diphenhydramine / Generic mfg. - LARVOL DELTA

Real-world step-up dosing of patients receiving elranatamab for multiple myeloma in Japan (ASH 2025) - "Almost all patients received dexamethasone during the SUD period (Group A: 192 [99.5%], Group A+B: 217 [99.5%]) and acetaminophen (Group A: 191 [99.0%], Group A+B: 216 [99.1%]). Other supportive medications received include diphenhydramine (Group A: 109 [56.5%], Group A+B: 124 [56.9%]) and tocilizumab (Group A: 101 [52.3%], Group A+B: 120 [55.0%])...Both the frequency and timing of CRS and ICANS were generally consistent with past findings from elranatamab clinical trials. Despite the occurrence of CRS and ICANS events, many patients continued to receive complete and timely SUD."

Clinical • Real-world • Real-world evidence • Hematological Malignancies • Inflammation • Multiple Myeloma

Prophylactic tocilizumab in Relapsed/Refractory multiple myeloma patients treated with bispecific antibodies: A single centre experience (ASH 2025) - "Twelve patients (46%) had received previous anti-BCMA therapy (8 belantamab, 2 both belantamab and teclistamab, 1 teclistamab and 1 idecel). Talquetamab was administered to 16 patients (61%), teclistamab to 8 (30%), elranatamab to 2 (8%)...Premedication for each step up dose included dexamethasone, acetaminophen and diphenhydramine...This data supported, in our center, the use of prophylactic tocilizumab in outpatient setting. Given these results, even if all CRS events were grade 1, remained fully manageable and ICANS were rare, the use of prophylactic tocilizumab could improve treatment safety, inpatient management, and ultimately support feasibility in the outpatient regimen."

Clinical • Hematological Disorders • Hematological Malignancies • Inflammation • Multiple Myeloma • Neutropenia • Thrombocytopenia

Multisystem flare of systemic lupus erythematosus presenting with severe warm autoimmune hemolytic anemia: A diagnostic and transfusion challenge (ASH 2025) - "Case Presentation: A 43-year-old woman with established SLE (diagnosed in 2016), previously treated with hydroxychloroquine and methotrexate, presented with fatigue, jaundice, dark urine, and right upper quadrant discomfort...The patient was premedicated with IV methylprednisolone and diphenhydramine and transfused with two units of the least incompatible RBCs...She received methylprednisolone 1 g IV daily for three days, followed by oral prednisone (1 mg/kg/day)... Severe wAIHA in SLE demands rapid diagnosis, interdepartmental collaboration, and flexibility in transfusion strategies. The least incompatible RBC transfusion, combined with immunosuppressive therapy, can be lifesaving. Comprehensive evaluation of systemic involvement is essential in such complex flares."

Anemia • Autoimmune Hemolytic Anemia • Autoimmune Hepatitis • Hematological Disorders • Hepatology • Immunology • Infectious Disease • Inflammation • Inflammatory Arthritis • Lupus • Solid Tumor • Systemic Lupus Erythematosus • Uterine Leiomyoma

IV diphenhydramine is not associated with poor outcomes among hospitalized people with sickle cell disease. (ASH 2025) - "Opioid exposure was standardized to oral morphine milligram equivalents per day (MME/day), calculated for the entire admission or, among patients who developed ACS, prior to the diagnosis. Despite some indication in the published literature of the opposite, use of IV diphenhydramine was not associated with acute chest syndrome in patients with sickle cell disease. However, the incidence of acute chest syndrome was associated with higher MME/day."

Clinical • Cough • Genetic Disorders • Hematological Disorders • Pruritus • Respiratory Diseases • Sickle Cell Disease

Motixafortide + G-CSF hematopoietic stem cell mobilization in patients with multiple myeloma following quadruplet induction therapy (ASH 2025) - P1, P3 | "All patients received"enhanced" premeds with: loratadine (10 mg, PO), famotidine (20 mg, PO) and montelukast (10 mg, PO)daily on Day 1-5; plus acetaminophen (975mg, PO), hydrocortisone (200 mg, IV), diphenhydramine (25mg, IV) and famotidine (20 mg, IV) on Day 4 (30-45 mins pre-M). Meanwhile,enhanced premeds were associated with a low rate of AEs relative to standard premeds. Ongoingextended immunophenotyping may shed insight into the mechanism of impaired HSC mobilization post-quad induction, possibly via targeted depletion of a large population of CD38+ HSCs within the CD34+graft."

