benadryl vs. epi-pen

Posted on: Sat, 09/27/2003 - 1:58am
pjama0502's picture
Joined: 08/04/2003 - 09:00

Hello all,

I am quite new to pa (my 17 mo old son has it).
Last week we were issued an epi-pen. The allergist did not mention using benadryl, but I notice a lot of people seem to use benadryl when a reaction is first suspected.

My question is: when do you use benadryl and when do use the epi-pen?

For those who have administered benadryl: do you use adult benadryl or children's benadryl and how much do you give?



Posted on: Sat, 09/27/2003 - 2:28am
Susanhopes's picture
Joined: 06/23/2003 - 09:00

Hi Jen, and welcome to the wonderful world of PA. My 18mo DD is PA and, I suspect, TNA.
We just found out a few months ago too, and there's a big learning curve ahead of you. I recommend getting one or more of the books that are linked to this site to get you up to speed. Surprised that the allergist didn't explain things better but then they have HMOs dogging their heels. It turns out that parents have to do a lot of self-educating on this issue anyway. Get ready to be your DS's best health advocate.
Also, you may want to look at the FAAN (food allergy and anaphylaxis network) site. You can join and get their newsletter, it's very informative.
Briefly, Benadryl is for minor reactions like hives and a little facial swelling. Your EpiJr is for full anaphylaxis, when DS can't breathe. You may want to look into the 2 pack of pens that comes with a trainer, very good to practice the technique. I keep one pen in my purse and the other in a fanny pack that goes with DH when he has DD out or to non-purse occasions. Both have a small bottle of children's benadryl with DD's name and dosage marked on a piece of tape (target store brand) and a dosing syringe. The dosage at this age is according to the doc's instructions since they are under 2, it depends upon weight.
GL with your "studies!"

Posted on: Sat, 09/27/2003 - 6:42am
CorinneM1's picture
Joined: 06/20/2002 - 09:00

Hi, and welcome.
My son (2 yrs) has only had one reaction to peanuts, which resulted in hives. At the time we didn't know what that he was allergic to nuts, but we gave him childrens benedryl which helps ease the hives and the puffy eyes.
We carry childrens benedryl with us, as well as 2 epi pens when we are out (in case one misfires). If you have only one epi pen, please consider asking your doctor for another prescription.
These 2 always stay in his diaper bag and we have an additional one in his medicine drawer in his room. Also, his daycare has one, as well as my mom (since he spends time at their house a few days a month as well).
In terms of dosage, I would go by weight or your drs recommendation. And from what I am reading here, if your child goes beyond hives, use the epi pen and call 911.

Posted on: Sat, 09/27/2003 - 7:02am
Carefulmom's picture
Joined: 01/03/2002 - 09:00

I would definitely NOT wait until your child can`t breathe to use the Epi. I used it only once and that was for hives, swelling around the eyes, and some wheezing. She was not having any trouble breathing at all. Her allergist said I did the right thing by using it. I NEVER would have waited for her to have trouble breathing. If you use it too late in the reaction, it may not work (because once the blood pressure has dropped then the epinephrine would sit in the leg where you inject it, and not go to the heart, lungs, etc.) That was why Nathan Walters died despite using the epi---because it was used too late in the reaction. I have read to use the Epi if two or more organ systems are affected or if breathing is affected. As far as the Benadryl, I used Zyrtec (similar to Benadryl) after the Epi so that it would start working when the Epi wore off. And yes, you should also call 911.
[This message has been edited by Carefulmom (edited September 27, 2003).]

Posted on: Sat, 09/27/2003 - 9:06am
attlun's picture
Joined: 06/13/2003 - 09:00

My PA son just turned 2, and his last reaction (and 1st since we found out he was PA), I tried giving him Benadryl first like the allergist had told me to, and he couldn't even swallow it because is throat was so swollen. I will always give epi at first sign of a reaction now!
Trevor 8/6/01
Harmony 1/22/03

Posted on: Sat, 09/27/2003 - 10:24am
Susanhopes's picture
Joined: 06/23/2003 - 09:00

As I said above, I'm still on the learning curve myself! Thanks to Carefulmom and others for clarifying how early you should use the Epi. (I guess I really meant "trouble breathing" instead of "not breathing" and wasn't clear enough there.) It's good to hear about people actually using the Epis and what that was like We haven't and have not encountered another reaction to have to make that decision. Let's hope few of us will have to do so.

Posted on: Sat, 09/27/2003 - 10:45am
Carefulmom's picture
Joined: 01/03/2002 - 09:00

I would definitely say if you are not sure whether to do it or not and you are sort of vascillating when it happens, you should probably do it. DD was not having any trouble breathing when I did it, and she was not wheezing a lot. I did it because she had three organ systems affected, and I used the two or more rule. By the way, she was fine within 60 seconds after I used it--it works very fast! However about two hours later the rash came back. By then she had already seen the doctor, and he had sent me home with steriods for if the rash came back. I have since learned that you should stay at the doctor`s for 3 to 4 hours because there can be a second phase to the reaction. However, we did not do that. Next time if she was released that soon, I would probably park outside until the time was up.

Posted on: Sat, 09/27/2003 - 10:48am
StaceyK's picture
Joined: 05/06/2003 - 09:00

We have an ER plan based on a version a doctor recommended at a food allergy seminar. Here it is:
After exposure to peanuts, tree nuts, any peanut or nut-containing product, observe for the following symptoms:

Posted on: Sat, 09/27/2003 - 11:41am
darthcleo's picture
Joined: 11/08/2000 - 09:00

all the comments so far have been quite good. I would simply add, from our ER plan:
if there's been a KNOWN *ingestion* of peanuts/nuts/whatchamacallit, you can give the Epi even before symptoms start.
But then, you should discuss all of those points with your doctor. We are not giving medical advice.

Posted on: Sun, 09/28/2003 - 12:15am
DebO's picture
Joined: 03/15/1999 - 09:00

I agree that it is very important you discuss this with a doctor. When either of my children has a possible exposure WITH ME, I will administer benadryl and observe and be ready with the epipen if necessary. I know my children and am familiar with their reactions.
Anywhere else, I do not even give them benadryl. I do not think it is fair for me to expect a teacher at school or a coach at gymnastics to use judgement of the severity of the reaction. My procedure is for them to use the epi and send my child to th ER. I would far rather have a doctor in the ER judging the severity of the reaction.
Just my opinion.
Take care

Posted on: Sun, 09/28/2003 - 1:27am
Carefulmom's picture
Joined: 01/03/2002 - 09:00

Well, here`s another opinion. Our allergist said the antihistamine (we use Zyrtec, similar to Benadryl) is for AFTER the Epi is used. He said not to use an antihistamine first to see if the reaction gets better because the hives or whatever could get better while the blood pressure is dropping and once the blood pressure has dropped the Epi may not work (same as above, the leg is not being perfused once the blood pressure has dropped so the epinephrine sits in the leg). So for that reason I would not use Benadryl and observe. He also tells me on every visit that almost all of the cases where someone had a reaction, used the Epi and still died, it was because the Epi was used more than 30 minutes after the reaction started. I am not saying it is okay to wait 29 minutes after the reaction starts before using the Epi, just saying that using Benadryl watching things get better then worse, can waste those precious 30 minutes. Having already used the Epi, I would be afraid to give antihistamine and observe. Too chancy for me.
[This message has been edited by Carefulmom (edited September 28, 2003).]


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