Risks of taking 3 Benadryl a night
May 29, 2020 2:22 PM   Subscribe

My 70-year-old mother is taking 3 Benadryl every night for allergies and to help her sleep. She says 2 aren’t enough to stop her eyes from itching. I haven’t been able to convince her to stop- she sometimes takes more when she wakes up. What are the risks?

I called my pharmacist to ask and he basically said “don’t do that” and hung up. I’m having a hard time convincing her so if I had more concrete reasons, that would help. Thank you!
posted by dianeF to Health & Fitness (21 answers total)
Long-term use is linked to dementia. (Re whether you can take three at once in the short term, though, I'll just note that Advil PM has 38 mg of diphenhydramine per pill and suggests taking two (not that it's necessarily a good idea, but that's about the same total amount as three 25 mg pills)...
posted by pinochiette at 2:29 PM on May 29 [11 favorites]

In 2015 there were a few studies that came out that Benadryl taken long term may increase risk of cognitive decline in older patients. There are other OTC allergy meds that may work for her better.

I'm a larger woman, and 1 benadryl can knock me on my ass, and I take 2-3 if I've been exposed to an allergen, but don't want to use an epipen/am not sure if the situation merits an epipen yet. 3 benadryl taken every night seems high to me, but IANAD.
posted by larthegreat at 2:32 PM on May 29 [4 favorites]

It's worth some effort to reduce allergens. People can become allergic/intolerant to dairy, wheat, eggs, strawberries, detergent, scent, lotion, hairspray, houseplants, Spring pollen, etc. When something was making my eyes itch, the PA recommended tea bags, black, caffeinated tea bags. She's 70, it's her eyes, call the doctor.
posted by theora55 at 2:43 PM on May 29 [5 favorites]

Does your mother take a daily medication (like Claritin, Allegra, Xyzal...)? I have terrible allergies but find that Xyzal plus an OTC allergy nose spray (Flonase or whatever is on sale) works for me 90% of the time. The other 10% I have to take Benadryl, but my doctor has told me not to take it too often for the reasons discussed above (dementia, plus it messes up your sleep if you take it all the time).

Obviously visiting a doctor might be tough right now, depending on where she lives, but this stuff is all OTC anyway. I've been getting mine through curbside pickup at Target.

Which is just to say -- if she's not doing that already, she should start. If she is already taking daily medications, it might be time to look at allergy shots.
posted by goodbyewaffles at 2:47 PM on May 29 [7 favorites]

She might have more success with cetirizine (zyrtec) for itching, and so need less. And if it's just her eyes, or primarily her eyes, antihistamine eyedrops. My eye doctor recommended ketotifen fumarate, which is sold OTC as Zaditor.
posted by still_wears_a_hat at 2:50 PM on May 29 [6 favorites]

The dosing guide is 1 to 2 tablets every 4 to 6 hours, at 25mg of Diphenhydramine.

The recommended max daily doseage for Diphenhydramine is 300mg per day. Your mother is taking half that on her highest dose days. This seems fine to me, but I live on Sudafed so what do I know.
posted by DarlingBri at 2:52 PM on May 29 [4 favorites]

Max dosage/dementia/other concerns aside, Benadryl tolerance develops really quickly if you take it every day as a sleeping aid. If she needs help getting to sleep independent of the itchy eyes, I would look for a more reliable sleep medication.

For the allergies, I take Zyrtec regularly but for itchy eyes specifically, I was amazed at how much more effective ketotifen eyedrops are.
posted by yeahlikethat at 3:14 PM on May 29 [4 favorites]

It's worth some effort to reduce allergens. People can become allergic/intolerant to dairy, wheat, eggs, strawberries, detergent, scent, lotion, hairspray, houseplants, Spring pollen, etc.

Or dust mites? The fact that her allergies are worse in bed (both night and morning) would lead me to suspect something like this. Reduce the humidity and clean everything in that bedroom (especially bedding) at least once a week. Seriously, getting my nighttime allergies under control changed my life. Not saying this is definitely what she's experiencing, but it's worth looking into.
posted by Joey Buttafoucault at 3:32 PM on May 29 [9 favorites]

Just because something is safe when you're younger doesn't mean it is later in life. Benadryl (diphenhydramine) is one of many drugs on the Beers List of medications to be avoided in the elderly.

