Tuesday, November 25, 2008

Hot Topic Tuesday-- Off label use of Benadryl

Okay, I have an actual hot parenting topic for you today... (results and commentary on the miniatures poll later today if I get to it.)

Here's the question?

Have you ever used Benadryl to help get your children to sleep? (at home, on airplanes, car rides, etc?) Or WOULD you (if you have not)? Is this ethical?

Okay, here's my two cents. Yes, I have. I don't have a problem with it under certain circumstances. Here's why.

Benadryl is a product that I have used for all of my children for its intended purpose at one time or another. From runny noses to allergic reactions, they have all had to take it for a "legitimate" reason, and they all tolerate it well.

Every medication has side effects. For Benadryl, an unintended side effect of this medication is that it makes them sleepy. This side effect has prompted the creation of all sorts of over-the-counter nighttime medications for adults-- Tylonel PM, even one of the name brand medications intended soley for sleep (nytol maybe?), etc. It's the same active ingredient and the same doseage as in an adult dose of Benadryl. Basically, they are using the side effect of Benadryl to treat another condition, sleeplessness.

Now, I have seen this with my beloved Trazadone. It's not a tranquilizer-- it's not intended for insomnia, it's actually an anti-depressant that has a side effect of sleepiness. So when taken at night, it helps sleep. Many people with insomnia have taken Trazadone as an insomnia cure. (Me included.) But it's still considered an "off-label" use of the product... in other words, not what the product was created to do.

So back to Benadryl for children. It's a doseage I know they can handle (because it's what the dr. has told me to give them), I know how they respond to the medication, and it produces a DESIRED side effect-- sleepiness.

I have used Benadryl "off-label" very rarely. I did use it on the plane on the way down here. And the kids slept on the plane/ on the three hour car ride. And I can think of one other time I have used it with Josiah when he'd been up for three hours in the middle of the night screaming.

I do not think that people should overuse this strategy, but I think in moderation it's fine.

How about you? What do you think?

18 comments:

  1. Hi there-
    I have had conversations with Jat centered around this topic many times. He doesn't like to take meds when he gets sick and I think he would prefer we not give them to our kids for any off-label reasons--such as plane rides, sleeping, etc. However, I tend to gently bend the rules of Benadryl (and Tylenol, if I am out of Benadryl!) for uses such as helping them through a plane ride or helping a child get to sleep in a new environment. I don't see anything wrong with that as long as you don't OD your child (obviously). Unfortunately for me, Jack responds to these meds with the fine print symptom called "excitability" instead of "market drowsiness":-- which I learned on our first plane ride together. Luckily, Tylenol pain reliever works to slow him down.
    So-- I am not against off-label use, but sometimes even drugs won't slow down a toddler!!

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  2. oops-- I meant MARKED drowsiness...

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  3. Bring it on! (In moderation haha).
    I have no problem using stuff for off-label purposes. That said, I can count on one hand the number of times I've used Benadryl off-label for my kids. As such, I can't remember which one of them responds like Julie's son. (One of them gets hyper.) So I just don't do it anymore!

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  4. So far, I have been blessed with pretty good sleepers and travelers, so I haven't had to resort to desperation yet. With that said, I will probably keep some on hand for any future "emergencies" seeing as to how much we plan to be traveling next year. With my luck, mine would probably land in the "excitability" category. I wouldn't know yet.
    Now on the other hand, I rarely use meds in general, unless the kids are really miserable. The only things I do use mostly are tylenol and motrin. I have been told not to use any over the counter cold meds for my kids under the age of 2 by multiple peds. That they really don't do anything and can actually cause more harm. I have heard that they are discovering more and more bad side effects in very young kids (< age 2) with decongestants, cough syrups, etc. used for treating colds and that they aren't doing much. I'm not sure that we have had any allergy type problems yet, so I don't think I have even purchased benadryl yet.
    I did use saline nose spray for severe congestion in Noah recently and it has been the most effective. But - hey - no judgements from me (with the no overdosing rule of course) because I would probably end up needing the offlabel use one of these days myself! I have used meds for myself for off label use many times :)

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  5. Ok, no children here - but my vet told me when we moved from OH to SC how much children's benadryl to give the cats to keep them calm on the drive. So I guess that's way off label. It worked. On the way from SC to NE it worked too thankfully, 3 days driving with 2 cats would have been bad without it. Not all vets approve, but this one gave me dosage per weight of cat.

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  6. I have been guilty of off-label activity with benadryl when my kids were younger and we traveled - fortunately they usually also had some sort of runny nose at the time... :-)

    Off-labeling is a common thing among prescription meds. It is mostly prohibited in Europe (with some expcetions) and is not practiced at all with children.

    We know this because the meds given by the docs here in the U.S. to our son with Asperger's was to treat his anxiety, but was definitely off-labeling and we were clearly informed of that. We could not access the drugs in the UK for that reason.

