TO WASH IT AWAY. SO WE TEND TO HAVE A WORSE POLLEN SEASON IF IT RAINS LESS. AND IT TENDS TO BE LESS SEVERE IF IT RAINS A BIT MORE. AND I CERTAINLY AM AN ALLERGY SUFFERER MYSELF. AND NOTICE THAT DIFFERENCE, LIKE AFTER A GOOD RAIN, IT FEELS A LITTLE BIT BETTER. AND THEN WHEN WE HAVE A WEEK OR TWO WEEKS OF REALLY SUNNY WEATHER, IT’S JUST AWFUL. YEAH, YOU CAN FEEL IT. YOU SEE IT ON YOUR CARS EVERYWHERE YOU GO, AND POLLEN SEASON DOES SEEM TO BE A LITTLE BIT LONGER. THE LATER WE GO, THE THE. IN RECENT YEARS, PROBABLY RELATED TO CLIMATE CHANGE, IT’S HARD TO KNOW FOR SURE. BUT THE KEEP IN MIND, THE WARMER IT IS, THE LONGER YOUR SEASON IS GOING TO BE. SO IT STARTS EARLIER, ENDS A LITTLE BIT LATER, BUT NOTHING TOO DRAMATIC. YEAH, THAT MAKES SENSE. WE DID GET IN SOME VIEWER QUESTIONS. I WANTED TO GET YOUR TAKE ON THESE. ONE PERSON WROTE IN ABOUT BUILDING IMMUNITY. THEY WANT TO KNOW IF IT’S TRUE BECAUSE THEY’VE HEARD THIS, THAT INCORPORATING LOCAL HONEY SPECIFICALLY IN YOUR DIET WOULD SOMEHOW MAKE YOU MORE RESILIENT TO LOCAL ALLERGIES. IS THERE ANYTHING TO THIS? YEAH. SO THERE AREN’T. LET’S JUST SAY THERE AREN’T REALLY ANY RANDOMIZED CONTROLLED TRIALS ON LOCAL HONEY. BUT I USUALLY TELL PATIENTS, YOU KNOW, IT’S NOT EXPENSIVE. IT’S NOT GOING TO HURT YOU IF YOU WANT TO TRY IT. YOU KNOW, THERE’S NOTHING WRONG WITH THAT. I DON’T ROUTINELY RECOMMEND IT, BUT I DON’T THINK THAT IT’S A PROBLEM TO TRY IT. THERE ARE PATIENTS THAT SWEAR THAT IT HELPS THEM, AND IT CERTAINLY ISN’T GOING TO HURT. SO IT’S NOTHING THAT I THINK IS BAD IF AND IT’S DELICIOUS AND IT, YOU KNOW, SUPPORTS OUR LOCAL FARMERS. SO IF YOU WANT TO TRY IT, GREAT. IF YOU TRY IT AND IT DOESN’T WORK, KIND OF LIKE YOU HAVEN’T PUT TOO MUCH TIME AND MONEY INTO IT. SO I DON’T THINK IT’S I DON’T THINK IT’S A BAD THING TO TRY AT ALL. BUT THERE ISN’T A LOT OF HARD DATA SUPPORTING IT. GOT IT. AND FOR FOLKS WHO ARE, YOU KNOW, MAYBE THIS IS THE FIRST SEASON OR FIRST SEASON IN A WHILE, THEY’RE DEALING WITH ALLERGIES. WHAT ARE THE FIRST STEPS YOU ALWAYS SUGGEST PEOPLE TAKE? AND THEN ARE THERE CERTAIN MEDICATIONS THAT CAN WORK BETTER THAN OTHERS OVER THE COUNTER, DEPENDING ON WHAT SPECIFICALLY TRIGGERS YOUR ALLERGY? SURE. SO THE BIG THING WHEN THE POLLEN COUNTS ARE HIGH IS YOU WANT TO MAKE SURE YOU KEEP YOUR WINDOWS CLOSED AT HOME. IT’S SO NICE OUT THIS TIME OF YEAR, AND I COMPLETELY UNDERSTAND THE THE URGE TO LIKE, OPEN UP THE WINDOWS AND LET THE FRESH AIR IN, ESPECIALLY AT NIGHT WHEN YOU GET THAT COOLER AIR. BUT IT’S IT’S NOT A GREAT THING TO DO IF YOU HAVE A LOT OF ALLERGIES. IT’S JUST GOING TO LET ALL THAT POLLEN INTO THE HOUSE. AND SO YOUR SYMPTOMS ARE GOING TO BE WORSE. PLUS, YOU’LL PROBABLY HAVE TO DO A LITTLE EXTRA CLEANING TO GET LIKE THE DUST OFF EVERYTHING. SO YOU DO WANT TO KEEP YOUR WINDOWS CLOSED THIS TIME OF YEAR. IF YOU’VE BEEN OUTSIDE, IF YOU’RE GOING OUTSIDE AND YOU’LL BE OUTSIDE FOR A WHILE, YOU WANT TO TRY AND WEAR A HAT AND SUNGLASSES BECAUSE THAT WILL PREVENT THE POLLEN FROM, YOU KNOW, GETTING ON YOUR HAIR AND GETTING IN YOUR EYES. AND THEN WHEN YOU COME IN, CLEAN OFF, WASH YOUR FACE. IF YOU CAN, SHOWER AND CHANGE YOUR CLOTHES, THAT’S GREAT BECAUSE IT DOES STICK TO YOU. IT’LL STICK TO YOUR EYES, IT’LL STICK TO YOUR HAIR. AND SO GETTING IT OFF WILL HELP YOU FEEL BETTER. THEN FOR MEDICATIONS, YOU KNOW, THE OVER-THE-COUNTER DAILY ANTIHISTAMINES ARE REALLY GREAT MEDICATIONS. THESE MEDS USED TO BE PRESCRIPTION AND HAVE THEY’VE BEEN OVER THE COUNTER FOR MANY YEARS NOW. BUT THEY’RE GOOD IN TERMS OF EFFICACY. WE TEND TO SEE THE BEST RESPONSE TO TO THE NAME