Specific concerns with 1st generation antihistamines like Benadryl are not just theoretical. Very common side effects with even low doses in older people include urinary retention, constipation, dry mouth, delirium, and falls.

While urinary retention and constipation may not sound like big problems, they are actually each associated with increased urinary stasis, meaning the urine stays in the bladder longer. That promotes bacterial overgrowth and infection as the bacteria get to hang out longer in the urinary tract. UTI's are huge problems in the elderly, especially elderly women.

Dry mouth may also sound relatively benign but it can lead to gum disease, tooth decay and oral infections like thrush.

Delirium and falls. These risks speak for themselves.

So, plenty of reasons to look for alternatives!
posted by 6thsense at 3:33 PM on May 29 [14 favorites]

Along with other non-medical interventions you could get your mother allergy covers for her mattress and pillows to reduce dust mites. And air purifier or humidifier in her bedroom might also alleviate night time issues.
posted by brookeb at 3:52 PM on May 29 [2 favorites]

Remove rugs, get new pillows, and run a hepa filter in the bedroom- these strategies made a huge difference in my household.
posted by pseudostrabismus at 3:57 PM on May 29 [2 favorites]

I've been using Visine AC (allergy/cold) eyedrops for itchy eyes, and they have worked really well for me. Maybe she could try that to help her cut down on Benadryl.

I also use unscented baby wipes to gently wipe down my eyes and lashes to get rid of any allergens on the skin before I put the drops in.
posted by Serene Empress Dork at 4:29 PM on May 29 [1 favorite]

Aside from the allergy issues, my grandfather was switched to 3mg of melatonin from Advil PM every night and has not complained. Personally I take 1/2 Zyrtec at a time, up to 2 a day, for itchiness from allergies.
posted by RoadScholar at 5:17 PM on May 29 [1 favorite]

Thanks, guys! I’m sharing this info with her right now. All very helpful! I might send her some stuff to try, like the eye drops and dust covers. I also appreciate knowing Advil PM is a similar dose in case she keeps it up. Thanks again!
posted by dianeF at 6:58 PM on May 29

Pataday is OTC now. Hands down one of the best allergy eye drops around. May help even more for the eye itching, which may make sleep easier. I'd recommend against the Visine allergy drops.
posted by piedmont at 8:03 PM on May 29 [2 favorites]

How active is she? Would she be able to dust the bedroom every other day, and vacuum?

No matter how lazy we get in our house, the bedsheets and duvet cover get changed once a week on the outside, and I dust on roughly the same schedule. Those two, plus allergen spray on the naked pillows, mattress cover, and (textile) window treatments, make a good hour's work, but makes sleep so much better.
posted by notsnot at 8:35 PM on May 29 [1 favorite]

You might want to consider an small air purifier for her bedroom. I am a mess of allergies each spring & fall & it has made a big difference. Also change the air filters in the house monthly to help keep dust down.
posted by wwax at 10:12 PM on May 29 [1 favorite]

I would definitely recommend Zyrtec for itchy face-focused allergies. For sleeping, I take melatonin, and I wonder if she has tried that?
posted by Autumnheart at 10:58 PM on May 29 [2 favorites]

If she has hayfever and allergic conjunctivitis that severe she should see a doctor.
posted by chiquitita at 3:57 AM on May 30 [1 favorite]

Can you buy her a robot vacuum or something?
posted by oceanjesse at 5:35 AM on May 30

Just to chime in to say that prolonged regular use of Advil or any NSAIDS is not a good idea for elderlies, as it promotes stomach ulcers, can damage kidneys, cause hypertension, and make preexisting heart failure worse. There are people who does okay with it but I see people every day hospitalized due to too much NSAIDS use.
posted by Pantalaimon at 11:16 AM on May 30 [1 favorite]

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