This has been met with criticism, both by doctors and members of the airline industry, as sedating young passengers may put them at risk if the flight encounters an emergency and they are unable to react to the situation efficiently, and the drugs side effects, especially the chance of a paradoxical reaction, may result in some individuals becoming hyperactive rather than sedated. The ethics of this use have also been challenged, with the Seattle Childrens hospital arguing in a 2009 article that "Using a medication for your convenience is never an indication for medication in a child. "The American Academy of Sleep Medicines 2017 clinical practice guidelines recommended against the use of diphenhydramine in the treatment of insomnia due to poor effectiveness and low quality of evidence. A major systematic review and network meta-analysis of medications for the treatment of insomnia published in 2022 found little evidence to inform the use of diphenhydramine for insomnia. Nausea
Diphenhydramine also has antiemetic properties, which make it useful in treating the nausea that occurs in vertigo and motion sickness. Special populations
Diphenhydramine is not recommended for people older than 60 or children under the age of six, unless a physician is consulted. These populations should be treated with second-generation antihistamines such as loratadine, desloratadine, fexofenadine, cetirizine, levocetirizine, and azelastine. Due to its strong anticholinergic effects, diphenhydramine is on the Beers list of drugs to avoid in the elderly.Diphenhydramine is category B in the FDA Classification of Drug Safety During Pregnancy. It is also excreted in breast milk.
Telmisartan/hydrochlorothiazide, sold under the brand name Micardis HCT among others, is a fixed-dose combination medication used to treat high blood pressure. It is a combination of telmisartan an angiotensin II receptor antagonist with hydrochlorothiazide a diuretic. It may be used if telmisartan by itself is not sufficient. It is taken by mouth.Common side effects include dizziness, upper respiratory tract infections, nausea, diarrhea, and tiredness. Severe side effects may include kidney problems, electrolyte problems, and allergic reactions. Use during pregnancy may harm the baby. Telmisartan works by blocking the effects of angiotensin II while hydrochlorothiazide works by decreasing the kidneys ability to retain water.The combination was approved for medical use in the United States in November 2000, and in the European Union in April 2002. The combination is on the World Health Organizations List of Essential Medicines. It is available as a generic medication. References
External links
"Hydrochlorothiazide mixture with telmisartan". Drug Information Portal. U.S. National Library of Medicine.