Clinical • Dermatology • Hematological Malignancies • Multiple Myeloma • Pruritus • CD34

Reducing premedication use with intravenous iron in the outpatient setting: A quality improvement project (ASH 2025) - "Premedication with acetaminophen and diphenhydramine are often ordered for IV ironinfusions, but these do not prevent reactions, can worsen reactions, and lead to longer appointmenttimes... Educational interventions for the hematology department and infusion center staff on thesafety of IV iron formulas, reduced the rate of premedication ordered for IV iron treatment plans from5.4% to 0.8%, an overall reduction in 85.1%, with no increase in the use of hypersensitivity reactionmedications. Total saved time post intervention was 480 minutes over 3 months between PDSA 1 and 2.Continued focus on specific populations, i.e. pregnant women, receiving IV iron formulations is necessarygiven hospital admissions noted post infusion for BP monitoring. We hope to showcase theseencouraging results regarding the safety of IV iron to other departments and across the enterprise.Future directions include removing premedication orders from standardized electronic medical recordordering plans."

Clinical • Hematological Disorders • Immunology

A standardized rapid dose escalation of epcoritamab for patients with lymphoid malignancies (ASH 2025) - "Supportive care with 500 ml intravenous fluids,dexamethasone (dex) 16 mg, acetaminophen 650 mg, and diphenhydramine 50 mg was administered 30-120 minutes prior to each epco injection, including through the completion of cycle (C) 1...Three pts received epco incombination with gemcitabine and oxalipatin...CRS was treated with tocilizumab (toci) alone in all 3 pts... We report a standardized process with enhanced supportive care in C1 for a rapid doseescalation of epco, enabling pts to achieve the 1st full therapeutic dose on D 7. This approach hasdemonstrated feasibility and safety. All CRS events were low grade and resolved quickly."

Clinical • B Cell Lymphoma • Chronic Lymphocytic Leukemia • Diffuse Large B Cell Lymphoma • Follicular Lymphoma • Hematological Malignancies • High-grade B-cell lymphoma • Large B Cell Lymphoma • Lymphoma • Non-Hodgkin’s Lymphoma • Oncology

Combined mosunetuzumab and zanubrutinib for the treatment of patients with newly diagnosed high-burden follicular lymphoma: First results of the multicenter phase 2 mithic-FL2 trial (ASH 2025) - "Premedication with single-dose dexamethasone, diphenhydramine, andacetaminophen was mandatory before each mosun dose in C1 (and C2 if cytokine release syndrome(CRS) occurred in C1), optional thereafter. We report the first study of combined zanubrutinib and mosunetuzumab in pts withpreviously untreated high-burden FL. AEs were manageable and the safety profile was as expected forthe individual agents, with no new safety signals observed. Most patients achieved a complete metabolicresponse."

Clinical • P2 data • Acute Kidney Injury • Atrial Fibrillation • B Cell Lymphoma • Cardiovascular • Dermatology • Diffuse Large B Cell Lymphoma • Follicular Lymphoma • Hematological Disorders • Hematological Malignancies • Hemophagocytic lymphohistiocytosis • Immunology • Infectious Disease • Lymphoma • Nephrology • Neutropenia • Non-Hodgkin’s Lymphoma • Rare Diseases • Renal Disease • CD20

Daratumumab for relapsed/refractory primary effusion lymphoma, plasmablastic lymphoma and multicentric castleman disease. (ASH 2025) - P2 | "To avoid systemic injection-related reactions,acetaminophen, diphenhydramine premedication will be administered before every Dara dose.Corticosteroids will be administered mandatorily in the first three doses prior to and after Dara.Responses for PEL and PBL will be assessed using a modified version of the International Working GroupResponse Criteria for Malignant Lymphoma (Cheson BD et al., J Clin Oncol 2007). A similar subgroup analysis will be performed for MCD. Progression-free survival and overall survival will be estimated separately by disease type using the Kaplan-Meiermethod, with 95% confidence intervals calculated for median PFS."

Clinical • IO biomarker • B Cell Non-Hodgkin Lymphoma • Epstein-Barr Virus Infections • Hematological Malignancies • Human Immunodeficiency Virus • Infectious Disease • Kaposi Sarcoma • Lymphoma • Multiple Myeloma • Non-Hodgkin’s Lymphoma • Rare Diseases • Sarcoma • Solid Tumor • CD20 • IRF4 • PTPRC • SDC1 • TINCR

Targeted LC-MS/MS method for quantifying respiratory pharmaceuticals in wastewater. (PubMed, Environ Sci (Camb)) - "Application to 12 neighborhood-level wastewater samples detected 9 of the 10 target compounds, with 6 (albuterol, amoxicillin, azithromycin, cetirizine, diphenhydramine, and fexofenadine), detected above their quantification limits. Fexofenadine was the most abundant, reaching 3309 ng L-1. This robust, low-volume, high-throughput LC-MS/MS method enables the reliable detection of respiratory pharmaceuticals in wastewater, supporting WBE applications for pharmaceutical use surveillance."

