Does Benadryl interfere with Epi-pen results?

Posted on: Wed, 08/30/2017 - 1:25am
mb1554's picture
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Joined: 08/30/2013 - 08:11

I am caring for my goddaughter's 3 y/o during the week who was just diagnosed with a peanut allergy. We have Benadryl and an epi-pen available at all times. I just read the news account of a 13 y/o California girl with a peanut allergy who died after eating one bite of a Rice Krispie treat. Her parents gave Benadryl first as they had been instructed. Shortly after, the child began vomiting. The father gave 2 doses of the epi-pen, and later a 3rd dose from the camp. EMT's who arrived were unable to save the child. Could the Benadryl have either interfered with the effects of the epinephrine or did it delay time in giving the life saving drug to prevent full anaphylaxis?

Posted on: Fri, 08/30/2013 - 1:48am
Katiedid50's picture
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Joined: 08/30/2013 - 08:40

No benadryl does not effect how the Epi-Pen works. As sad as it is and I'm not pointing any fingers or belittling anyone in this caes, this little girl should have been given the epi-pen right away as she had a known peanut allergy. I have a PA son and the plan of action for him is if he ingests peanuts/peanut butter etc. the Epi-Pen Jr. is to be administered immediately. Benadryl is for relief of itching, hives etc. Benadryl won't save a life but an EpiPen will.
This is the information that I personally have been given for my son, I know everyone is different.

Posted on: Fri, 08/30/2013 - 2:42am
mb1554's picture
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Joined: 08/30/2013 - 08:11

Thanks for the info. What confused me about the news story was that the girl only had one bite of a Rice Krispie, which does not contain peanuts and which she had eaten before. The parents gave Benadryl as instructed. Since the 3 y/o I watch also has an egg allergy, my first thought (if in the same situation) would be eggs, and give Benadryl, especially if the symptoms were hives, itching. Now I am wondering, in light of this tragedy, if the epi-pen should be used no matter what the ingested substance was and no matter how slight the reaction is. My only guess for the CA girl is that the reaction was too advanced by the time the epi was given. An epi overdose or giving it when not really needed, can be reversed. Death cannot. Any thoughts on overreacting?

Posted on: Fri, 08/30/2013 - 5:53am
Katiedid50's picture
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Joined: 08/30/2013 - 08:40

The Rice Krispie treat was made with peanut butter which she realized right away and spit it out,they should have given the epi pen. It depends on the doctor though and her dad is a doctor (not neccasarily and allergist but a doctor) My son is also allergic to eggs but his only reaction has been itching and eczema, no anaphylaxis. They should have given her mom some sort of allergy action plan to follow. It's all very confusing and every case is different. Scary though, my son started kindergarten this week and I've been half-expecting a phone call because his school isn't peanut free.

Posted on: Sat, 08/31/2013 - 4:09am
AD75's picture
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Joined: 08/04/2013 - 17:59

My son has a class 4 peanut allergy with history of ana. Our allergist said if there is ANY possibility of peanut ingestion, give Epi immediately and call 911 (don't transport him to ER ourselves). He said don't bother with Benadryl because it does nothing to stop a deadly reaction and that most people who die from ana do so because they delay giving the Epi. He was pretty direct about this when we asked about an "allergy action plan" basically saying, there is no plan, you absolutely give the Epi and call 911 in every instance. That really hit home for us and we feel a little safer about giving the Epi because both the allergist and ped said research has shown small children's hearts usually do well with handling the Epi meds. So better to risk small possiblity of side effect to Epi than possiblity of dying from allergist reaction.

Posted on: Mon, 09/02/2013 - 3:31am
mb1554's picture
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Joined: 08/30/2013 - 08:11

Thanks for your comments. Since this little one spends as much time with me as her parents, I am greatly concerned. The allergist's instructions are to give Benadryl for rash, hives; Epi pen for wheezing, difficulty breathing or known peanut ingestion. What if you don't know what she ingested and she starts with rash, hives, lip swelling which is how her first rx to peanut butter began? What if we are at the park & she picks something up & I don't see it? She would react to eggs w/ rash, hives which Benadryl would treat, but if it were peanuts, this would waste time. If I wait for respiratory symptoms, wouldn't it be too late for the epi pen to work? I am inclined to treat any reaction w/ the epi pen as epi can be reversed. I am agonizing over this dilemma especially with an unknown ingestion & early signs of reaction. Any thoughts?