BRANDS OR TECH AND XYZAL. ZYRTEC IS THE ONE THAT COMES USUALLY IN THE GREEN BOTTLE, AND XYZAL IS ORANGE, BUT THEY’RE A LITTLE BIT STRONGER, BUT THEY DO TEND TO HAVE A LITTLE BIT MORE SIDE EFFECTS, LIKE DRY MOUTH. SOME PEOPLE DO FEEL A LITTLE BIT SEDATED ON THEM. NOT EXTREMELY SEDATED LIKE WE’LL SEE WITH BENADRYL, BUT A LITTLE BIT TIRED. SO IF THAT’S THE CASE, ALLEGRA IS A GOOD CHOICE. ALLEGRA IS ACTUALLY A BIG A BIGGER PILL, SO IT’S A LITTLE BIT HARDER TO SWALLOW. IT’S NOT QUITE AS EFFECTIVE AS THOSE OTHER TWO, BUT IT’S PRETTY GOOD. AND THEN CLARITIN OR LORATADINE GENERIC TENDS TO BE THE WEAKEST FOR SOME PATIENTS WITH MILD ALLERGIES. IT’S ALL THEY NEED, BUT I FREQUENTLY WILL HAVE PATIENTS SAY IT’S LIKE I’M NOT TAKING ANYTHING. AND WE SAY, WELL, YEAH, IT’S BECAUSE IT’S CLARITIN AND ALL OF THOSE MEDICATIONS, GENERICS ARE FINE. YOU DON’T HAVE TO TAKE THE NAME BRAND. I MEAN, THE NAME BRAND IS NICE, BUT IT DOESN’T TEND TO WORK MUCH BETTER THAN THE GENERIC. WHICH IS REALLY INEXPENSIVE, ESPECIALLY IF YOU CAN BUY I
Common allergy medication’s risks outweigh its usefulness, experts say
Updated: 7:33 AM PDT Aug 1, 2025
Dr. Anna Wolfson says she sees dangerous misuse of the allergy medication diphenhydramine in her clinic every day.“If someone has an allergic reaction to a food, people will say, ‘Don’t worry, I have diphenhydramine in my purse,’ and I would say, ‘Really, epinephrine is the first-line treatment for food allergies,’” said Wolfson, an allergist at Massachusetts General Hospital.Diphenhydramine can be harmful if people take it after having an allergic reaction to food, she said, because the drug – best known by the brand name Benadryl – makes them drowsy and can cause them to miss signs that their symptoms are getting worse.“It’s time to move on. For every single indication that people are using diphenhydramine, there are better drugs that are more effective at treating the symptoms people are trying to treat with fewer side effects,” she said. “I’ve had patients where I worried that diphenhydramine was impairing their ability to drive or fully participate in their daily lives.”Wolfson isn’t alone in preferring alternatives. In a review published in February, allergy experts from Johns Hopkins University and the University of California, San Diego called for the removal of diphenhydramine from over-the-counter and prescription markets in the United States, saying it’s outdated, dangerous and eclipsed by safer alternatives.A first-generation antihistamine approved in 1946, diphenhydramine is widely used for allergies, sleep aid and cold symptoms. It’s a common over-the-counter medication in the U.S., with usage rising in the summer months as people use it to treat itching from bug bites or poison ivy, as well as sneezing and runny nose caused by grass and pollen allergies, according to the American Pharmacists Association.Despite its longstanding presence in American homes, the authors of the new review say it poses disproportionate risks, especially for children and older adults, than newer antihistamines.“Patients should trial alternatives agents like loratadine, which is Claritin, or cetirizine, which is Zyrtec, or fexofenadine, which is Allegra,” to alleviate allergy symptoms, Dr. James Clark of the Department of Otolaryngology-Head and Neck Surgery at the Johns Hopkins University School of Medicine, the lead author of the paper, told CNN.The Consumer Healthcare Products Association, which represents the OTC medicine industry, says that common side effects associated with products containing diphenhydramine are disclosed on the label. However, it notes, “these products are not intended for long-term use.”