Dramamine

Dramamine Drug Overview

Dramamine is a trademarked name for the medication dimenhydrinate, an antihistamine used primarily to prevent and treat symptoms of motion sickness such as nausea, vomiting, and dizziness. It is also occasionally used off-label for reducing symptoms of vertigo.

Chemical Composition

Dimenhydrinate, the active ingredient in Dramamine, is composed of two main chemicals: diphenhydramine and 8-chlorotheophylline. Diphenhydramine is an antihistamine known to cause drowsiness, and 8-chlorotheophylline is a stimulant to counteract the sedative effects of diphenhydramine.

Available Formulations

Dramamine comes in various forms, including tablets, chewable tablets, and liquid. The standard tablet typically contains 50 mg of dimenhydrinate, while chewables and liquids may have different concentrations designed for easier dosing in children or adults who have difficulty swallowing pill.

Indications and Usage

Dramamine is indicated for the prevention and treatment of nausea, vomiting, and dizziness associated with motion sickness. It is also used to relieve symptoms of Ménière’s disease and other balance disorders as clinically appropriate, although this is an off-label use.

Dosage and Administration

The usual adult dose for motion sickness prevention is 50-100 mg taken 30 minutes to one hour before travel and then every four to six hours as needed. For children, the dose is calculated based on their weight and age, following specific pediatric guidelines. It should not be used in children under two unless directed by a physician.

Mode of Action

Dramamine works primarily by blocking the action of acetylcholine (a neurotransmitter) and histamine at H1 receptors in the vomiting center of the brain, which helps prevent nausea, vomiting, and dizziness. Its anticholinergic effect is responsible for reducing motion sickness symptoms.

Special Populations Considerations

In the elderly, dosage may need to be adjusted due to increased sensitivity to the drug’s effects and a higher likelihood of side effects. Caution is recommended when administering Dramamine to individuals with underlying conditions such as asthma, enlarged prostate, glaucoma, and certain heart conditions due to the potential for exacerbation of these conditions.

Drug Interactions

Dramamine may interact with other CNS depressants, alcohol, and monoamine oxidase inhibitors (MAOIs). These interactions can enhance the sedative effects of dimenhydrinate and increase the risk of adverse reactions, thus it is important to consult with a healthcare professional before concurrent use of these substances.

Side Effects and Adverse Reactions

Common side effects of Dramamine include drowsiness, dry mouth, blurred vision, and dizziness. Some patients may experience tachycardia, hypotension, or palpitations as cardiovascular effects. Less commonly, serious side effects such as seizures and anaphylaxis may occur.

Precautions

Patients should be cautioned about performing activities requiring mental alertness, such as driving a vehicle or operating machinery until they are familiar with how Dramamine affects them. Due to its anticholinergic properties, it can also reduce sweating, thus increasing the risk of heatstroke in hot environments.

Overdose Management

An overdose of Dramamine can lead to symptoms such as seizures, respiratory depression, and anticholinergic effects like dilated pupils, dry skin, and mucous membranes. If overdose is suspected, immediate medical attention is necessary. Treatment for overdose may involve supportive care, including airway management and seizure control.

Pharmacokinetics

After administration, dimenhydrinate is well-absorbed with peak blood concentrations occurring in about two to three hours. It is metabolized in the liver and excreted mainly by the kidneys. The drug’s half-life ranges from 3.5 to 6 hours, though this may be prolonged in higher doses and in patients with renal impairment.

Pregnancy and Breastfeeding Concerns

Dramamine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is categorized as FDA pregnancy category B. Small amounts of dimenhydrinate may pass into breast milk, so nursing mothers should use this drug only if the benefits outweigh the risks to the infant.

Storage and Handling

Dramamine should be stored at room temperature, between 20 to 25 degrees Celsius (68 to 77 degrees Fahrenheit). The medication should be kept in its original packaging, away from light and moisture, and out of reach of children and pets to prevent accidental ingestion.

Reporting Adverse Reactions

Adverse reactions should be reported to healthcare providers and could also be reported to the FDA’s MedWatch adverse event reporting program to facilitate better surveillance of medication-related adverse effects and safety concerns.