NIMBEX 5mg/2.5ml Price

Overview

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This medicine contains an important and useful components, as it consists of
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Name

Diphenhydramine Hydrochloride

Precaution

- **Atropine-Like Action**: Diphenhydramine hydrochloride has an atropine-like action and should be used with caution in patients with a history of bronchial asthma, increased intraocular pressure, hyperthyroidism, cardiovascular disease, or hypertension. This is because the drug can exacerbate these conditions by causing dryness of the mouth, nose, and throat, as well as increased heart rate and blood pressure. - **Lower Respiratory Disease**: Use diphenhydramine hydrochloride with caution in patients with lower respiratory diseases, including asthma, as it can thicken bronchial secretions and make it more difficult to breathe. - **Elderly Patients**: Elderly patients may be more sensitive to the side effects of diphenhydramine hydrochloride, such as drowsiness, dizziness, and confusion. Therefore, it should be used with caution in this population. - **Pregnancy and Breastfeeding**: Although animal studies have shown no evidence of impaired fertility or harm to the fetus, there are no adequate and well-controlled studies in pregnant women. Therefore, diphenhydramine hydrochloride should be used during pregnancy only if clearly needed. It is also not known whether diphenhydramine hydrochloride passes into breast milk, so it should be used with caution in breastfeeding women. - **Pediatric Use**: Diphenhydramine hydrochloride should not be used to cause sleepiness in children. It should be used with caution in children younger than 4 years of age due to the risk of paradoxical excitation, which can lead to restlessness and insomnia. - **Allergic Reactions**: Before using diphenhydramine hydrochloride, inform your doctor if you have any allergies, especially to diphenhydramine or any of its components. Allergic reactions can occur and may include symptoms such as rash, itching, swelling, and difficulty breathing. - **Drug Interactions**: Diphenhydramine hydrochloride can interact with other medications, including sedatives, tranquilizers, and alcohol. These interactions can enhance the sedative effects of diphenhydramine hydrochloride and increase the risk of side effects such as drowsiness and dizziness. - **Prolonged Use**: Prolonged use of diphenhydramine hydrochloride can lead to tolerance, where the drug becomes less effective over time. It can also lead to dependence, where the body becomes reliant on the drug to function normally. - **Driving and Operating Machinery**: Diphenhydramine hydrochloride can cause drowsiness and dizziness, which can impair your ability to drive or operate machinery. Therefore, it is important to avoid these activities until you know how the drug affects you. - **Alcohol Use**: Avoid drinking alcohol while taking diphenhydramine hydrochloride, as it can enhance the sedative effects of the drug and increase the risk of side effects such as drowsiness and dizziness.

Indication

- **Allergic Reactions**: Diphenhydramine hydrochloride is used to relieve symptoms of allergic reactions, including sneezing, runny nose, itchy/watery eyes, itching of the nose or throat, and hives. It is effective in treating seasonal allergies, hay fever, and other allergic conditions. - **Common Cold**: Diphenhydramine hydrochloride is used to relieve symptoms of the common cold, such as sneezing, runny nose, and cough. It helps to reduce the severity of these symptoms but does not treat the underlying cause of the cold. - **Insomnia**: Diphenhydramine hydrochloride is used to treat insomnia, or difficulty falling asleep or staying asleep. Its sedative effects help to induce sleep and improve sleep quality. - **Motion Sickness**: Diphenhydramine hydrochloride is used to prevent and treat nausea, vomiting, and dizziness caused by motion sickness. It helps to reduce the symptoms associated with travel by car, boat, or airplane. - **Parkinsonian Syndrome**: Diphenhydramine hydrochloride is used to control abnormal movements in people with early-stage parkinsonian syndrome, a disorder of the nervous system that affects movement, muscle control, and balance. It is also used to treat movement problems as a side effect of certain medications. - **Local Anesthetic**: Diphenhydramine hydrochloride possesses local anesthetic properties and can be used as an alternative to other local anesthetics in patients who are allergic to them. This is an off-label use of the medication. - **Oral Mucositis**: Diphenhydramine hydrochloride is used off-label to treat oral mucositis, a condition characterized by inflammation and ulceration of the mucous membranes in the mouth. This use is not approved by regulatory authorities but has been reported in medical literature. - **Dystonias**: Diphenhydramine hydrochloride is used to treat and prevent dystonias, or involuntary muscle contractions that cause slow repetitive movements or abnormal postures. This use is not approved by regulatory authorities but has been reported in medical literature. - **Vertigo**: Diphenhydramine hydrochloride is used to treat vertigo, a sensation of spinning or dizziness. It helps to reduce the symptoms associated with this condition. - **Pruritus and Urticaria**: Diphenhydramine hydrochloride is used to treat pruritus (itching) and urticaria (hives), which are common symptoms of allergic reactions. It helps to reduce the severity of these symptoms and provide relief.

