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.