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diphenhydramine and ibuprofen

Generic Name: diphenhydramine and ibuprofen (DYE fen HYE dra meen and EYE bue proe fen)
Brand Name: Advil PM, Advil PM Liqui-Gels, Ibuprofen PM, Motrin PM

What is diphenhydramine and ibuprofen?

Diphenhydramine is an antihistamine that reduces the effects of natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose. Antihistamines can cause drowsiness, which can aid in the treatment of occasional sleep problems (insomnia).

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). Ibuprofen works by reducing hormones that cause inflammation and pain in the body.

Diphenhydramine and ibuprofen is a combination medicine used to treat occasional insomnia associated with minor aches and pains.

Diphenhydramine and ibuprofen is not for use in treating sleeplessness without pain, or sleep problems that occur often.

Diphenhydramine and ibuprofen may also be used for purposes not listed in this medication guide.

What is the most important information I should know about diphenhydramine and ibuprofen?

Ibuprofen can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Ibuprofen may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using ibuprofen, especially in older adults.

What should I discuss with my healthcare provider before taking diphenhydramine and ibuprofen?

Ibuprofen can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Even people without heart disease or risk factors could have a stroke or heart attack while taking this medicine.

Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Ibuprofen may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using ibuprofen, especially in older adults.

You should not use this medicine if you are allergic to diphenhydramine or ibuprofen, or if you have ever had an asthma attack or severe allergic reaction after taking aspirin or an NSAID.

Ask a doctor or pharmacist if it is safe for you to use this medicine if you have other medical conditions, especially:

  • heart disease, high blood pressure;

  • a history of heart attack, stroke, or blood clot;

  • a history of stomach ulcers or bleeding;

  • a breathing problem, such as asthma, emphysema, or bronchitis;

  • liver or kidney disease;

  • glaucoma;

  • enlarged prostate or problems with urination; or

  • if you drink 3 or more alcoholic beverages per day.

This medicine may be harmful to an unborn baby. Taking ibuprofen during the last 3 months of pregnancy may result in birth defects and prolonged labor and delivery. Do not use this medicine without a doctor's advice if you are pregnant.

Diphenhydramine and ibuprofen may pass into breast milk and may harm a nursing baby. Antihistamines may also slow breast milk production. Do not use this medicine without a doctor's advice if you are breast-feeding a baby.

This medicine is not approved for use by anyone younger than 12 years old. Always ask a doctor before giving an antihistamine to a child. Death can occur from the misuse of antihistamines in very young children.

How should I take diphenhydramine and ibuprofen?

Use exactly as directed on the label, or as prescribed by your doctor. Do not take this medicine in larger amounts or for longer than recommended. Use the lowest dose that is effective in treating your condition. This medicine is usually taken only for a short time until your symptoms clear up.

Take this medicine with food or milk if it upsets your stomach.

Do not take this medicine for longer than 10 days without your doctor's advice.

Call your doctor if your symptoms do not improve, or if they get worse.

If you need surgery or medical tests, tell the surgeon or doctor ahead of time if you have taken this medicine within the past few days.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Since this medicine is taken when needed, you may not be on a dosing schedule. If you are on a schedule, use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking diphenhydramine and ibuprofen?

This medicine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Avoid drinking alcohol. It may increase your risk of stomach bleeding.

Avoid taking aspirin or other NSAIDs while you are taking diphenhydramine and ibuprofen.

Avoid taking ibuprofen if you are taking aspirin to prevent stroke or heart attack. Ibuprofen can make aspirin less effective in protecting your heart and blood vessels.

Ask a doctor or pharmacist before using any cold, cough, allergy, or other sleep medicine. Antihistamines and NSAIDs are contained in many combination medicines. Taking certain products together can cause you to get too much of a certain drug. Check the label to see if a medicine contains an antihistamine or ibuprofen (or similar NSAIDs such as aspirin, naproxen, ketoprofen, and others).

Diphenhydramine and ibuprofen side effects

Get emergency medical help if you have signs of an allergic reaction: sneezing, runny or stuffy nose; wheezing or trouble breathing; hives; swelling of your face, lips, tongue, or throat.

Get emergency medical help if you have signs of a heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, feeling short of breath.

Stop using this medicine and call your doctor at once if you have:

  • the first sign of any skin rash, no matter how mild;

  • a light-headed feeling, like you might pass out;

  • signs of stomach bleeding--bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

  • liver problems--nausea, upper stomach pain, itching, tired feeling, flu-like symptoms, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • kidney problems--little or no urinating, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath; or

  • severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

  • drowsiness;

  • day-time drowsiness, dizziness, "hangover" feeling;

  • upset stomach, mild heartburn, diarrhea, constipation;

  • dry mouth, nose, or throat;

  • blurred vision;

  • mild itching or rash; or

  • ringing in your ears.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Diphenhydramine and ibuprofen dosing information

Usual Adult Dose for Insomnia:

DiphenhydrAMINE-ibuprofen 38 mg-200 mg oral tablet:
2 tablets orally at bedtime not to exceed 2 tablets daily.

DiphenhydrAMINE-ibuprofen 25 mg-200 mg oral capsule:
2 capsules orally at bedtime not to exceed 2 capsules daily.

Usual Pediatric Dose for Insomnia:

DiphenhydrAMINE-ibuprofen 38 mg-200 mg oral tablet:
12 yrs or older: 2 tablets orally at bedtime not to exceed 2 tablets daily.

DiphenhydrAMINE-ibuprofen 25 mg-200 mg oral capsule:
12 yrs or older: 2 capsules orally at bedtime not to exceed 2 capsules daily.

What other drugs will affect diphenhydramine and ibuprofen?

Ask your doctor before taking diphenhydramine and ibuprofen if you take an antidepressant such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone. Taking any of these medicines with an NSAID may cause you to bruise or bleed easily.

Ask a doctor or pharmacist if it is safe for you to use diphenhydramine and ibuprofen if you are also using any of the following drugs:

  • a blood thinner (warfarin, Coumadin, Jantoven);

  • a diuretic or "water pill"; or

  • diphenhydramine (Benadryl) used on the skin.

This list is not complete. Other drugs may interact with diphenhydramine and ibuprofen, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about diphenhydramine and ibuprofen.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.01. Revision Date: 2016-01-15, 8:29:57 AM.

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