Journal • Respiratory Diseases

Pharmacokinetic assessment and metabolic stability of a novel multi-targeted Clk/Dyrk inhibitor using a validated LC-MS/MS method: In vitro and in vivo insights. (PubMed, J Chromatogr B Analyt Technol Biomed Life Sci) - "Diphenhydramine was used as the internal standard...The oral bioavailability (F) was calculated to be 19.62 %. Collectively, these findings highlight compound BHBC-01's favorable pharmacokinetic and stability profiles, supporting its potential as a drug candidate for further clinical development as a multi-target anticancer agent."

Journal • PK/PD data • Preclinical • Oncology • DYRK1B

Motion Sickness: Multiple Linear Regression Identifies Behaviours Linked to Motion-Induced Emesis in Suncus murinus (House Musk Shrew). (PubMed, Eur J Pharmacol) - "Administration of two anti-MS drugs, diphenhydramine (30 mg/kg, s.c.) and scopolamine (10 mg/kg, s.c.), significantly reduced the MS symptom score from 14.25 ± 1.89 to 7.84 ± 0.85 and from 18.11 ± 2.28 to 11.91 ± 0.87 respectively, indicating the validity of the scoring system as a quantitative measure of motion-induced 'sickness', 'malaise', and even 'nausea' in this species. Shapley additive explanation (SHAP) analysis further indicated the contributions of two individual spontaneous behaviours, stationary duration and chin on the floor episode, to MS prediction. Our findings suggest that this behavioural scoring system provides a reliable and translationally relevant tool for studying MS and screening potential anti-emetic treatments for humans."

Journal

Focused ultrasound delivery of enzyme replacement therapy to the brain of Gaa-/- Pompe disease mice. (PubMed, Mol Genet Metab) - "We investigated GAA delivery and glycogen accumulation in 5-month-old Gaa-/- knockout mice following administration of two clinically available rhGAA ERTS (alglucosidase alfa and avalglucosidase alfa) at different dosages with and without FUS-BBB opening over four biweekly treatment sessions...Diphenhydramine was administered intraperitoneally 10 min before ERT to avoid anaphylactic response...Biochemical analysis supported these results, showing an increase in GAA enzyme activity and reduction in glycogen content for FUS + ERT treated mice compared to No FUS + ERT groups. Future work will determine if this promising treatment paradigm can rescue disease phenotypes that are downstream of glycogen accumulation and work towards clinical translation."

Journal • Preclinical • Pompe Disease

Effective Prevention of Steroid-Requiring Chronic Graft-Vs.-Host Disease with B Cell Depletion: A Randomized, Placebo-Controlled Trial (ASH 2023) - "B cells are involved in cGVHD pathobiology, and strategies that eliminate or inhibit B cells (rituximab, ibrutinib) can be therapeutic in advanced disease...Obinutuzumab (Obin, Genentech) is a 2nd generation monoclonal anti-CD20 antibody with enhanced B cell depletion activity over rituximab...Obin (1000 mg iv) or placebo was administered at 3, 6, 9 and 12 months after HSCT (+/- 10 days) with acetaminophen and diphenhydramine prior to each study drug dose... In subjects undergoing well-matched PBSC HSCT using tacrolimus-based GVHD prophylaxis, a strategy of B cell depletion with 4 doses of Obin significantly reduces the requirement for corticosteroids for treatment of cGVHD and significantly increases CRFS. Obin is well tolerated and is associated only with transient neutropenia. Further studies may determine whether prolonged B cell depletion may be of greater utility, however this double-blind, placebo-controlled randomized trial supports practice changing cGVHD..."

Clinical • Acute Graft versus Host Disease • Bone Marrow Transplantation • Chronic Graft versus Host Disease • Febrile Neutropenia • Graft versus Host Disease • Hematological Disorders • Immunology • Infectious Disease • Neutropenia • Novel Coronavirus Disease • Respiratory Diseases • CD27

Trial in Progress: Phase 2 Study of Subcutaneous Isatuximab, Administered By an on-Body Delivery System, in Combination with Weekly Carfilzomib and Dexamethasone in Patients with Relapsed/Refractory Multiple Myeloma (SubQSA) (ASH 2024) - P1, P2 | "Intravenous (IV) Isa is currently approved to treat relapsed and/or refractory multiple myeloma (RRMM) in combination with pomalidomide and dexamethasone (Isa-Pd) or carfilzomib and dexamethasone (Isa-Kd)...In addition to dexamethasone, patients will receive premedication for IRs with montelukast (C1 only), acetaminophen, and diphenhydramine...ORR will be summarized with a two-sided 95% confidence interval by the Clopper-Pearson method. This study is not yet recruiting."

