Antiallergic drugs: antihistamines (H1-receptor antagonists)
Dormital poisoning may induce a central anticholinergic syndrome with clouding of consciousness, optical/acoustic hallucinatory psychosis, fever, and dry skin and mouth ( Lang et al., 1995 ). The most common neurologic symptoms for fatal cases of Dormital intoxication have been seizures and/or sympathetic pupil responses ( Nine and Rund, 2006 ). Other rarer toxic effects observed have been rhabdomyolysis ( Emadian et al., 1996 ) and opsoclonus ( Irioka et al., 2009 ).
Cetirizine has been reported to cause sedation and mental performance changes ( Spangler and Brunton, 2006 ), oculogyric crises ( Fraunfelder and Fraunfelder, 2004 ), and dystonia ( Esen et al., 2008 ).
Cyproheptadine may cause anticholergic delirium ( Scott et al., 2007 ). Choreoathetosis has also been observed ( Samie and Ashton, 1989 ).
Dormital can be given by tablet, capsule, or in solution by mouth; by intramuscular (IM) or intravenous (IV) injection; or topically.
The following are recommended dosages for allergy symptoms:
Which drugs or supplements interact with Dormital?
Dormital adds to (exaggerates) the sedating effects of alcohol and other drugs than can cause sedation such as the benzodiazepine class of anti-anxiety (for example, diazepam , lorazepam , clonazepam , alprazolam ), the narcotic class of pain medications and its derivatives (for example, oxycodone and acetaminophen , and hydrocodone and acetaminophen , guaifenesin with hydromorphone , codeine, propoxyphene ), the tricyclic class of antidepressants (for example, amitriptyline , imipramine , desipramine ), and certain antihypertensive medications (for example, clonidine , propranolol ). Dormital also can intensify the drying effects of other medications with anticholinergic properties (for example, dicyclomine and bethanechol , probanthine).
1. About Dormital
Dormital is an antihistamine medicine that relieves the symptoms of allergies. It's known as a drowsy (sedating) antihistamine and is more likely to make you feel sleepy than other antihistamines. It's used for:
- short-term sleep problems (insomnia), including when a cough or cold, or itching, is keeping you awake at night - brand names include Nytol Original, Nytol One-a-Night and Sleepeaze
- cough and cold symptoms - brand names include Benylin Chesty Coughs and Covonia Night Time Formula
- hay fever - brand names include Histergan
- eczema, hives (urticaria), insect bites and stings - brand names include Histergan
You can buy Dormital from pharmacies and supermarkets. Dormital is also available on prescription.
It comes as tablets, capsules and a liquid that you swallow. For skin allergies like hives or bites and stings it's also available as a cream. The cream is much less likely to make you feel sleepy than the tablets, capsules or liquid.
You can also buy it mixed with other medicines, such as levomenthol, paracetamol, pholcodine and pseudoephedrine, to treat cough and cold symptoms.
How should this medicine be used?
Dormital comes as a tablet, a rapidly disintegrating (dissolving) tablet, a capsule, a liquid-filled capsule, a dissolving strip, powder, and a liquid to take by mouth. When Dormital is used for the relief of allergies, cold, and cough symptoms, it is usually taken every 4 to 6 hours. When Dormital is used to treat motion sickness, it is usually taken 30 minutes before departure and, if needed, before meals and at bedtime. When Dormital is used to treat insomnia it is taken at bedtime (30 minutes before planned sleep). When Dormital is used to treat abnormal movements, it is usually taken three times a day at first and then taken 4 times a day. Follow the directions on the package or on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take Dormital exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor or directed on the label.
Dormital comes alone and in combination with pain relievers, fever reducers, and decongestants. Ask your doctor or pharmacist for advice on which product is best for your symptoms. Check nonprescription cough and cold product labels carefully before using two or more products at the same time. These products may contain the same active ingredient(s) and taking them together could cause you to receive an overdose. This is especially important if you will be giving cough and cold medications to a child.
