Bena-Flu10 mg/5 ml

Bena-Flu is a first-generation (sedating) antihistamine indicated for the following uses, classified by strength of evidence:

Established / Approved Uses

• Allergic symptoms: Temporary relief of symptoms associated with seasonal or perennial allergic rhinitis and other upper respiratory allergies, including sneezing, rhinorrhea, itching of the nose or throat, and itchy, watery eyes.
• Urticaria and pruritus: Relief of allergic skin reactions such as hives (urticaria) and itching.
• Motion sickness: Prevention and treatment of nausea, vomiting, and dizziness associated with motion sickness.
• Occasional insomnia: Short-term (OTC) use as a nighttime sleep aid for the relief of occasional sleeplessness.
• Antitussive: Temporary relief of cough due to minor throat and airway irritation associated with the common cold (as an ingredient in some cough/cold combination products).

Guideline-Supported Adjunct Use

• Anaphylaxis and acute allergic reactions: Used as an adjunct to epinephrine (the primary, first-line treatment) to relieve histamine-mediated cutaneous symptoms such as urticaria and pruritus. Bena-Flu is not a substitute for epinephrine in anaphylaxis.

Off-Label Use

• Bena-Flu is sometimes used off-label as an adjunct in the management of drug-induced (extrapyramidal) reactions, such as acute dystonic reactions, under medical supervision.

Each dosage unit contains Diphenhydramine Hydrochloride as the active pharmaceutical ingredient. Diphenhydramine Hydrochloride is available in multiple strengths and dosage forms (e.g., 25 mg and 50 mg tablets/capsules, oral liquid/elixir, and injectable solution for intramuscular or intravenous use), along with pharmaceutically acceptable excipients.

Bena-Flu is a first-generation antihistamine belonging to the ethanolamine chemical class. It works primarily by blocking histamine H1 receptors, which relieves allergy symptoms, and it also has notable anticholinergic, sedative, antiemetic, and local anesthetic properties. Because it readily crosses the blood-brain barrier, Bena-Flu commonly causes central nervous system sedation, which is why it is also used as an over-the-counter sleep aid.

Bena-Flu is available in tablet, capsule, chewable tablet, oral liquid, and injectable forms, and is used both as a single-ingredient product and as a component of combination cough, cold, and allergy formulations.

Bena-Flu belongs to the therapeutic class of first-generation (sedating) antihistamines (H1-receptor antagonists), ethanolamine derivatives.

Diphenhydramine Hydrochloride is a first-generation H1-receptor antagonist. It competitively blocks the action of histamine at peripheral H1 receptors, reducing histamine-mediated symptoms such as itching, sneezing, rhinorrhea, and urticaria.

Because Diphenhydramine Hydrochloride is lipophilic and readily crosses the blood-brain barrier, it also blocks central H1 receptors, producing prominent CNS depression (drowsiness/sedation), which underlies its use as a sleep aid. Diphenhydramine Hydrochloride additionally has anticholinergic (antimuscarinic) activity, which contributes to its antiemetic and antivertigo effects (useful in motion sickness) as well as to side effects such as dry mouth, blurred vision, and urinary retention. It also has weak local anesthetic and antitussive properties.

Pharmacokinetics

• Absorption: Well absorbed orally; onset of action approximately 15-30 minutes.
• Metabolism: Extensively metabolized in the liver (largely via N-demethylation and oxidation).
• Elimination half-life: Approximately 3.4 to 9 hours in adults (may be prolonged in the elderly).
• Excretion: Primarily renal, as metabolites.

Bena-Flu tablets/capsules should be swallowed with water and may be taken with or without food; taking with food may reduce stomach upset. Chewable tablets should be chewed thoroughly. Oral liquid formulations should be measured using an accurate dosing device, not a household spoon.

Injectable Bena-Flu is for administration by a healthcare professional only, via deep intramuscular or slow intravenous injection.

Avoid alcohol and use caution when driving or operating machinery after taking Bena-Flu, due to its sedating effects.

Clinically significant drug interactions with Bena-Flu include:

• Monoamine oxidase inhibitors (MAOIs): Concurrent use is contraindicated. MAOIs prolong and intensify the anticholinergic (drying) effects of Bena-Flu, increasing the risk of anticholinergic toxicity.
• CNS depressants (e.g., alcohol, sedatives, opioids, benzodiazepines): Additive sedative and CNS-depressant effects can occur when taken with Bena-Flu, increasing the risk of excessive drowsiness and impaired psychomotor performance.
• Other anticholinergic drugs (e.g., tricyclic antidepressants, other antihistamines, some antipsychotics): Concurrent use with Bena-Flu can produce additive anticholinergic effects, including confusion, urinary retention, constipation, and blurred vision, particularly in elderly patients.