Contra indication

- **Hypersensitivity**: Diphenhydramine hydrochloride is contraindicated in patients with a known hypersensitivity to the drug or any of its components. Allergic reactions can occur and may include symptoms such as rash, itching, swelling, and difficulty breathing. - **Premature and Full-Term Neonates**: Diphenhydramine hydrochloride should not be given to premature or full-term neonates due to the risk of serious side effects, including respiratory depression and apnea. - **Glaucoma**: Diphenhydramine hydrochloride should be used with caution in patients with glaucoma, as it can increase intraocular pressure and exacerbate this condition. - **Prostatic Hypertrophy**: Diphenhydramine hydrochloride should be used with caution in patients with prostatic hypertrophy, as it can cause urinary retention and exacerbate this condition. - **Bladder Neck Obstruction**: Diphenhydramine hydrochloride should be used with caution in patients with bladder neck obstruction, as it can cause urinary retention and exacerbate this condition. - **Pyloroduodenal Obstruction**: Diphenhydramine hydrochloride should be used with caution in patients with pyloroduodenal obstruction, as it can cause gastric retention and exacerbate this condition. - **Elderly Patients**: Diphenhydramine hydrochloride should be used with caution in elderly patients, as they may be more sensitive to the side effects of the drug, such as drowsiness, dizziness, and confusion. - **Pregnancy and Breastfeeding**: Although animal studies have shown no evidence of impaired fertility or harm to the fetus, there are no adequate and well-controlled studies in pregnant women. Therefore, diphenhydramine hydrochloride should be used during pregnancy only if clearly needed. It is also not known whether diphenhydramine hydrochloride passes into breast milk, so it should be used with caution in breastfeeding women. - **Monoamine Oxidase Inhibitors (MAOIs)**: Diphenhydramine hydrochloride should not be used in patients taking MAOIs, as the combination can lead to serious side effects, including severe hypertension and hyperpyrexia (elevated body temperature). - **Alcohol Use**: Diphenhydramine hydrochloride should not be used in combination with alcohol, as it can enhance the sedative effects of the drug and increase the risk of side effects such as drowsiness and dizziness.

Side Effect

- **Drowsiness**: Diphenhydramine hydrochloride can cause drowsiness, which can impair your ability to drive or operate machinery. This side effect is more common at higher doses and in elderly patients. - **Dizziness**: Diphenhydramine hydrochloride can cause dizziness, which can increase the risk of falls and accidents. This side effect is more common at higher doses and in elderly patients. - **Dry Mouth, Nose, and Throat**: Diphenhydramine hydrochloride can cause dryness of the mouth, nose, and throat, which can lead to discomfort and difficulty swallowing. This side effect is due to the drug's anticholinergic properties. - **Blurred Vision**: Diphenhydramine hydrochloride can cause blurred vision, which can impair your ability to drive or operate machinery. This side effect is due to the drug's anticholinergic properties and is more common at higher doses. - **Constipation**: Diphenhydramine hydrochloride can cause constipation, which can lead to discomfort and difficulty passing stools. This side effect is due to the drug's anticholinergic properties and is more common in elderly patients. - **Urinary Retention**: Diphenhydramine hydrochloride can cause urinary retention, which can lead to discomfort and difficulty urinating. This side effect is due to the drug's anticholinergic properties and is more common in patients with prostatic hypertrophy or bladder neck obstruction. - **Increased Heart Rate**: Diphenhydramine hydrochloride can cause an increased heart rate, which can exacerbate conditions such as hypertension and cardiovascular disease. This side effect is due to the drug's anticholinergic properties and is more common at higher doses. - **Confusion**: Diphenhydramine hydrochloride can cause confusion, which can impair your ability to think clearly and make decisions. This side effect is more common in elderly patients and at higher doses. - **Hallucinations**: Diphenhydramine hydrochloride can cause hallucinations, which can be disturbing and disorienting. This side effect is more common at higher doses and in elderly patients. - **Nervousness**: Diphenhydramine hydrochloride can cause nervousness, which can lead to restlessness and agitation. This side effect is more common in children and at higher doses.

