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dimenhydrinate (Rx, OTC)Brand and Other Names:Dramamine

 
 
 

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

injectable solution

  • 50mg/mL

tablet

  • 50mg

tablet, chewable

  • 50mg
more...

Prevention of Motion Sickness

50-100 mg PO/IV/IM q4-6hr PRN, 30 minutes before exposure to motion; not to exceed 400 mg/day

Meniere's Disease (Off-label)

25-50 mg PO q8hr for maintenance

50 mg IM for acute attack

Administration

IV: 50 mg in 10 mL NS over 2 minutes

Dosage Forms & Strengths

injectable solution

  • 50mg/mL

tablet, chewable

  • 50mg

tablet

  • 50mg
more...

Prevention of Motion Sickness

General dose: 1.25 mg/kg or 37.5 mg/sq.meter IV/IM q6hr; not exceed 300 mg/day 

2-6 years old: 12.5-25 mg PO q6-8hr; no more than 75 mg/day

6-12 years old: 12.5-25 mg PO q6-8hr; no more than 150 mg/day

>12 years old: Same as adult dosing

Prevention of Motion Sickness

50-100 mg PO/IV/IM q4-6hr PRN, 30 minutes before exposure to motion; not to exceed 400 mg/day

Meniere's Disease (Off-label)

25-50 mg PO q8hr for maintenance, 50 mg IM for acute attack

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Interactions

Interaction Checker

dimenhydrinate and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Varies in incidence and severity with the individual drug; also individual patients vary in susceptibility

            Frequency Not Defined

            Paradoxical CNS stimulation (children and occasionally in adults)

            CNS depression

            Drowsiness

            Sedation ranging from mild drowsiness to deep sleep (most frequent)

            Dizziness

            Lassitude

            Disturbed coordination

            Muscular weakness

            Restlessness, insomnia, tremors, euphoria, nervousness, delirium, palpitation, seizures is less common

            Epigastric distress

            Anorexia

            Nausea

            Vomiting

            Diarrhea

            Constipation

            Cholestasis, hepatitis, hepatic failure, hepatic function abnormality, jaundice is rare

            Eczema, pruritus, inflammation, papular rash, erythema on exposed skin may occur with topical formulation

            Tachycardia, palpitation ECG changes (eg, widened QRS)

            Arrhythmias (eg, extrasystole, heart block)

            Hypotension

            Hypertension

            Dizziness, sedation, and hypotension may occur in geriatric patients

            Dryness of mouth, nose, and throat

            Dysuria

            Urinary retention

            Impotence

            Vertigo

            Visual disturbances

            Blurred vision

            Diplopia; tinnitus

            Acute labyrinthitis

            Insomnia

            Tremors

            Nervousness

            Irritability

            Facial dyskinesia

            Tightness of the chest

            Thickening of bronchial secretions

            Wheezing

            Nasal stuffiness

            Sweating

            Chills

            Early menses

            Toxic psychosis

            Headache

            Faintness

            Paresthesia

            Agranulocytosis

            Hemolytic anemia

            Leukopenia

            Thrombocytopenia

            Pancytopenia

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            Warnings

            Contraindications

            Documented hypersensitivity to dimenhydrinate or diphenhydramine

            Lower respiratory disease, eg, asthma (controversial)

            Preemies and neonates

            Nursing women

            Cautions

            May impair ability to drive or operate heavy machinery

            May mask early signs of ototoxicity if given concomitantly with ototoxic drugs (eg, aminoglycosides)

            Patients with seizures, angle-closure glaucoma, enlargement of prostate gland, asthma, emphysema, acute hepatic insufficiency

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            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: Crosses into breast milk, discontinue drug or do not nurse

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
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            Pharmacology

            Mechanism of Action

            Ethanolamine H1 antagonist containing diphenhydramine and 8-chloro-theophylline; pharmacological effects principally result from diphenhydramine moiety, has CNS depressant, anticholinergic, antiemetic, antihistamine, and local anesthetic effects

            Antiemetic action may result from inhibiting vestibular stimulation, and inhibiting acetylcholine

            Pharmacokinetics

            Half-Life: unknown, (half-life of diphenhydramine is about 3.5 hr)

            Duration: 3-6 hr

            Onset: 20-30 min (IM); 15-30 min (PO); almost immediately (IV)

            Bioavailability: Well absorbed

            Metabolism: Extensively metabolized in the liver, based on data for diphenhydramine

            Excretion: Principally in urine (as metabolites)

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            Administration

            IV Compatibilities

            Solution: compatible with most common solvents

            Additive: amikacin, amobarbital (at 1 g amobarbital/500 mg dimenhydrinate), calcium gluconate, chloramphenicol sodium succinate, corticotropin, heparin, hydroxyzine, norepinephrine, penicillin G, pentobarbital, phenobarbital, KCl, prochlorperazine, vancomycin, vitamin B/C

            Syringe: atropine, codeine, diatrizoate meglumine, diatrizoate sodium, diphenhydramine, droperidol, fentanyl, heparin, hydromorphone, hyoscine, iothalamate meglumine, iothalamate sodium, meperidine, metoclopramide, morphine, pentazocine, perphenazine, ranitidine, scopolamine

            Y-site: acyclovir

            IV Incompatibilities

            Additive: aminophylline (at 1g/L aminophylline and 500 mg/L dimenhydrinate; may be compatible at lower conc), ammonium chloride(?), hydrocortisone (at 500 mg hydrocortisone and 500 mg dimenhydrinate; may be compatible at lower conc), thiopental

            Syringe: butorphanol, chlorpromazine, glycopyrrolate, hydroxyzine, iodipamide, midazolam, nalbuphine, papaveretum, pentobarbital, prochlorperazine, promazine, promethazine, thiopental

            IV Administration

            50 mg in 10 mL NS over 2 min

            Storage

            Do not use if cloudy or contains a precipitate

            Store at controlled room temp 15-30°C

            Protect from freezing

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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