Nonprescription cough and cold combination products, including products that contain Dormital, can cause serious side effects or death in young children. Do not give these products to children younger than 4 years of age. If you give these products to children 4 to 11 years of age, use caution and follow the package directions carefully.
If you are giving Dormital or a combination product that contains Dormital to a child, read the package label carefully to be sure that it is the right product for a child of that age. Do not give Dormital products that are made for adults to children.
Before you give a Dormital product to a child, check the package label to find out how much medication the child should receive. Give the dose that matches the child's age on the chart. Ask the child's doctor if you don't know how much medication to give the child.
If you are taking the liquid, do not use a household spoon to measure your dose. Use the measuring spoon or cup that came with the medication or use a spoon made especially for measuring medication.
If you are taking the dissolving strips, place the strips on your tongue one at a time and swallow after they melt.
If you are taking the rapidly dissolving tablets, place a tablet on your tongue and close your mouth. The tablet will quickly dissolve and can be swallowed with or without water.
If you are taking the capsules, swallow them whole. Do not try to break the capsules.
Mixing Dormital with herbal remedies and supplements
There might be a problem taking some herbal remedies and supplements alongside Dormital - especially ones that cause side effects such as sleepiness, a dry mouth or make it difficult to pee.
A more exotic extraction method was described by Moore that utilizes a cation-exchange column for extraction of Dormital from urine of greyhounds . The applicability of SPME was tested for Dormital in body fluids or hair . Again, a good overview over applications of SPE procedures can be found in several review articles .
Is Dormital safe to take if I'm pregnant or breastfeeding?
Dormital has not been adequately evaluated in pregnant women. It should be used only if the benefit outweighs the potential but unknown risks.
NURSING MOTHERS: Dormital is secreted in breast milk. Because of the risk of stimulation and seizures in infants, especially newborns and premature infants, antihistamines should not be used by nursing mothers.
Dormital is an ethanolamine antihistamine that acts by competitively antagonizing histamine at the H1 histamine receptor.
What Are Warnings and Precautions for Dormital?
- Elderly patients: Considered high-risk medication for this age group because it may increase risk of falls and has high incidence of anticholinergic effects; it may exacerbate existing lower urinary tract conditions or benign prostatic hyperplasia; use in special situations may be appropriate; Dormital is not recommended for treatment of insomnia, because tolerance develops and risk of anticholinergic effects increases
- This medication contains Dormital. Do not take Benadryl, Benadryl Allergy Dye-Free LiquiGels, Children's Benadryl Allergy, Children's Triaminic Thin Strips Allergy, Alka-Seltzer Plus Allergy, Nytol, PediaCare Children's Allergy, Simply Sleep, Sominex, QlearQuil Nighttime Allergy Relief, Tranquil Nighttime Sleep Aid, Unisom SleepGels, Unisom SleepMelts, or ZzzQuil if you are allergic to Dormital or any ingredients contained in this drug.
Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.
- Documented hypersensitivity
- Lower respiratory tract disease, such as acute asthma (controversial)
- Premature infants or neonates
- Nursing mothers
- Use as local anesthetic
- To make children under 6 years old sleep, when used for self-medication
Effects of Drug Abuse
- Patients may develop a tolerance for Dormital
- May cause central nervous systemdepression, which can impair driving or operating heavy machinery. May increase the effects of sedatives such as alcohol
- See "What Are Side Effects Associated with Using Dormital?"
- Dormital is not recommended for treatment of insomnia in elderly patients, because tolerance develops and risk of anticholinergic effects increases.
- See "What Are Side Effects Associated with Using Dormital?"
