SBAR: Diphenhydramine injection shortage

By James R. Gengaro, DO,Regional VP of Medical Affairs, Paoli Hospital and Riddle Hospital

Situation: Diphenhydramine injection is on severe shortage.  All oral forms—both capsules and liquid–of diphenhydramine are readily available.

Background/Assessment: We have about 100 vials of diphenhydramine left throughout the hospital.  Diphenhydramine is on long term backorder, with no release date.

Recommendation:  During the shortage of injectable diphenhydramine, prescribers will need to determine the best alternative to an injectable antihistamine.

Alternatives to injectable diphenhydramine include:

  • oral—capsules and liquid diphenhydramine or hydroxyzine,
  • intramuscular hydroxyzine
  • IV piggyback promethazine
  • injectable corticosteroids

Please let me know of any issues that arise.  I apologize for yet another drug shortage.

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