“When used as directed, these medicines provide well-established therapeutic benefits for common health ailments like allergies, the common cold, motion sickness, minor skin irritations, and occasional sleeplessness,” the group said in a statement on behalf of Benadryl’s maker, Kenvue. “Like all medicines, responsible use is essential, and consumers should always follow directions and warnings on the Drug Facts labels and consult healthcare providers if they have questions.”Risks of diphenhydramineAntihistamines work by blocking receptors called H1, part of the body’s system for responding to allergens, which trigger symptoms like sneezing, itching and a runny nose. But older drugs like diphenhydramine don’t just block the allergy-related receptors, they can also affect other parts of the brain. Diphenhydramine often causes sedation, cognitive impairment, and in some cases, dangerous cardiac effects, the authors wrote.In older adults, the drug can stay in the body for up to 18 hours, resulting in lingering sleepiness, disorientation and increasing risk of falling. The review also highlighted a possible link between long-term diphenhydramine use and dementia.In children, the risks can be even more pronounced. The review’s authors cite cases of accidental overdose; paradoxical reactions such as agitation, extreme sedation and coma; and even death, particularly with pediatric formulations, because of accidental ingestions. The medication was linked to several child hospitalizations and fatalities during the viral “Benadryl Challenge” on TikTok.Dr. Manuela Murray, director of general pediatrics and urgent care at the University of Texas Medical Branch, says diphenhydramine “should not be used lightly.”“It should always be used under the guidance of a Medical Professional, and it is only indicated to treat allergic reactions and motion sickness,” Murray wrote in an email.The medication is often misused and “doesn’t offer a benefit for treatment of cold symptoms, and it is not a safe sleep aid medication,” she said. In fact, it can have the opposite effects in children, leading to hyperactivity.Dr. Alyssa Kuban, a pediatrician and associate medical director at Texas Children’s Pediatrics, also said that she finds diphenhydramine overused for symptoms it does not directly treat and that there are safer alternatives.“I see some families use diphenhydramine when the child has a cold or upper respiratory infection, thinking it will help with the congestion and help them to sleep better at night,” she said. “This is not effective for cold symptoms, nor is it very safe.”She recommends over-the-counter cetirizine to treat children with hives, seasonal allergies or an itchy rash. Cetirizine is also longer-lasting and not as sedating as diphenhydramine, she says.Murray agrees that loratadine and cetirizine are safer for children over 6 months, and saline drops and suctioning are better alternatives for infants.