Posted on: Wed, 09/11/2013 - 3:20am
PeanutAllergy.com's picture
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Joined: 06/21/2013 - 11:03

Hi mb1554,
We posted this question on our Facebook page, and it got several responses. You can see what our fans had to say by following this link - https://www.facebook.com/PeanutsAllergy/posts/592633197441942
Thank you!

Posted on: Wed, 09/11/2013 - 11:40am
survivingfood's picture
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Joined: 09/04/2013 - 19:29

Benadryl is for histamine released during an allergic reactions. Benadryl helps. However, there are many more substances released during a severe allergic reaction besides histamine. Epi works to reverse the effects of those. Unfortunately sometimes in a true anaphylactic reaction nothing works because too much damage done. Epi used to be prescribed widely for asthma before inhalers. Experts say even if you were to give a shot and it wasn't a true reaction the child would be ok.

Posted on: Thu, 09/12/2013 - 4:31am
mb1554's picture
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Joined: 08/30/2013 - 08:11

Very interesting responses! Thank you.

Posted on: Fri, 09/13/2013 - 1:53am
Katiedid50's picture
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Joined: 08/30/2013 - 08:40

Yes, there is no set "allergy plan" for schools etc. My allergist's office has what they call an "Emergency Protocol" form which guides the caregiver/school etc step by step directions of what to do. I actually have a copy of it in my son's "allergy emergency bag" in case there is any doubt. His levels rose from Class III when he was 15 months old to "off the charts" when he was 4. One ambulance ride is enough for us.

Posted on: Sun, 09/15/2013 - 12:33pm
raye's picture
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Joined: 09/15/2013 - 17:27