Clinical • Combination therapy • P2 data • Hematological Malignancies • Lymphoma • Multiple Myeloma • Oncology

Death due to diphenhydramine toxicity: A 9-year review from the Cook County Medical Examiner's Office and a review of the literature. (PubMed, J Forensic Sci) - "DPH-only toxicity should be carefully considered in postmortem investigations, especially due to the lack of specific autopsy findings and the wide range of postmortem concentrations in all matrices. Circumstantial evidence, scene findings, and reference to the available literature are essential for the accurate certification of the cause and manner of death in such cases."

Journal • CNS Disorders • Depression • Gastrointestinal Disorder • Psychiatry • Respiratory Diseases

Preoperative Aprepitant Decreases Postoperative Nausea After Laparoscopic Sleeve Gastrectomy. (PubMed, R I Med J (2013)) - "The addition of preoperative aprepitant to a multimodal protocol can reduce nausea after laparoscopic sleeve gastrectomy."

Journal • Retrospective data • Gastrointestinal Disorder

Opioid-Induced Pruritus: A Case Series on Novel Uses of Nalbuphine in the Emergency Department. (PubMed, J Am Coll Emerg Physicians Open) - "Opioid-induced pruritus is a frequent and distressing adverse effect of mu-opioid receptor agonists, often unresponsive to antihistamines such as diphenhydramine...We present 2 cases highlighting nalbuphine's utility in the emergency department: one demonstrating prophylactic low-dose nalbuphine (2.5 mg IV) coadministered with hydromorphone in a pruritus-prone patient and one where nalbuphine (10 mg IV) served as a primary analgesic. In both cases, patients achieved pain relief without experiencing pruritus or sedation. These cases underscore nalbuphine's potential as a safe and evidence-informed alternative in acute care settings."

Journal • Anesthesia • Dermatology • Pain • Pruritus

30-Minute Infusion of Isatuximab in Newly Diagnosed Multiple Myeloma (NDMM) Patients: Results of a Phase 1b Study (ASH 2023) - P1, P1/2 | "Introduction: The anti-CD38 antibody isatuximab (Isa) is approved in various countries with pomalidomide-dexamethasone for relapsed/refractory multiple myeloma (RRMM) patients (pts) with ≥2 prior therapies including lenalidomide and a proteasome inhibitor, based on the ICARIA-MM study, and with carfilzomib-dexamethasone for RRMM pts with ≥1 prior therapy, based on the IKEMA study...Results previously reported from this study showed efficacy of treatment with Isa in combination with bortezomib-cyclophosphamide-dexamethasone (VCd) or bortezomib-lenalidomide-dexamethasone (VRd), with manageable safety profiles...]), acetaminophen (paracetamol) 650 to 1000 mg PO; ranitidine 50 mg IV (or eq. ), diphenhydramine 25 to 50 mg IV (or eq. ), and montelukast 10 mg PO (or eq... These preliminary results show that 30-min infusion of Isa is a feasible, well-tolerated, and convenient administration method for pts with multiple myeloma on Isa treatment for several months. The..."

Clinical • P1 data • Hematological Malignancies • Leukemia • Multiple Myeloma • Oncology

Phase I Trial of Systemic Administration of Vesicular Stomatitis Virus Genetically Engineered to Express NIS and Human Interferon, in Patients with Relapsed or Refractory Multiple Myeloma, Lymphomas, or Histiocytic/Dendritic Cell Neoplasms (ASH 2023) - P1 | "The virus was administered via IV infusion over 30 minutes, and patients received 650 mg acetaminophen and 50 mg diphenhydramine hydrochloride before infusion and every 6 hours for 24 hours to manage fever and hypotension...Ruxolitinib is added from days 2-5 or day -1 to day 9 depending on the arm to mitigate IFNβ toxicity...Spearman rank correlation tests are used evaluated correlations between laboratory-based measures, and Wilcoxon rank sum tests compared continuous measures between response groups. Response rates will be summarized by DL and disease group, with estimated response rates and corresponding 95% binomial confidence intervals calculated."

