2020 Volume 23 Issue 4 Pages 611-615
Diphenhydramine is widely used as an anti-allergy medication, cold preparation, and sleeping aid. We report a case in which the blood level of diphenhydramine was measured in the course of treatment and was shown to be 4,990 mg. A 22-year-old woman presented to our emergency department with a disturbance in consciousness, nystagmus, and convulsions. We suspected diphenhydramine poisoning because Restamin U Kowa tablets had been found in her belongings. She was admitted to the critical care unit, where she was mechanically ventilated and underwent hemodialysis. She was extubated on the 4th day, was lucid. She recovered without complications and was discharged from the hospital on the 8th day. The blood diphenhydramine level suggested that diphenhydramine was removed not only by renal excretion but also by hemodialysis, which was normally considered ineffective. Therefore treatment with hemodialysis may be considered in serious diphenhydramine overdose.