    Reality is, if they didn't off-label, many kids wouldn't have access to some of the drugs that are used. That itself is a controversy. I am not into drugging kids for everything. But just as "labels" can be overused, they can also be a huge releif to a family who needs answers and relief. Using an off-label prescrition was a huge releif to our son and family.

    Any other opinions on prescription off-labeling?

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  7. hugs, not drugs.

    just kidding. we couldn't have made the china flight without benadryl. 15 hours on a plane. a 2 year old. it's the only solution. i'm convinced jesus would do the same thing.

    by the way, am i the only male person that reads this blog?

    skc

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  8. My baby is too young for this yet (4months)..(although I have heard of it being used in children this small, not my style) but you can probably count on me doing it at some point.. I'll even give you another one Dramamine! It is for motion sickness but it knocks you OUT! So its actually a legitimate thing to give for traveling to your kids don't get 'motion sick'.
    I have used benadryl for myself off-label occasionally, and while I was pregnant my OB actually recommended Benadryl to help me sleep.

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  9. Who hasn't, should be the question! I have given my kids Gravol for plane rides a few times when they were small but now that they are older and seasoned travellers it isn't needed.

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  10. I've did it for a plane ride, just to realize that my boys don't get sleepy from it. Oh, well.

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  11. Stephen-

    You are not the only guy who reads this blog. Gwenn cracks me up and her frequent posting far surpasses all other bloggers I know!!!

    Re: Benadryl....
    Short term, moderate use of an item to be used due to an intended side effect is just plain common sense. Can anyone say "hot toddy?" Lemon juice, honey, whiskey or vodka or brandy...... alcohol is a barbituate that helps you sleep, which is what you need when you are sick... ergo- Nyquil anybody?

    And yes I know that alcohol is a dehydrator- which is not a good idea when you're sick, therefore the first disclaimer of short term, moderate use; followed by the old advice...Drink plenty of fluids and get some rest.

    Sleep well kids.

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  12. I have used gravol to help with my over anxious (at times) oldest daughter for traveling, settling down etc because she throws up when she gets too worked up....mmmm, nice - I know!

    I do think it can be overused by some parents - and that worries me. Like to get to sleep at night, for example. My oldest has babysat for a family and they said just give them a bit of this if they are not
    going to sleep. I told her no, not to do it...crazy!

    I generally do not keep any meds in the house with the exception of a bottle of children's t and adult t. We are just like that, no judgment against those who do. I do think people can over use them and then reduce their "threshold" of discomfort. Working with the elderly I have seen some hardly whimper while in pain, others are ready for their next shot of morphine about 2 hour after their last one.

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  13. Ok...I am the only person in the world who has not given my children Benadryl to make them sleep. I guess I fall into the no unnecessary meds category. My kids were a pain to travel with when they were little so we didn't take them places :-) Not an option for everyone obviously.

    Creating some controversy here but how about not putting children in situations where drugging them is necessary to elicit "good" behavior.

    Trish

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  14. I'm another that doesn't like to use meds unless really needed. But then again, I also was blessed with my first child being a wonderful sleeper, traveler, etc. The younger one is still too young to tell (three and a half months) and way too young to give any meds to! I've never had the need to give the older one anything to help calm him down. (I've also never had him on a long plane ride - but by now, he's old enough to not need any meds to help with any of that.) Now, I myself have needed to use meds off-label... I also took Trazadone regularly (haven't had it since before getting pregnant and I'm still nursing, so it will be a while). And I've taken other things to help when I *really* needed it. Unfortunately, Benadryl never ever made me drowsy - would have been nice some of those times when my insomnia was kicking in and I had nothing else to take. But in our home, we really try to rely more on home remedies if meds aren't needed - so we don't normally even have things to give to the kids. Camden hardly ever is sick or needs anything. And I don't want to teach him it's ok to take meds when you don't need them or for the wrong reasons - he's old enough to know what's going on. We typically just have ibuprofen and allergy meds (nondrowsy at that)...

    So, Trish, you're not the only one. :)

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  15. I agree that drugging our kids to elisit good behaviour is not the ideal. I have used Gravle on a red-eye flight twice with my kids when they were small. Both times we were to attend a wedding later the same day and the mere thought of no sleep for 48 hours for the the under 6 crowd was not something I wanted to experience. I was unsure if they would sleep on the plane and knew that to not have the option of "help" was crazy.

    I do however disagree that we should not put our children in certain situations. We have five kids and have never altered our lives to accomodate them. From the time they were small they have always been taken to nice restaurants, stores in which very good behaviour was expected, etc...We travel a lot and our kids have always come with us. They have learned from these situations what is expected of them and to this day behave better than some adults I know.

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  16. Once bitten, twice shy. I tried it once with my eldest and it had the opposite effect ... he was bouncing off the walls in his plane seat for the whole trip!

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  17. Thank God for whoever created Benadryl. What a flippin lifesaver on long trips. The kids have no idea that just by inducing sleep in them on a long trip, it saved our marriage and their lives. :)

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