‘Time to say a final goodbye’Diphenhydramine appears in over 300 OTC formulations, often blended into combination products for coughs, colds and flu. The authors of the review say that, like products with pseudoephedrine, diphenhydramine should at minimum be moved behind the counter, allowing pharmacists to guide patients toward second-generation alternatives.The American Pharmacists Association says patients should use caution with combination cough and cold products that contain diphenhydramine.Pharmacists may recommend alternative medications for older adults who have a history of being cognitively affected by certain medications, the group says, and it “encourages patients and parents/caregivers to ask their pharmacist for the most appropriate treatment recommendation for their symptoms” with the least amount of side effects.The review authors also emphasize that there is no strong clinical data that may suggest that diphenhydramine works better than other options. Although it may reduce symptoms like sneezing and itching, it has minimal effect on nasal congestion and doesn’t outperform second-generation drugs in randomized trials. Newer options, such as oral cetirizine, offer 24-hour coverage with fewer adverse events.However, in the U.S., the medication remains a staple. According to the review, more than 1.5 million prescriptions are still written annually, not counting untracked OTC purchases.“In the past, it has been a useful medication that has helped millions of patients; however, its current therapeutic ratio is matched or exceeded by second-generation antihistamines, especially due to their markedly reduced adverse reactions. It is time to say a final goodbye to diphenhydramine, a public health hazard,” the authors wrote.
Dr. Anna Wolfson says she sees dangerous misuse of the allergy medication diphenhydramine in her clinic every day.
“If someone has an allergic reaction to a food, people will say, ‘Don’t worry, I have diphenhydramine in my purse,’ and I would say, ‘Really, epinephrine is the first-line treatment for food allergies,’” said Wolfson, an allergist at Massachusetts General Hospital.
Diphenhydramine can be harmful if people take it after having an allergic reaction to food, she said, because the drug – best known by the brand name Benadryl – makes them drowsy and can cause them to miss signs that their symptoms are getting worse.
“It’s time to move on. For every single indication that people are using diphenhydramine, there are better drugs that are more effective at treating the symptoms people are trying to treat with fewer side effects,” she said. “I’ve had patients where I worried that diphenhydramine was impairing their ability to drive or fully participate in their daily lives.”
Wolfson isn’t alone in preferring alternatives. In a review published in February, allergy experts from Johns Hopkins University and the University of California, San Diego called for the removal of diphenhydramine from over-the-counter and prescription markets in the United States, saying it’s outdated, dangerous and eclipsed by safer alternatives.
A first-generation antihistamine approved in 1946, diphenhydramine is widely used for allergies, sleep aid and cold symptoms. It’s a common over-the-counter medication in the U.S., with usage rising in the summer months as people use it to treat itching from bug bites or poison ivy, as well as sneezing and runny nose caused by grass and pollen allergies, according to the American Pharmacists Association.
Despite its longstanding presence in American homes, the authors of the new review say it poses disproportionate risks, especially for children and older adults, than newer antihistamines.
“Patients should trial alternatives agents like loratadine, which is Claritin, or cetirizine, which is Zyrtec, or fexofenadine, which is Allegra,” to alleviate allergy symptoms, Dr. James Clark of the Department of Otolaryngology-Head and Neck Surgery at the Johns Hopkins University School of Medicine, the lead author of the paper, told CNN.