Pregnancy Category ID

2

Mode of Action

- **Histamine H1 Receptor Antagonism**: Diphenhydramine hydrochloride is a first-generation antihistamine that works by blocking histamine H1 receptors. Histamine is a chemical released by the body in response to allergens, and it binds to H1 receptors to cause symptoms such as sneezing, itching, and runny nose. By blocking these receptors, diphenhydramine hydrochloride prevents histamine from causing these symptoms. - **Anticholinergic Effects**: Diphenhydramine hydrochloride also has anticholinergic properties, which means it blocks the action of acetylcholine, a neurotransmitter involved in various bodily functions. This leads to side effects such as dry mouth, constipation, and urinary retention. However, it also contributes to the drug's effectiveness in treating conditions such as parkinsonian syndrome and motion sickness. - **Sedative Effects**: Diphenhydramine hydrochloride has sedative effects, which means it can cause drowsiness and help induce sleep. This is due to its ability to block histamine H1 receptors in the brain, which are involved in wakefulness. The sedative effects of diphenhydramine hydrochloride make it effective in treating insomnia. - **Local Anesthetic Properties**: Diphenhydramine hydrochloride possesses local anesthetic properties, which means it can numb the skin and mucous membranes. This makes it effective in treating conditions such as oral mucositis and providing relief from itching and pain. However, this use is off-label and not approved by regulatory authorities. - **Antimuscarinic Effects**: Diphenhydramine hydrochloride acts as an antimuscarinic, which means it blocks muscarinic acetylcholine receptors. This contributes to its effectiveness in treating conditions such as parkinsonian syndrome and motion sickness, but it also leads to side effects such as dry mouth, constipation, and urinary retention. - **Antiparkinson Effects**: Diphenhydramine hydrochloride is used to control abnormal movements in people with early-stage parkinsonian syndrome due to its anticholinergic and antimuscarinic effects. It helps to reduce symptoms such as tremors, rigidity, and bradykinesia (slowness of movement). - **Antiemetic Effects**: Diphenhydramine hydrochloride is used to prevent and treat nausea, vomiting, and dizziness caused by motion sickness due to its anticholinergic and antimuscarinic effects. It helps to reduce the symptoms associated with travel by car, boat, or airplane. - **Antipruritic Effects**: Diphenhydramine hydrochloride is used to treat pruritus (itching) and urticaria (hives) due to its antihistamine effects. It helps to reduce the severity of these symptoms and provide relief from itching and discomfort.

Interaction

- **Sedatives and Tranquilizers**: Diphenhydramine hydrochloride can interact with sedatives and tranquilizers, enhancing their sedative effects and increasing the risk of side effects such as drowsiness and dizziness. This interaction can impair your ability to drive or operate machinery. - **Alcohol**: Diphenhydramine hydrochloride can interact with alcohol, enhancing its sedative effects and increasing the risk of side effects such as drowsiness and dizziness. This interaction can impair your ability to drive or operate machinery. - **Monoamine Oxidase Inhibitors (MAOIs)**: Diphenhydramine hydrochloride can interact with MAOIs, leading to serious side effects, including severe hypertension and hyperpyrexia (elevated body temperature). This interaction can be life-threatening and should be avoided. - **Anticholinergic Drugs**: Diphenhydramine hydrochloride can interact with other anticholinergic drugs, enhancing their side effects and increasing the risk of adverse reactions such as dry mouth, constipation, and urinary retention. This interaction can exacerbate conditions such as glaucoma, prostatic hypertrophy, and bladder neck obstruction. - **Antihypertensive Drugs**: Diphenhydramine hydrochloride can interact with antihypertensive drugs, reducing their effectiveness and leading to increased blood pressure. This interaction can be dangerous for patients with hypertension and should be monitored closely. - **Antidepressants**: Diphenhydramine hydrochloride can interact with antidepressants, enhancing their side effects and increasing the risk of adverse reactions such as drowsiness, dizziness, and dry mouth. This interaction can impair your ability to drive or operate machinery. - **Antihistamines**: Diphenhydramine hydrochloride can interact with other antihistamines, enhancing their side effects and increasing the risk of adverse reactions such as drowsiness, dizziness, and dry mouth. This interaction can impair your ability to drive or operate machinery. - **Antipsychotics**: Diphenhydramine hydrochloride can interact with antipsychotics, enhancing their side effects and increasing the risk of adverse reactions such as drowsiness, dizziness, and dry mouth. This interaction can impair your ability to drive or operate machinery. - **Muscle Relaxants**: Diphenhydramine hydrochloride can interact with muscle relaxants, enhancing their sedative effects and increasing the risk of side effects such as drowsiness and dizziness. This interaction can impair your ability to drive or operate machinery.

