di·men·hy·dri·nate (d  m n-h dr -n t)n. An antihistamine used to treat motion sickness and allergic disorders. |
dimenhyDRINATE
dimenhydrinate
n brand names: Calm-X, Dimentabs, Dinate, Dramamine;
drug class: antihistamine, H1 receptor antagonist;
actions: acts on blood vessels and gastrointestinal and respiratory systems by competing with histamine for H1 receptor sites; decreases allergic response by blocking histamine;
uses: motion sickness, nausea, vomiting.
dimenhydrinate
Apo-Dimenhydrinate (CA), Dramamine, Dramanate (CA), Gravol (CA), PMS-Dimenhydrinate (CA), Travamine (CA)
Pharmacologic class: Anticholinergic
Therapeutic class: Antiemetic, antivertigo agent
Pregnancy risk category B
Action
Prevents nausea and vomiting by inhibiting vestibular stimulation of chemoreceptor trigger zone and inhibiting stimulation of vomiting center in brain
Availability
Capsules: 50 mg
Capsules (extended-release): 25 mg
Elixir: 12.5 mg/5 ml, 15 mg/5 ml
Injection: 50 mg/ml
Liquid: 12.5 mg/4 ml, 15.62 mg/5 ml
Suppositories: 50 mg, 100 mg
Tablets: 50 mg
Tablets (chewable): 50 mg
⊘Indications and dosages
➣ Prevention and treatment of nausea, vomiting, dizziness, and vertigo
Adults and children ages 12 and older: 50 to 100 mg P.O. q 4 hours (not to exceed 400 mg/day), or 50 to 100 mg P.R. q 6 to 8 hours, or 50 mg I.M. or I.V. q 4 hours p.r.n.
Children ages 6 to 12: 25 to 50 mg P.O. q 6 to 8 hours (not to exceed 150 mg/day), or 25 to 50 mg P.R. q 8 to 12 hours, or 1.25 mg/kg I.M. (37.5 mg/m2) q 6 hours p.r.n.
Children ages 2 to 6: 12.5 to 25 mg P.O. q 6 to 8 hours (not to exceed 75 mg/day)
Contraindications
• Hypersensitivity to drug or tartrazine
• Alcohol intolerance
Precautions
Use cautiously in:
• angle-closure glaucoma, seizure disorders, prostatic hypertrophy.
Administration
• For I.V. use, dilute with dextrose 5% in water or normal saline solution.
• Give each 50-mg I.V. dose over 2 minutes.
☞ Don't administer by I.V. route to premature or low-birth-weight infants. Solution contains benzyl alcohol, which can cause fatal "gasping" syndrome.
| Route | Onset | Peak | Duration |
| P.O. | 15-60 min | 1-2 hr | 3-6 hr |
| I.V. | Rapid | Unknown | 3-6 hr |
| I.M. | 20-30 min | 1-2 hr | 3-6 hr |
| P.R. | 30-45 min | Unknown | 6-12 hr |
Adverse reactions
CNS: drowsiness, dizziness, headache, paradoxical stimulation (in children)
CV: hypotension, palpitations
EENT: blurred vision, tinnitus
GI: diarrhea, constipation, dry mouth
GU: dysuria, urinary frequency
Skin: photosensitivity
Other: decreased appetite, pain at I.M. site
Interactions
Drug-drug. Disopyramide, quinidine, tricyclic antidepressants: increased anticholinergic effects
MAO inhibitors: intensified and prolonged anticholinergic effects
Other CNS depressants (such as antihistamines, opioids sedative-hypnotics): additive CNS depression
Ototoxic drugs (such as aminoglycosides, ethacrynic acid): masking of signs or symptoms of ototoxicity
Drug-diagnostic tests. Allergy skin tests: false-negative results
Drug-behaviors. Alcohol use: increased CNS depression
Patient monitoring
• Assess for lethargy and drowsiness.
• Monitor for dizziness, nausea, and vomiting (possible indicators of drug toxicity).
Patient teaching
• To prevent motion sickness, advise patient to take drug 30 minutes before traveling and to repeat dose before meals and at bedtime.
• Instruct patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• Caution patient to avoid alcohol and sedative-hypnotics during therapy.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs, tests, and behaviors mentioned above.
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