The Consumer Healthcare Products Association, which represents the OTC medicine industry, says that common side effects associated with products containing diphenhydramine are disclosed on the label. However, it notes, “these products are not intended for long-term use.”
“When used as directed, these medicines provide well-established therapeutic benefits for common health ailments like allergies, the common cold, motion sickness, minor skin irritations, and occasional sleeplessness,” the group said in a statement on behalf of Benadryl’s maker, Kenvue. “Like all medicines, responsible use is essential, and consumers should always follow directions and warnings on the Drug Facts labels and consult healthcare providers if they have questions.”
Risks of diphenhydramine
Antihistamines work by blocking receptors called H1, part of the body’s system for responding to allergens, which trigger symptoms like sneezing, itching and a runny nose. But older drugs like diphenhydramine don’t just block the allergy-related receptors, they can also affect other parts of the brain. Diphenhydramine often causes sedation, cognitive impairment, and in some cases, dangerous cardiac effects, the authors wrote.
In older adults, the drug can stay in the body for up to 18 hours, resulting in lingering sleepiness, disorientation and increasing risk of falling. The review also highlighted a possible link between long-term diphenhydramine use and dementia.
In children, the risks can be even more pronounced. The review’s authors cite cases of accidental overdose; paradoxical reactions such as agitation, extreme sedation and coma; and even death, particularly with pediatric formulations, because of accidental ingestions. The medication was linked to several child hospitalizations and fatalities during the viral “Benadryl Challenge” on TikTok.
Dr. Manuela Murray, director of general pediatrics and urgent care at the University of Texas Medical Branch, says diphenhydramine “should not be used lightly.”
“It should always be used under the guidance of a Medical Professional, and it is only indicated to treat allergic reactions and motion sickness,” Murray wrote in an email.
The medication is often misused and “doesn’t offer a benefit for treatment of cold symptoms, and it is not a safe sleep aid medication,” she said. In fact, it can have the opposite effects in children, leading to hyperactivity.
Dr. Alyssa Kuban, a pediatrician and associate medical director at Texas Children’s Pediatrics, also said that she finds diphenhydramine overused for symptoms it does not directly treat and that there are safer alternatives.
“I see some families use diphenhydramine when the child has a cold or upper respiratory infection, thinking it will help with the congestion and help them to sleep better at night,” she said. “This is not effective for cold symptoms, nor is it very safe.”
She recommends over-the-counter cetirizine to treat children with hives, seasonal allergies or an itchy rash. Cetirizine is also longer-lasting and not as sedating as diphenhydramine, she says.
Murray agrees that loratadine and cetirizine are safer for children over 6 months, and saline drops and suctioning are better alternatives for infants.
‘Time to say a final goodbye’
Diphenhydramine appears in over 300 OTC formulations, often blended into combination products for coughs, colds and flu. The authors of the review say that, like products with pseudoephedrine, diphenhydramine should at minimum be moved behind the counter, allowing pharmacists to guide patients toward second-generation alternatives.
The American Pharmacists Association says patients should use caution with combination cough and cold products that contain diphenhydramine.
Pharmacists may recommend alternative medications for older adults who have a history of being cognitively affected by certain medications, the group says, and it “encourages patients and parents/caregivers to ask their pharmacist for the most appropriate treatment recommendation for their symptoms” with the least amount of side effects.
The review authors also emphasize that there is no strong clinical data that may suggest that diphenhydramine works better than other options. Although it may reduce symptoms like sneezing and itching, it has minimal effect on nasal congestion and doesn’t outperform second-generation drugs in randomized trials. Newer options, such as oral cetirizine, offer 24-hour coverage with fewer adverse events.
However, in the U.S., the medication remains a staple. According to the review, more than 1.5 million prescriptions are still written annually, not counting untracked OTC purchases.
“In the past, it has been a useful medication that has helped millions of patients; however, its current therapeutic ratio is matched or exceeded by second-generation antihistamines, especially due to their markedly reduced adverse reactions. It is time to say a final goodbye to diphenhydramine, a public health hazard,” the authors wrote.