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DimenhyDRINATE

Classification

Antiemetic
Antihistamine
Anticholinergic
Antivertigo

Indications

PCP: Prevention or control of nausea caused by motion sickness

PCP: Relief of moderate to severe nausea and vomiting

ACP: Prevention or control of nausea caused by narcotic administration

Contraindications

Known sensitivity to dimenhydrinate, diphenhydramine, or caffeine derivatives

Adult dosages

PCP and above: Nausea relief

25-50 mg IV/IM
12.5 mg IV/IM in elderly or frail patients
May repeat dose once after 4-6 hours if required
Give IM dose as direct injection; IV dose should be diluted with saline; administer medication at rate of 25 mg/min

Pediatric Considerations And Dosing

⚠️ Not authorized for patients < 12 years of age by PCP

ACP: Nausea relief

Follow weight-based dosing

1.25 mg/kg IV/IM; maximum single dose of 25 mg
May repeat dose once after 4-6 hours if required
Maximum total daily dose 5 mg/kg/day

Mechanism Of Action

Inhibits cholinergic vestibular and reticular stimulation from motion.

Pharmacokinetics

Onset: 20-30 minutes (IM); almost immediate (IV)
Peak: Unknown
Duration: 3-6 hours (IM/IV)

Adverse Effects

Drowsiness and dizziness are the most frequently reported adverse effects
Most side effects are dose-related

Overdose

Symptoms of overdose are similar to those of atropine toxicity and can include flushing, dilated pupils, hallucinations, confusion, ataxia, seizures, and loss of consciousness. Treatment is primarily supportive.

Warning And Precautions

Older adults may be particularly susceptible to dimenhyDRINATE’s effects. Use with caution in patients with increased ocular pressure or glaucoma, prostatic hypertrophy or urinary obstruction, cardiovascular disease, and asthma or chronic obstructive pulmonary disease.

The benefits of dimenhydrinate for pregnant women must be weighed against the risk. Dimenhydrinate crosses the placenta. The risk of fetal abnormalities was not increased following maternal use of dimenhydrinate during any trimester of pregnancy.

Drug Interactions

DimenhyDRINATE may potentiate the effects of alcohol, benzodiazepines, or other CNS depressants. Drugs with anticholinergic properties, including tricyclic antidepressants, monoamine oxidase inhibitors, or other antihistamines, may also act synergistically.