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Clinical Practice Guidelines
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DimenhyDRINATE

Classification

Antiemetic
Antihistamine
Anticholinergic
Anti-vertigo

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: Nausea relief

25-50 mg IV/IM
12.5 mg IV/IM in elderly or frail patients
May repeat dose once 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

Follow weight-based dosing

PCP: Nausea relief

1.25 mg/kg IV/IM. Maximum single dose of 25 mg
Maximum total daily dose 5 mg/kg/day
Note: not authorized for patients under 12 years by PCP

Mechanism Of Action

Inhibits cholinergic vestibular and reticular stimulation from motion

Pharmocokinetics

Intravenous:

Onset: nearly immediate
Peak: uncertain
Duration: 3-6 hours

Intramuscular:

Onset: 20-30 minutes
Peak: uncertain
Duration: 3-6 hours

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 weight against the potential oxytocic effect in these patients.

Drug Interactions

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