Dimenhydrinate

 


Other Names

Gravol, Dramamine


Classification

Antiemetic; Antivertigo


Action

  1. Uncertain, probably inhibits nausea and vomiting by centrally depressing sensitivity of the labyrinth apparatus which relays stimuli to the chemoreceptor trigger zone and stimulates the vomiting center in the brain


Indications

  1. Treatment of nausea and vomiting

  2. Treatment and prevention of irradiation sickness

  3. Treatment of severe motion sickness, when patient cannot be removed from stimulus (i.e. aircraft)


Contraindications

Hypersensitivity to the medication


Precautions

  1. Undiluted solution is irritating to the veins and may produce sclerosis

  2. Overdose will cause antichoinergic toxidrome ("red as a beet, dry as a bone, blind as a bat, mad as a hatter, and hot as a hare.")


Adverse Reactions

  1. Convulsions in small children with high doses

  2. Drowsiness

  3. Insomnia

  4. Hypotension

  5. Palpitations

  6. Dry mouth

  7. Blurred vision


Interactions/Compatibility/Stability

  1. Compatible with NS, Dextrose, Ringer’s Lactate

  2. Anti-anxiety agents, barbiturates, sleeping agents and tranquilizers may cause additive sedation and depression


Special Considerations

  1. For children, IV doses have not been established but should be less than those administered orally

  2. Gravol may alter or confuse tests results for xanthines such as aminopylline (caffeine)


Dosages

Preparation:    50 mg – PO, 50 mg/5 ml – IV

Adult:

  1. For prevention of vertigo and nausea: 25 - 50 mg IV or PO every 4 hours PRN

  2. Dilute dose to at least 10 ml with NS and inject slowly (IV) over a 2 minute period (dilution is necessary since drug is irritating and may produce sclerosis)

Pediatric: 1 mg/kg IV, to a maximum of 40 mg


Kinetics (IV)

Onset           Immediate

Peak             1-4 hours

Duration       4-7 hours



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