Clinical • P1 data • B Cell Lymphoma • Hematological Malignancies • Hypotension • Lymphoma • Multiple Myeloma • Non-Hodgkin’s Lymphoma • Oncology • Plasmacytoma • T Cell Non-Hodgkin Lymphoma • IFNB1

Diphenhydramine overdose in an older adult with neuropsychiatric and cardiovascular comorbidities: a case report. (PubMed, Am J Med) - No abstract available

Journal • Cardiovascular • CNS Disorders • Movement Disorders • Parkinson's Disease • Psychiatry

Implementation of an Adult Sickle Cell Center Directly Correlates with Improved Patient Outcomes and Decreased Acute Care Utilization (ASH 2023) - "In line with other adult sickle cell centers, we eliminated use of parenteral diphenhydramine as well intermittent parenteral opioid bolus use...With IASC opening, we were able to begin implementation of disease modifying therapies including enhanced hydroxyurea compliance as well as initiation of vaccinations and screening studies including nephropathy and iron overload... Individuals with SCD without a ‘medical home’ face many barriers to care including access to regular clinic visits where ongoing education and gaps in care can be identified including physical, psychological, and social impact. It is important for sickle cell providers to account for all aspects of a patient's well-being when devising individual treatment strategies. Caring for a sickle cell patient is complex and time consuming and best done by sickle cell disease experts in a dedicated center."

Clinical • Anesthesia • Genetic Disorders • Hematological Disorders • Renal Disease • Sickle Cell Disease

Asparaginase-Associated Toxicities and Hypersensitivity Reactions in Pediatric and Adolescent Down Syndrome Patients with Acute Lymphoblastic Leukemia or Lymphoma (ASH 2023) - "Pegaspargase (PEG) is integral in protocols for the treatment of pediatric ALL and lymphoblastic lymphoma (LBL), and full exposure to all doses of PEG can be limited by toxicities, including hypersensitivity reactions (HSR) due to the production of anti-asparaginase antibodies rendering PEG therapy ineffective...An H1 blocker (diphenhydramine) and H2 blocker (ranitidine, famotidine or cimetidine) were administered prior to PEG administration in consolidation and subsequent cycles...Most toxicity occurred during the consolidation phase and no grade 4 or 5 toxicities were observed. Given the PEG-associated toxicity observed in DS ALL/LBL, we are conducting pharmacokinetic analysis to propose a lower dose of PEG which may minimize toxicity while maintaining therapeutic efficacy."

Clinical • Acute Lymphocytic Leukemia • Developmental Disorders • Genetic Disorders • Hematological Malignancies • Hepatology • Immunology • Leukemia • Lymphoma • Obesity • Oncology • Pediatrics

Successful Management of D816V Mutated c-KIT Systemic Mastocytosis with Chronic Imatinib: A Case Report (ASH 2023) - "When reactions did occur, she treated them at one point with a cocktail of an histamine-2 blocker (ranitidine), histamine-1 blocker (diphenhydramine), and a mast cell stabilizer (cromolyn) and without requiring the use of epinephrine...After the most recent BMB the patient altered her daily regimen due to gastric upset and found she could take of her histamine-1 blocker (diphenhydramine) once daily along with a twice daily regimen of her imatinib (split into two smaller daily doses), histamine-1 antagonist (cetirizine), her histamine-2 antagonist (famotidine), and citalopram (selective serotonin reuptake inhibitor or SSRI) with improved symptomatic control to this day. This case serves to illustrate the diagnostic and therapeutic challenges associated with SM, as well as the potential therapeutic use of imatinib in patients with D816V outside of its original FDA indication. Further characterization of the effect of imatinib on D816V mutated SM may warrant the..."

Case report • Clinical • Atrial Fibrillation • Endocrine Disorders • Gastroenterology • Gastroesophageal Reflux Disease • Hematological Disorders • Metabolic Disorders • Myeloproliferative Neoplasm • Oncology • Rare Diseases • FLT3 • IDH1 • IDH2 • KIT • NPM1

Real-World Treatment Outcomes of Teclistamab Under an Outpatient Model for Step-up Dosing Administration (ASH 2023) - "Among patients who were admitted for CRS (n=12), the majority were treated with acetaminophen (92%), diphenhydramine (83%) and dexamethasone (83%); tocilizumab was given to the 2 patients with CRS grade 2 or higher. Conclusion This study evaluated early RW safety outcomes of teclistamab under an outpatient administration model and found the CRS rate and severity to be comparable with other RW evidence generated from various data sources. Outcomes related to teclistamab SUD from Mayo Clinic supported the safety and feasibility of outpatient administration model as a potential option to reduce healthcare resource utilization and improve treatment experiences."

Clinical • HEOR • Real-world • Real-world evidence • Anemia • Cardiovascular • Hematological Disorders • Hematological Malignancies • Hypertension • Inflammation • Multiple Myeloma • Neutropenia • Oncology • Renal Disease