I am grandmom and caretaker of a 3-year-old PA toddler and I have had to take him to the ER twice this year, the last visit was very recent, requiring that I give the Epi-Pen at home (on his third birthday) before running to the ER. His first reaction and subsequent diagnosis of peanut allergy came about from his first taste of peanut, two peanut butter M&Ms. He reacted violently within 2 minutes of ingesting them. Since then, I have read constantly about this allergy, its symptoms, when to do what--and the consensus of SPECIALISTS in the allergy field is that many of the Emergency Room doctors for some reason are far too reluctant to give epinephrine right away, but prefer giving Benedryl and perhaps a steroid for hives or itchy throat and "wait for other symptoms." As in the sad recent case of Natalie Giorgi in CA, who died in her father's arms after only having tasted then spit out a peanut-butter treat, he(a doctor himself, but not an allergist)did every thing he had been told to do, apparently by the EMT who had been called. So, he only gave her Benedryl and waited for symptoms. She died within 30 minutes without symptoms, until vomiting began and it was her particular case's onset of anaphylaxis, although each case is different, even in same individuals. You need to read books or articles by authorities, not just any medical doctor and certainly do not take the advice of an EMT in most cases. In some areas, EMTs are actually not even allowed to carry EpiPens or to give them, so do not rely on their knowledge in the case of anaphylaxis. I had an awful experience during our little boy's last emergency, in that I gave the Epipen at my home, immediately called 911 and for some odd reason, the dispatcher insisted I speak with the EMT! The EMT told me, "You say you are an RN. Then you will understand when I say that we cannot come because we have an epileptic seizure to go to." I could not believe I was hearing this or even that the dispatcher required me to speak to the EMT! Meanwhile, my 40-pound grandson was screaming in my arms, having just received the injection, I was on an adrenalin rush myself because of fear, I am 76-years-old and have had a 5-artery-heart bypass and have congestive heart failure, and I was being told they could not send help for my grandson who was possibly about to go into anaphylaxis and had already received the EpiPen? And we were in a city of 8 million people, with how many ambulances? He even went on to say, "I would advise you to stay there." At NO TIME DID HE ADD, "and we will send someone else." I just said, "No, I am not staying here! I will take him to the ER myself!" I put him in a stroller and race-walked the several blocks to the ER. Upon arriving, the baby was by then feeling better and typical toddler playful, from having had the Epipen at home. So, the ER personnel, including the Chief-of-ER, treated me in a very patronizing manner and did not give him any more medication at all. When his EpiPen that I had given him wore off (20+ minutes after given) and we were in the ER,he became restless and was salivating and pulling his tongue again and I was told by the doctor when I called him in, "Hmmm, I don't see any foaming saliva in his mouth." It was drooling down his chin. He is a late talker and not able yet to describe his symptoms, so I could only go by body-language and visual signs. I begged them, as did my daughter, his Mom who finally arrived from work, to give another Epi-Pen, because he was again pulling at his tongue and acting anxious and uncomfortable. The Chief-Dr. was calling me "Grandma" and a nurse kept telling me to "Just take a deep breath!" Finally, the baby threw up all over the room, on the bed, the floor, and my daughter. Then they gave him some medicine. We were very fortunate in that he did not go into anaphylaxis that night, but the chief doctor seemed to think he had God-like powers that could help him divine the exact moment to give epinephrine. I reminded him of the little girl who died in her doctor-father's arms just weeks before in CA, because, although she had had no symptoms at all, and had had 3 Epipens when she finally threw up (her first symptom), they were given too late. He smirked and said, "Yes, but HE was not Chief of this hospital's ER like I am! (and showed me his badge)" What total arrogance. This was at Methodist Hospital ER in Brooklyn. Read an article, or better yet, buy a book written by Dr. Scott H. Sicherer, M.D. of Jaffe Food Allergy Institute in New York City. He will wisely walk you though the difficult-to- discern right time to give the EpiPen. He also states that Benedryl is not going to do any harm, but that IT WILL IN NO WAY STOP ANAPHYLAXIS! It is only a palliative measure, a way to ease the itching throat or tame the hives, but it WILL NOT STOP THE BODY SHUTDOWN, SO--in my opinion, NEVER, EVER THINK BENEDRYL FIRST! This doctor, and others I have read, say that you can do no harm in giving Epinephrine, even if it turns out not to have been called for. How will we ever know anaphylaxis would not have occurred? Epinephrine has been around and has been used safely for a very, very long time, originally used for severe asthma attacks, and still is. So, do not be afraid to give it, if YOU FEEL IT IS MERITED, even if the all-knowing EMT says later on, as one Mom reported, "You should not have given epinephrine, this child is fine now." Yes, the child is expected to feel fine within 5 minutes or so of receiving the injection. THAT IS THE PURPOSE, FOR GOODNESS SAKE!! But, another reaction can follow the first one, and the second can be much worse, hence, we are told, "give the Epipen and then get the child to the ER or Doctor within 20 minutes for observation for another 4 hours to see if another attack is coming". NOBODY, NOT EVEN A DOCTOR (and the good ones will admit this) can foresee whether or not a reaction is going to come. If YOU CHILD SEEMS SICK AND FEARFUL AND HAS 2-3 OR THE MANY SYMPTOMS OF IMPENDING ANAPHYLAXIS, OR (AND THIS IS SO IMPORTANT!) IF THE CHILD IS KNOWN TO HAVE INGESTED EVEN A TINY PARTICLE OF PEANUT and HAS NO SYMPTOMS (AS IN Natalie's Giorgi's case),DO NOT WAIT FOR EVEN ONE SYMPTOM - GIVE THE EPIPEN! So many, many doctors whose articles or books I have read advise this. But, PLEASE continue doing your own research, and while I am an RN, I am not representing myself as an authority on this subject, because I definitely am not. Do not do a I say, therefore, but continue to read the advice of researchers, doctor who ARE authorities, and I think you will find as I did that Epinephrine is safe and should be given at FIRST signs of distress if your FEEL FAIRLY SURE it is from an allergic reaction (first determine, if you can, if it could more likely be from another OBVIOUS cause, but unless you are sure it is, then go for the allergy supposition). Again, just my opinion, and not for you to follow unless you have done your own research. By the way, regarding the above-mentioned experience with local 911, in which the dispatcher should never have connected me to the EMT in the first place, and he should never have refused to come, and did not say, "but we will send someone else right away," I have spoken to an EMT since then and he told me i should never have even spoken to anyone other than the dispatcher. and that it was the dispatcher's duty to FIND A FREE emergency crew if the first one she contacted was busy! The local fire department somehow heard the same radio call and did come later, but there was absolutely no indication that this would happen when I spoke with 911 or the EMT she connected me with--quite the contrary. Of course, by the time the fire department crew arrived, I had already left, running with the baby to the ER. I reported this incident and it is being full investigated by both the Fire Department and by the City of New York and they promised that I would hear from them within the next two weeks.

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