Benadryl and Aleve interaction?
 

My daughter had a very difficult week. She became so weak that she couldn't walk, swallow, talk, etc. All of this exacerbated a day after her first IVIg treatment ended. She ended up in the Neuro critical care unit of the hospital for 4 days (just released yesterday). Upon admission the doc told us that she shouldn't have been taking benadryl because it is contraindicated with MG. She said it was a big No, No. We didn't know that since this is a new diagnosis for Caitlin. She had been taking it at night to help her sleep. It may have been aggravating her MG even more. Has anyone else heard of this? The pharmacist in the hospital gave us a list of drugs not to use if you are MG on mestinon, and benadryl was NOT on the list. This is confusing.

A friend told me that she can't take Aleve because it affects her throat and she can't swallow (she doesn't have MG). Does anyone know if Aleve can make swallowing difficult for MG patients? My daughter was taking Aleve for the IVIg headache.

Sarah

Benadryl has anticholinergic properties...so yes, it would be problematic for MGers. It is also a problem for men with prostate issues, for the same reason.

All of the first generation antihistamines are included because they have these anticholinergic actions too.

Second generation ones like Claritin and Allegra may be better, but I'll leave that to Annie who is planning a long list of drugs to avoid. The second generation ones are less effective as antihistamines also, and do not have drowsiness side effects (Claritin and Allegra).

Zyrtec is related to Atarax and therefore problematic as well, but less so.

I am not sure about Naproxyn (Aleve). Someone with allergies to NSAIDs may have swallowing problems if allergic to it.
There is a dry mouth reported side effect but it is less than 1%... and most drugs that cause dry mouth are not used in MGers, either.

I am sure others will be along with answers for you, that are more definitive.

Violet, I'm sorry your daughter is having such a hard time. When an MGer gets that weak, the best place for them is in a hospital.

What Mrs. D. may not know is that your daughter was also on a sleeping pill! When you add together two sedating medicines, you are putting yourself at risk even if you don't have MG.

Aleve is not contraindicated in MG. But when you start adding meds together like she is doing, you can end up with a drug cocktail that would be hard on anyone. The liver and kidneys clear medications from the body. Has your daughter had a comprehensive chemistry done? That would include things like electrolytes, kidney/liver function, protein level, glucose, etc. You might want to get a copy of the tests they did in the hospital. That is often a standard test run on MGers and other patients in critical care.

You can't really compare one person's reaction to a drug to another person's reaction! Everyone is different. What drugs like Aleve often do is make a person retain fluids. That, in turn, can effect the electrolyte levels in the body. For example, potassium could then be too high. She should get a baseline chemistry of her electrolytes when she is doing better to see if there is yet another issue here.

What Benadryl does, besides reducing histamine, is to "shift" fluids in the body. It's complicated but that too can affect electrolytes like potassium.

Potassium, magnesium and calcium are essential to muscle function (and other functions). When those are too high or too low, they can create more muscle weakness. So while Aleve itself is not a "bad" drug, the retention of fluid which might occur can then lead to electrolytes being off balance which might result in muscle weakness! :cool:

Not every doctor knows what prescription drugs, over-the-counter drugs and even foods/drinks effect MG. We are working on a list to put here. In the meantime, if you have questions, please ask!

MG has a fairly big learning curve. It really sucks but as long as you are well-informed, you can attempt to avoid getting worse. I really hope your daughter is getting better and will continue to do so.

Annie

Thanks Annie and MrsD. Cait is doing so much better now that she's on Cellcept and mestinon (doc gave her permission to take the mestinon every 4 hours around the clock if she needed it). Maybe the IVIg has kicked in too (started first dose 12 days ago). She's 100% stronger. Now we just need to maintain. I contacted a local support group and we hope to learn more from the members.

I am looking forward to the drug interaction list that is being prepared. That will be helpful to all of us. The pharmacist gave us a list of drugs not to use, but it didn't have benadryl listed (no antihistamines were on the list) so the "official" lists published by the pharmaceutical companies is not sufficient.

Sarah

I am looking forward to that list too.

I'd like to suggest making its own sticky.... when the time comes, let me know and I'll take it to the team for discussion.

In our experience the stickies do not get read by many people for some reason, so having its own thread may help people find it better.

Benadryl reaction
 

I had a reaction to Benadryl which included sudden, severe weakness. My face was nearly paralyzed, unable to swallow or cough and could barely breathe for almost 4 hours. My oxygen saturation stayed around 90 - 92 but the ICU was ready to put me on a ventilator. Benadryl (25 mg) and Solumedrol (25 mg) were given to me before an IVIg treatment. The nurses and doctor were baffled by my reaction and thought I was possibly having a cholinergic crisis due to Solumedrol combined with my Mestinon. Thank goodness they didn't give me Atropine (another antimuscarinic /anticholinergic) which is normally used to counteract a cholinergic crisis!

I have had Solumedrol quite a few times before, at even higher doses, with no problems (except insomnia). I found out later through my own research that Benadryl is a potent anticholinergic! I'm very surprised it isn't on the MGFA drug list. I think Benadryl is the type of anticholinergic which inhibits production of acetylcholine (ACh) - which could certainly affect myasthenics! I'm surprised Benadryl doesn't affect everyone with MG.

It would be very helpful if there was a searchable drug list in an app or something that could quickly describe what ingredients drugs contain that could endanger us. My nurse wasn't aware that Benadryl is an anticholinergic and that anticholinergics could affect myasthenics.

Your post in this forum is the only result my Google search showed which pointed out that Benadryl may be problematic for myasthenics. I read below your post that someone is preparing a more comprehensive drug list. Is the list available yet?

Try searching for the generic name of Benadryl, which is diphenhydramine. Here is a link from the MGFA about drugs and MG (it discusses Benadryl): http://www.myasthenia.org/LinkClick....JuFvZPPq2vg%3D

Abby

I have lambert eaton syndrome and they give me benedryl all the time for my ivig
I get IVIG 2 days every 2 weeks I drive home really tired from it but that is about it?