Pregnancy Category Note

Information not available

Adult Dose

- **Allergic Reactions**: The recommended dose of diphenhydramine hydrochloride for allergic reactions in adults is 25-50 mg every 4-6 hours, not to exceed 300 mg in 24 hours. This dosage helps to relieve symptoms such as sneezing, runny nose, and itching. - **Common Cold**: The recommended dose of diphenhydramine hydrochloride for the common cold in adults is 25-50 mg every 4-6 hours, not to exceed 300 mg in 24 hours. This dosage helps to relieve symptoms such as sneezing, runny nose, and cough. - **Insomnia**: The recommended dose of diphenhydramine hydrochloride for insomnia in adults is 25-50 mg at bedtime. This dosage helps to induce sleep and improve sleep quality due to the drug's sedative effects. - **Motion Sickness**: The recommended dose of diphenhydramine hydrochloride for motion sickness in adults is 25-50 mg every 4-6 hours, not to exceed 300 mg in 24 hours. This dosage helps to prevent and treat nausea, vomiting, and dizziness caused by travel. - **Parkinsonian Syndrome**: The recommended dose of diphenhydramine hydrochloride for parkinsonian syndrome in adults is 25-50 mg every 4-6 hours, not to exceed 300 mg in 24 hours. This dosage helps to control abnormal movements and improve symptoms such as tremors, rigidity, and bradykinesia. - **Local Anesthetic**: The recommended dose of diphenhydramine hydrochloride for local anesthesia is not standardized and should be determined by a healthcare provider based on the individual patient's needs. This use is off-label and not approved by regulatory authorities. - **Oral Mucositis**: The recommended dose of diphenhydramine hydrochloride for oral mucositis is not standardized and should be determined by a healthcare provider based on the individual patient's needs. This use is off-label and not approved by regulatory authorities. - **Dystonias**: The recommended dose of diphenhydramine hydrochloride for dystonias is not standardized and should be determined by a healthcare provider based on the individual patient's needs. This use is not approved by regulatory authorities but has been reported in medical literature. - **Vertigo**: The recommended dose of diphenhydramine hydrochloride for vertigo is 25-50 mg every 4-6 hours, not to exceed 300 mg in 24 hours. This dosage helps to reduce the symptoms associated with this condition. - **Pruritus and Urticaria**: The recommended dose of diphenhydramine hydrochloride for pruritus and urticaria is 25-50 mg every 4-6 hours, not to exceed 300 mg in 24 hours. This dosage helps to reduce the severity of these symptoms and provide relief from itching and discomfort.

