Quebec is considering tighter controls on Benadryl and other medications containing diphenhydramine after the overdose death of an 18-year-old in 2023.
Under a proposed regulation, the medications would be moved behind the pharmacy counter, with pharmacists required to document each sale as the province looks to reduce the risk of misuse and overdose.
Dr. Michael Kalin, a Montreal family doctor in the Côte Saint-Luc, joined CityNews to discuss the proposal.
Does Quebec’s proposal to tighten access to Benadryl make sense and why?
So first of all, it doesn’t mean that they’re pulling Benadryl from the market. It just means that the medicine won’t be available on the shelf. Instead, you’ll have to go to a pharmacist and the pharmacist can give it to you without a prescription from behind the counter. This allows for extra control and also allows the pharmacist to discuss the possible side effects.
Many people use Benadryl for allergies or to help them sleep. Is it still a medication you recommend, and if so, in what situations?
So Benadryl is widely used. It’s a first-generation antihistamine. So I think we’ve all used it when we got a bug bite, perhaps some poison ivy. And it’s very effective. But the main side effect is sedation. It can make people very drowsy. So while it’s very effective, it’s short-acting, and there are newer medicines that have come out that are equally effective. And I think we know the names Reactine, Claritin, Allegra, and they’re very effective. They last a full day and they don’t have the same side effects as for sedation.
So the proposal is to maintain the second-generation antihistamines over the counter. But the first generation will be behind the counter where a pharmacist would have to discuss the added side effects. And it’s not that we need a prescription for it, but they’re just an extra control, a safety control.
What are the risks of taking too much diphenhydramine, particularly for teens and young adults?
Well, and unfortunately, it was a tragic death of an 18-year-old and that precipitated this. And this is the result of the coroner report and recommendation.
And it’s not the only medicine that’s behind the counter. We can think of certain pain medicines, cough, syrups, morning-after pill, and these also are behind the counter. So I think it makes sense as far as hiding a safeguard. The risk is low, but it can happen. And if we can save one life, then it’s worth doing.