Common and important side effects of Bena-Flu include:

• Central nervous system: Sedation and drowsiness (most common), dizziness, impaired coordination, headache. Paradoxical CNS excitation (restlessness, insomnia, nervousness, tremor) may occur, particularly in children and the elderly.
• Anticholinergic effects: Dry mouth, nose, and throat; blurred vision; urinary retention; constipation; thickened bronchial secretions.
• Cardiovascular: Palpitations, tachycardia, hypotension (uncommon).
• Gastrointestinal: Nausea, vomiting, loss of appetite.

Severe anticholinergic toxicity can occur with high doses or overdose (see Overdose Effects).

Pregnancy: Bena-Flu should be used during pregnancy only if clearly needed, and only after the potential benefit has been weighed against the potential risk to the fetus. Use near term should be avoided where possible, as antihistamines may be associated with adverse effects in neonates. A physician should be consulted before use during pregnancy.

Lactation: Bena-Flu is excreted in breast milk. It may cause sedation, irritability, or other effects in a nursing infant, and may also suppress milk production, particularly in early lactation. Use during breastfeeding is not recommended unless clearly needed and only under medical advice.

The following precautions apply to the use of Bena-Flu:

• Sedation: Bena-Flu causes drowsiness. Patients should avoid driving, operating machinery, or performing other hazardous tasks requiring mental alertness until they know how it affects them, and should avoid alcohol and other CNS depressants.
• Elderly patients: Bena-Flu should generally be avoided or used with caution in the elderly, who are more sensitive to its anticholinergic effects and sedation, with increased risk of confusion, dizziness, falls, and urinary retention.
• Not for chronic use as a sleep aid: Bena-Flu is intended for occasional, short-term use for sleeplessness; a physician should be consulted if insomnia persists beyond 2 weeks.
• Respiratory conditions: Use with caution in patients with asthma, chronic obstructive pulmonary disease, or other lower respiratory conditions, as the anticholinergic effect can thicken bronchial secretions.
• Hepatic or renal impairment: Use with caution; clearance may be reduced, increasing risk of side effects.
• See Contraindications for absolute restrictions (hypersensitivity, MAOIs, narrow-angle glaucoma, symptomatic prostatic hypertrophy, newborns/premature infants).

Overdose of Bena-Flu can cause significant anticholinergic toxicity, including flushed skin, dilated pupils, dry mouth, fever, agitation, hallucinations, tremor, involuntary movements, tachycardia, urinary retention, and in severe cases, seizures, arrhythmias, and coma. In young children, overdose may present with paradoxical excitation rather than sedation.

Suspected overdose of Bena-Flu is a medical emergency. Seek immediate medical attention or contact a poison control center / emergency services right away. Treatment is generally supportive and should be provided in a hospital setting; do not attempt specific home treatment.

Store at room temperature (below 30°C), away from light and moisture. Keep out of reach of children.

Pediatric patients: Bena-Flu is not recommended for children under 6 years of age except under medical supervision, and is not to be used to sedate a child. Use in newborns or premature infants is contraindicated. Paradoxical excitation is more common in children.

Elderly patients: Increased sensitivity to the anticholinergic and sedative effects of Bena-Flu is expected in older adults; use with caution due to higher risk of confusion, dizziness, falls, urinary retention, and constipation. Regular use as a sleep aid in the elderly is generally discouraged.

Renal/hepatic impairment: Use with caution and consider reduced doses or longer dosing intervals, as clearance of Bena-Flu may be reduced.

For allergic symptoms and motion sickness, Bena-Flu is generally used on an as-needed, short-term basis. As an OTC sleep aid, use should be limited to occasional sleeplessness and not continued beyond 2 weeks without consulting a physician. Longer or continuous use for any indication should be guided by a healthcare professional.

First-generation antihistamine (H1-receptor antagonist); ethanolamine derivative

Diphenhydramine Hydrochloride acts as a competitive antagonist at histamine H1 receptors, both peripherally (relieving allergic symptoms) and centrally (producing sedation, due to crossing the blood-brain barrier). It also exhibits anticholinergic (antimuscarinic) activity, contributing to its antiemetic/antivertigo effects, and has mild local anesthetic and antitussive properties.

Category B

Bena-Flu is contraindicated in newborn and premature infants. In children under 6 years of age, it should be used only under the guidance of a physician, and it should not be used to sedate or quiet a child. In children 6 years and older, oral dosing follows age-based guidelines (see Dosage and Administration). Paradoxical excitation (hyperactivity, nervousness, insomnia) may occur in children and should prompt discontinuation. Safety and efficacy of Bena-Flu for indications outside these established age-based uses have not been established.