Docs celebrate a 'long overdue farewell' to this 'dirty drug'
Key Takeaways
Industry Buzz
"It's a dirty drug... It crosses the blood-brain barrier, causes sedation, weight gain, and cognitive impairment—especially in kids." — Amiirah Aujnarain, MD, pediatrician and allergist
Docs across social media are celebrating the "long overdue farewell" to Benadryl.
The World Allergy Organization (WAO) just released a formal advisory against using first-generation antihistamines like Benadryl, citing their outdated pharmacology and unfavorable safety profile.[]
And doctors like Amiirah Aujnarain, MD, an allergist and pediatrician in Toronto, are buzzing about it. In an Instagram Reel, Dr. Aujnarain explains that she hopes North American can follow in the footsteps of Sweden and Germany, where Benadryl is reportedly already pulling these meds off the shelves.
Why this matters now
Benadryl has been a household name in the US for decades. It’s often the first thing patients grab for allergies, hives, or even sleep.
But Dr. Aujnarain says it’s time for a serious practice rethink: “It’s a dirty drug,” she explains. “It crosses the blood-brain barrier, causes sedation, weight gain, and cognitive impairment—especially in kids.”
For physicians in the US, this raises several questions:
Is it time to de-emphasize Benadryl in clinical recommendations?
Are we doing enough to educate patients on the risks of first-gen antihistamines?
Should pediatric and allergy societies in the US push for similar labeling or policy changes?
What are the risks?
Diphenhydramine’s side effects have long been documented, according to Dr. Aujnarain, and include sedation and next-day somnolence, cognitive impairment, weight gain, poor school performance in children, and delirium in older adults.
Yet it remains widely used—often over second-gen antihistamines like cetirizine, loratadine, or fexofenadine, which are non-sedating and have fewer CNS effects.[]
What WAO is recommending
The WAO's recommendation is clear: Clinicians should no longer recommend first-generation antihistamines due to their risk profile, especially when safer and equally effective options exist.
This marks a pivotal shift, especially in countries where OTC use is rampant and often patient-initiated without physician input.
Don't wait for the FDA...
You don’t need to wait for the FDA to act. Many allergists already avoid recommending Benadryl when possible. But this new push offers an opportunity to reinforce the message:
Update your patient handouts, especially for parents and caregivers.
Discuss second-gen alternatives first. Emphasize non-sedating benefits.
Reinforce this in pharmacy and urgent care settings where Benadryl is often reflexively given.
Bottom line
Benadryl isn’t banned in the US (yet), but the writing may be on the wall. For allergy specialists, pediatricians, internists, and even ER physicians, now might be the time to help patients say goodbye to diphenhydramine—for good.
Related: Common OTC drugs that carry serious health risks