Paracetamol Diphenhydramine

Uniflu paracetamol, diphenhydramine, phenylephrine, codeine, caffein ascorbic acid... 

Infusion-related adverse effects of gemtuzumab ozogamicin can be treated with a brief course of an intravenous glucocorticoid. Of 143 patients with refractory myeloid leukemia treated with gemtuzumab ozogamicin, 110 received paracetamol 650 mg orally with diphenhydramine 50 mg intravenously and 33 received the same premeditations plus methylprednisolone sodium succinate 50 mg intravenously before the infusion and repeated 1 hour later (1). There were grade 2 or worse infusion-related adverse events in 32 (29%) of the former, but in only one of the latter (3%). 

Propantheline reduced the rate, but not the extent, of paracetamol absorption. This would be expected to reduce the rate of onset of analgesia. Other antimuscarinic drugs that delay gastric emptying would be expected to interact similarly. In one case, the diphenhydramine component of a paracetamol product delayed paracetamol absorption after an overdose, and complicated the evaluation of the risk of toxicity. 

One study in 10 healthy subjects reported that diphenhydramine 250 mg taken with paracetamol 5 g (simulated paracetamol overdose) had little effect on the absorption of paracetamol. However, a case has been described where the diphenhydramine component of a paracetamol product Tylenol PM) taken in overdose (paracetamol 7.5 g and diphenhydramine 375 mg) delayed the absorption of paracetamol, so that the peak serum-paracetamol level did not occur until 8 hours after ingestion... 

Anti-D immunoglobulin is used as an alternative to intravenous immunoglobulin to treat idiopathic thrombocytopenic purpura. Patients treated with anti-D immunoglobulin (WinRho ), in contrast to earlier published reports, had more adverse reactions, particularly chills and rigors, despite pretreatment with paracetamol and diphenhydramine [66 ]. Two patients needed treatment for severe anemia and one for severe hemoglobinuria. Pretreatment with glucocorticoids or the use of subcutaneous anti-D immunoglobulin may reduce transfusion-related adverse reactions. However, the... 

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