More than two years after allergy experts recommended newer antihistamines and warned against using Benadryl as a first-line treatment, many Canadians are still reaching for that recognizable brand name over others.
In October 2019, the Canadian Society of Allergy and Clinical Immunology (CSASI) put out a position statement regarding oral allergy medication, stating that newer antihistamines were safer than first-generation ones, and that they should be recommended over older staples like Benadryl due to a higher rate of potential side effects. The position statement referred specifically to medications that treat non-life-threatening allergic reactions such as hay fever and hives.
If it’s news to you that Benadryl is no longer recommended as a first-line treatment for common allergies, you’re not the only one. In 2022, it’s not only adult patients and parents who are still influenced by brand familiarity and haven’t made the switch — some doctors are as well, experts say.
“I think there are a fair number of pediatricians who still recommend Benadryl for allergies,” Daniel Flanders, owner and executive director of Kindercare Pediatrics in Toronto, Ontario, told CTVNews.ca in a phone interview.
“And if you speak to an allergist, they would simply say that that’s outdated advice.”
Benadryl is one of the most well-known brands for allergy medication, with numerous products available to buy without a prescription, including versions specifically made for children. Benadryl is approved by Health Canada, which has deemed it safe for over-the-counter use, concluding in a recent safety review of first-generation antihistamines that there hasn’t been any change in risk that would prompt it to change the drug to prescription-only.
While both first and second-generation antihistamines bind to receptors in the brain and spinal cord to block the release of histamines — the chemicals that cause allergy symptoms — first-generation crosses the blood-brain barrier and causes more sedation in patients, something that was corrected in second-generation antihistamines.
Because of this difference, first-generation antihistamines like Benadryl are associated with more side effects such as increased drowsiness, issues with motor functions and working memory, as well as a risk of hallucination or even death in the event of an overdose.
But if many experts have believed for years that Benadryl shouldn’t be the first choice for oral allergy medication anymore, why are many Canadians and doctors unaware of this?
“Unfortunately far too often, physicians and other health-care practitioners, including pharmacists and paramedics, continue to commonly recommend Benadryl as a first line antihistamine for treatment of allergic symptoms, including symptoms from food allergy,” CSACI told CTVNews.ca in an email, adding that its 2019 messaging has “still not reached many health-care practitioners.”
Flanders said that while he’s not aware of any doctors in his clinic still recommending Benadryl, there are likely many across Canada still turning to the well-known allergy medication to treat mild allergies.
“I would say probably for 10 years it has been the case that we’ve known that it’s better to use the second and third generation antihistamines preferentially over Benadryl, but […] one of the funny things about medicine is that it does take a long time for information to trickle down from research through to practice,” he said.
“It is measured in years. It’s not uncommon, but it takes a good 10 years for the standard of care for the practice to adjust to some of the changes that science discovers.”
Flanders said if he had to make an estimate, anywhere from 25 to 50 per cent of pediatricians may still be recommending Benadryl as a first line treatment, though he cautioned that this is just his personal assessment.
“I’m hopeful that more than half of my colleagues are making that correct recommendation [instead of Benadryl],” he said.
A big reason that Benadryl is still recommended by health-care professionals is the familiarity of that brand name, which has been a giant in allergy medication for decades.
“Benadryl has so much recognition as an allergy remedy,” Flanders said. “The trade name is so well known, and so commonly used that I could imagine it would take a whole lot of work to sort of deprogram and reprogram parents’ minds. And also the minds of doctors who are not sort of keeping up with the cutting edge [of medicine].”
It was a sentiment that CSACI echoed.
“The familiarity of health-care practitioners, parents and adult patients with Benadryl and other first generation antihistamines makes it difficult to motivate changes in practice,” the organization said.
WHY DID CSACI DECIDE BENADRYL SHOULDN’T BE RECOMMENDED?
More than two years ago, CSACI put out a paper explaining that newer antihistamines are just as effective and safer than first-generation antihistamines such as Benadryl, and that they should always be recommended over older antihistamines.
The active ingredient in Benadryl sold in Canada is diphenhydramine, and it’s one of the oldest first-generation antihistamines, having been available for sale since 1946.
In the position statement, CSASI explained that older antihistamines are associated with more severe side effects than second and third generation antihistamines which became available in Canada starting in the 1980s and had to pass high-quality trials.
“It is always preferred to use safer and more effective medications,” CSACI told CTVNews.ca in an email. “First generation antihistamines are significantly more likely to cause side effects, including sedation, poor sleep quality, and poor cognitive performance (including poor school and work performance). In addition, overdoses of first generation antihistamines can cause severe toxicity.”
Johnson & Johnson, the company that sells Benadryl in Canada, did not respond to a request for comment from CTVNews.ca.
In 2019, the company told the Canadian Press that “Benadryl products have been trusted by doctors and moms for more than 60 years to provide effective symptom relief from allergies and allergic reactions,” and that the products are approved by Health Canada and “when used as directed, are safe and effective.”
CSACI’s position statement explained that newer antihistamines have less serious side effects associated with them, and that as of 2019, accidental exposure to higher levels of second and third generation antihistamines had not resulted in severe adverse events, unlike first generation antihistamines.