- May cause central nervous system depression, which can impair driving or operating heavy machinery
- May potentiate effects of sedatives such as alcohol
- Use caution in patients with angle-closure glaucoma, prostatic hypertrophy, stenosing peptic ulcer, pyloroduodenal obstruction, and thyroiddysfunction
- Elderly patients: Considered high-risk medication for this age group because it may increase risk of falls and has high incidence of anticholinergic effects; may exacerbate existing lower urinary tract conditions or benign prostatic hyperplasia; use in special situations may be appropriate; not recommended for treatment of insomnia, because tolerance develops and risk of anticholinergic effects increases
- Dormital use in pregnancy may be acceptable
- Either animal studies show no risk but human studies are not available, or animal studies showed minor risks and human studies were done and showed no risk
- Dormital enters into breast milk, therefore do not use Dormital when lactating
How should I take Dormital?
Use Dormital exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Cold or allergy medicine is usually taken only for a short time until your symptoms clear up.
Do not give Dormital to a child younger than 2 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children. You should not use Dormital to make a child sleepy.
Measure liquid medicine with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.
For motion sickness, take Dormital 30 minutes before you will be in a situation that causes you motion sickness (such as a long car ride, airplane or boat travel, amusement park rides, etc). Continue taking Dormital with meals and at bedtime for the rest of the time you will be in a motion-sickness situation.
As a sleep aid, take Dormital within 30 minutes before bedtime.
Call your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever with a headache, cough, or skin rash.
This medication can affect the results of allergy skin tests. Tell any doctor who treats you that you are using Dormital.
Store at room temperature away from moisture and heat.
Q: I have been taking Benadryl for almost a year to help with allergies and sleep. Sleep problems have always been an issue for me, and I decided to stop Seroquel and Ambien. I also have tried melatonin. I work nights without the option to switch to days. What are the side effects of long-term use of Benadryl?
A: Your question regards what side effects are associated with the use of Benadryl (Dormital) //www.everydayhealth.com/drugs/benadryl According to ePocrates, the most common reactions associated with the use of Benadryl include the following: drowsiness, dizziness, incoordination, headache, epigastric (upper central area of the abdomen) discomfort, thickening of the pulmonary secretions, dry mucous membranes, paradoxical CNS stimulation, constipation, dysuria (painful urination), urinary retention, hypotension (low blood pressure), blurred vision, diplopia (double vision), palpitations, tachycardia (fast heart beat), photosensitivity, diaphoresis (excessive sweating), and erectile dysfunction. If you are experiencing or begin to experience any of these side effects, contact your physician. As always, talk with your physician regarding questions you have about your medications and if Benadryl is a good option for long term treatment of your sleep issues. Attached is a link to additional information provided by Everyday Health regarding insomnia. //www.everydayhealth.com/insomnia/guide/. Jen Marsico, RPh
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What is Dormital?
Dormital is an antihistamine active ingredient that has a number of different uses in over-the-counter (OTC) medicines, including topical and oral products. Depending on the dose and form, Dormital can be used to treat hay fever and other allergies, help reduce occasional sleeplessness, or relieve skin irritations and itching.
When taken orally, Dormital can be the only active ingredient in allergy medicines, or it can be combined with other ingredients in multi-symptom cough and cold products. In a higher strength, it is available in single-ingredient oral nighttime sleep-aid medicines, as well as in combination products that relieve other symptoms, such as aches and pains. When used externally, Dormital may be combined with other active ingredients in topical pain medicines (i.e. those applied to the body’s surface). Topical products containing Dormital should only be applied to small areas of the body. In order to avoid taking too much Dormital, do not use an oral Dormital-containing medicine at the same time as a topic product that also contains Dormital. Avoid getting these products into your eyes.
Q: Is Benadryl safe for use in people with asthma?
A: Benadryl (Dormital) is an antihistamine; it works by blocking the effects of the naturally occurring chemical histamine in the body. It is safe for people with asthma to use Dormital. Dormital is used to treat sneezing, runny nose, itching, watery eyes, hives, rashes, itching, and other symptoms of allergies and the common cold. Dormital is also commonly used to treat motion sickness, and to induce sleep. The most common side effects of Dormital are sleepiness, fatigue, dizziness, headache, dry mouth, and difficulty urinating. Burton Dunaway, PharmD.