Friday 10 November 2017

Safe use of subcutaneous diphenhydramine in the inpatient hospice unit

American Journal of Hospice and Palliative Medicine, 2017 34(10) p954-957
Chen A1, Loquias EJ1, Roshan R, Levene R, Zelhof R, Hickey T, Cooney GA, Gonzalez F.

Although commonly administered in an impatient setting via the subcutaneous (SC) route, outside the hospice setting subcutaneous DPH has not been widely used, primarily because of a handful of case reports published in the 1990s that report skin necrosis following subcutaneous administration of DPH for local anesthesia. 
In this study a total of 648 diphenhydramine subcutaneous injections were administered in 109 individual patients. None of the patients were reported to have an adverse cutaneous reaction. The authors suggest that this review demonstrates that subcutaneous diphenhydramine injection is a safe alternative to oral and other parenteral routes, and may be particularly valuable in terminally ill patients, who are often unable to swallow and are without IV access.