In 2020, a TikTok “challenge” spurred some teenagers to take enough Benadryl to induce hallucinations, which resulted in several teens being rushed to hospital.
The CSACI statement mentioned that in Canada, online surveys had shown that Benadryl was, at the time, the “most recommended antihistamine for allergic symptoms in children in each of the last 7 years.”
WHY IS BENADRYL STILL AVAILABLE OVER THE COUNTER?
It’s important to note that Benadryl isn’t considered dangerous — when instructions are followed, serious side effects are rare.
CSACI’s position was that there are new options that are just as effective and have fewer side effects overall, or milder side effects.
“I wouldn’t so much say that one should never use [Benadryl], it just doesn’t make sense to use it currently or in present day, because there are alternatives that are just as good and have a better side effect profile,” Flanders explained.
“Why would you take a medication that you know has significant side effects when you can take another medication that does the exact same thing, but without the side effects?”
After CSACI released this position statement in 2019, there was a flurry of articles that questioned whether Benadryl should be available as over-the-counter medication. As a result, Health Canada announced that while products containing diphenhydramine met the requirements of the Food and Drugs Act, they would be assessing “to determine if further risk mitigation measures for diphenhydramine-containing products are required,” noting that the safety of children was a big concern of the Canadian public.
On March 1 of this year, Health Canada posted a summary of that safety review, which focused on whether there have been any increases in frequency of the known side effects associated with oral, over-the-counter diphenhydramine in children under two years old or an increase in frequency of overdoses in children under 18.
“There are no new safety concerns to warrant regulatory action at this time,” Health Canada stated in the monthly Health Product InfoWatch.
Flanders believes that one of the factors driving Benadryl’s enduring ubiquity in the minds of Canadians is because it’s available so easily.
“I think it would make sense to take Benadryl off the list of over-the-counter allergy medications, because just there are better options and there are side effects and those can have long term implications,” he said.
“And that might be a nice way to sort of educate or to leave the general public with no choice but to choose a more appropriate medication.”
In 2019, some pharmacists pointed out that putting Benadryl behind the counter doesn’t solve the safety issues, and could cause conflict if customers are still pushing for it.
Nardine Nakhla, a pharmacist who teaches at the University of Waterloo in Ontario, said at the time that there are many other products that contain diphenhydramine that are on the shelves, making it unrealistic to pull all of them, and that there are other products available over the counter that have safety concerns, making this a complicated problem.
IF I HAVE BENADRYL AT HOME, SHOULD I KEEP USING IT FOR MYSELF OR MY KIDS?
For CSACI, it’s pretty straightforward.
“It is strongly encouraged that parents replace older first generation antihistamines such as Benadryl in their medicine cabinets with newer generation antihistamines,” it stated.
Flanders said that his advice depends on a family’s budget.
“If the purchase was made and there isn’t much money in the budget and there’s really bad allergy symptoms that need to be controlled, then Benadryl will do the trick, so I think it’s reasonable to complete the package,” he said. “And then next time you need it, buy the newer generation antihistamine.”
But if the cost of replacing the Benadryl immediately isn’t a concern, “then I would go right ahead and buy the new one and throw out the Benadryl, because there’s better options,” he said.
CSACI’s position statement pertained to all ages, but Flanders said that as a pediatrician, he is more concerned about making sure that children are receiving the best medication for whatever ails them.
“I think there’s an added dimension of risk for children because they’re still developing and they’re still in a very formative period of their lives. So if a child is chronically sleep deprived, I think there are more dire long term consequences,” he said, referring to side effects for Benadryl pertaining to poor sleep.
“For kids who are going to be taking it on a regular basis, it does interfere with the quality of their sleep and it can interfere with learning and with their sort of day to day functioning. It’s not like it’s the end of the world if you take Benadryl periodically for allergy relief, it’s just, there’s better options.”
WHICH NEWER ANTIHISTAMINES ARE PREFERRED?
CSACI gave CTVNews.ca a list of newer antihistamines currently available in Canada that it recommends over first-generation antihistamines:
bilastine (Blexten)
cetirizine (Reactine)
desloratadine (Aerius)
fexofenadine (Allegra)
loratadine (Claritin)
rupatadine (Rupall)
“Many of these are available over-the-counter, some of which are also available as generic preparations, and others are only available by prescription,” CSACI stated.
Skinstitut Holiday Gift Kits take the stress out of gifting
Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.
In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.
“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.
There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.
Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.
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In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.
Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.
Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.
LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?
It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.
Here’s how you can prepare your digital life for your survivors:
Apple
The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.
For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.
You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.
Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.
Google
Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.
When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.
You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.
There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.
Facebook and Instagram
Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.
When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.
The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.
You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.
TikTok
The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.
Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.
X
It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.
Passwords
Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?
Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.
But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.
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Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.
The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.
New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.
The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.
Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.
Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.
“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.
“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”
McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.
But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.
The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.
He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.
“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.
“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.
McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”
McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.
He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.
“Early identification of reading difficulty can truly change the trajectory of a child’s life.”
This report by The Canadian Press was first published Oct. 23, 2024.
