Oral Treatment and prophylaxis of motion sickness, Nausea and vertigo caused by Meniere's disease
Adult: 50-100 mg 6-8 hourly. As prophylaxis for motion sickness: Give 30 minutes to 1 hour prior to activity. Max: 400 mg daily. Child: 2-6 years 12.5-25 mg 6-8 hourly. Max: 75 mg daily; 6-<12 years 50 mg 6-8 hourly. Max: 150 mg daily; ≥12 years Same as adult dose.
Parenteral Treatment and prophylaxis of motion sickness, Nausea and vertigo caused by Meniere's disease
Adult: 50-100 mg 4 hourly via IM or slow IV inj over 2 minutes. Max: 100 mg 4 hourly. Child: 1.25 mg/kg or 37.5 mg/m2 4 times daily via IM inj. Max: 300 mg daily.
May be taken with or without food.
IV inj: Dilute a 50 mg vial with 10 mL of 0.9% NaCl soln.
Incompatible with aminophylline, glycopyrronium bromide, hydrocortisone Na succinate, hydroxyzine, meglumine adipiodone, phenothiazines and soluble barbiturates.
Patient with history of asthma or lower respiratory tract symptoms (e.g. emphysema, chronic bronchitis), angle-closure glaucoma, prostatic hypertrophy, bladder neck obstruction, stenosing peptic ulcer, pyloroduodenal obstruction, cardiovascular disease (e.g. cardiac arrhythmias, hypertension, ischaemic heart disease), seizure, thyroid dysfunction. Children. Pregnancy and lactation. Hepatic impairment.
Cardiac disorders: Tachycardia. Ear and labyrinth disorders: Tinnitus. Eye disorders: Blurred vision. Gastrointestinal disorders: Dry mouth, nose, throat; epigastric distress, nausea. General disorders and admin site conditions: Lassitude. Nervous system disorders: Drowsiness, excitement, headache. Psychiatric disorders: Nervousness, restlessness, insomnia (children), confusion. Renal and urinary disorders: Painful urination. Respiratory, thoracic and mediastinal disorders: Thickening of bronchial secretions. Skin and subcutaneous tissue disorders: Rash.
This drug may cause drowsiness and dizziness, if affected, do not drive or operate machinery.
Symptoms: Drowsiness, hallucination, severe delirium, extrapyramidal symptoms, vomiting, vertigo, convulsions, coma, respiratory depression. Management: May induce emesis or perform gastric lavage within 3 hours after ingestion. Administer oxygen and initiate mechanically assisted respiration in respiratory depression. Administration of vasopressors may be use to treat hypotension. Administer diazepam for convulsions or phenobarbital (5-6 mg/kg) in paediatric patients.
Concomitant use with antibiotics may cause ototoxicity and dimenhydrinate may mask ototoxicity symptoms . Enhanced adverse effect (e.g. drowsiness) of other CNS depressants. May prolong and intensify the antimuscarinic effects with MAOIs and other antimuscarinic agents (e.g. atropine, TCA).
Enhanced CNS depressant effect of alcohol.
Description: Dimenhydrinate, a monoethanolamine derivative, is a sedating antihistamine with antimuscarinic and significant sedative effects. It competes with histamine in binding for H1-receptor sites on effector cells in the gastrointestinal tract, blood vessels, and respiratory tract. It has central anticholinergic activity which blocks chemoreceptor trigger zone, diminishes vestibular stimulation and reduces labyrinth function. Onset: Antiemetic: Oral: 15-30 minutes; IM: 20-30 minutes. Duration: 4-6 hours. Pharmacokinetics: Absorption: Well absorbed from the gastrointestinal tract . Time to peak plasma concentration: Approx 1 hour. Distribution: Crosses the placenta and present in breastmilk (small amounts). Volume of distribution: 3-4 L/kg. Plasma protein binding: 70-85%. Metabolism: Extensively metabolised in the liver to diphenyl-methoxy-ethylamine, diphenyl-methoxy-acetic, and diphenyl-methoxy-N-methylamine. Excretion: Via urine. Elimination half-life: 5-8 hours.
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