Child Dose

- **General Considerations**: The use of diphenhydramine hydrochloride in pediatric patients should be determined by a healthcare provider based on the individual patient's needs and response to the medication. The dosing regimen is typically based on the adult dosing regimen, with adjustments made for the child's age and weight. - **Allergic Reactions**: The recommended dose of diphenhydramine hydrochloride for allergic reactions in children is 5 mg/kg/day divided into 4 doses, not to exceed 300 mg in 24 hours. This dosage helps to relieve symptoms such as sneezing, runny nose, and itching. - **Common Cold**: The recommended dose of diphenhydramine hydrochloride for the common cold in children is 5 mg/kg/day divided into 4 doses, not to exceed 300 mg in 24 hours. This dosage helps to relieve symptoms such as sneezing, runny nose, and cough. - **Insomnia**: The recommended dose of diphenhydramine hydrochloride for insomnia in children is 1 mg/kg (up to a maximum dose of 50 mg) 30 minutes before bedtime. This dosage helps to induce sleep and improve sleep quality due to the drug's sedative effects. However, it should not be used for self-medication for longer than 7-10 nights. - **Motion Sickness**: The recommended dose of diphenhydramine hydrochloride for motion sickness in children is 5 mg/kg/day divided into 4 doses, not to exceed 300 mg in 24 hours. This dosage helps to prevent and treat nausea, vomiting, and dizziness caused by travel. For children 6 to younger than 12 years of age, the recommended dose is 12.5-25 mg every 4-6 hours, not to exceed 150 mg in 24 hours. For children 2 to younger than 6 years of age, the recommended dose is 6.25-12.5 mg every 4-6 hours, not to exceed 37.5 mg in 24 hours. - **Parkinsonian Syndrome**: The recommended dose of diphenhydramine hydrochloride for parkinsonian syndrome in children is not standardized and should be determined by a healthcare provider based on the individual patient's needs. This use is not approved by regulatory authorities but has been reported in medical literature. - **Local Anesthetic**: The recommended dose of diphenhydramine hydrochloride for local anesthesia in children is not standardized and should be determined by a healthcare provider based on the individual patient's needs. This use is off-label and not approved by regulatory authorities. - **Oral Mucositis**: The recommended dose of diphenhydramine hydrochloride for oral mucositis in children is not standardized and should be determined by a healthcare provider based on the individual patient's needs. This use is off-label and not approved by regulatory authorities. - **Dystonias**: The recommended dose of diphenhydramine hydrochloride for dystonias in children is not standardized and should be determined by a healthcare provider based on the individual patient's needs. This use is not approved by regulatory authorities but has been reported in medical literature. - **Vertigo**: The recommended dose of diphenhydramine hydrochloride for vertigo in children is not standardized and should be determined by a healthcare provider based on the individual patient's needs. This use is not approved by regulatory authorities but has been reported in medical literature. - **Pruritus and Urticaria**: The recommended dose of diphenhydramine hydrochloride for pruritus and urticaria in children is 5 mg/kg/day divided into 4 doses, not to exceed 300 mg in 24 hours. This dosage helps to reduce the severity of these symptoms and provide relief from itching and discomfort. - **Precautions**: Diphenhydramine hydrochloride should not be used to cause sleepiness in children. It should be used with caution in children younger than 4 years of age due to the risk of paradoxical excitation, which can lead to restlessness and insomnia. The same precautions that apply to adult patients also apply to pediatric patients receiving diphenhydramine hydrochloride.

Renal Dose

- **General Considerations**: Diphenhydramine hydrochloride is primarily metabolized by the liver and excreted in the urine. Therefore, no dose adjustment is typically required for patients with renal impairment. However, patients with severe renal impairment or those on dialysis should be monitored closely for any adverse effects. - **Mild to Moderate Renal Impairment**: In patients with mild to moderate renal impairment, no dose adjustment is necessary. The standard dosing regimen can be followed, with 25-50 mg every 4-6 hours, not to exceed 300 mg in 24 hours, depending on the condition being treated. - **Severe Renal Impairment**: In patients with severe renal impairment (creatinine clearance less than 30 mL/min) or those on dialysis, no specific dose adjustment is recommended. However, these patients should be monitored closely for any adverse effects, as they may be more sensitive to the drug's effects. The standard dosing regimen can be followed, but with caution. - **Hemodialysis**: Diphenhydramine hydrochloride is not significantly removed by hemodialysis. Therefore, no additional dose is needed after dialysis. The standard dosing regimen can be followed in patients undergoing hemodialysis. - **Monitoring**: Patients with renal impairment should be monitored for side effects, particularly those related to the drug's anticholinergic properties, such as dry mouth, constipation, and urinary retention. Regular follow-up appointments are essential to monitor the effectiveness of diphenhydramine hydrochloride and to check for any adverse effects. - **Dosing Regimen**: The standard dosing regimen for diphenhydramine hydrochloride can be followed in patients with renal impairment. For allergic reactions, the common cold, motion sickness, parkinsonian syndrome, vertigo, pruritus, and urticaria, the recommended dose is 25-50 mg every 4-6 hours, not to exceed 300 mg in 24 hours. For insomnia, the recommended dose is 25-50 mg at bedtime. - **Special Populations**: Elderly patients with renal impairment may be at higher risk for complications due to their age and reduced kidney function. Close monitoring and individualized treatment plans are necessary for these populations.

Administration

Information not available