Dramamine (Dimenhydrinate): Patient Information for Australia
Basic Product Information
| International Nonproprietary Name (INN): | Dimenhydrinate |
| Common Australia Brand Names: | Dramamine, Travacalm, Dimenhydrinate (generic options also available) |
| ATC Code: | A04AD06 |
| Available Forms & Strengths: | Tablets (50 mg), Chewable tablets (various), Suppositories (if imported); some liquid forms for children |
| Manufacturers: | Bayer, GlaxoSmithKline, various generics |
| Prescription Status (Australia): | Pharmacy Medicine (Schedule 2): Available from pharmacies without a prescription but pharmacist advice is recommended. |
Mechanism of Action
For Patients: Dimenhydrinate is an antihistamine that works by blocking certain signals in the brain that trigger nausea, vomiting, and dizziness. It is commonly used to prevent and treat motion sickness and symptoms of inner-ear disorders (such as vertigo).
For Healthcare Professionals: Dimenhydrinate is a combination salt of diphenhydramine and 8-chlorotheophylline. Its antiemetic and antivertigo properties are primarily mediated via competitive inhibition of central and peripheral H1 histamine receptors and subsequent suppression of labyrinthine function and vestibular stimulation.
Pharmacokinetics
- Absorption: Rapidly absorbed from the gastrointestinal tract after oral administration.
- Onset of Action: Typically 15–30 minutes after ingestion.
- Duration of Action: 4–6 hours on average.
- Metabolism: Extensively metabolised in the liver via CYP450 enzymes.
- Elimination: Excreted primarily via the urine as metabolites.
Use in Everyday Life and Best Practices
- When to Use: Dimenhydrinate is best taken 30–60 minutes before commencing travel to prevent motion sickness. For nausea or vertigo, use as soon as symptoms appear.
- How to Use: Swallow tablets with water. Chewable tablets should be thoroughly chewed before swallowing. Dosage frequency is every 6–8 hours if symptoms persist, but do not exceed the recommended maximum daily dose for your age group.
- Australian Context: Commonly taken before car, bus, train, or sea journeys, especially during summer holidays or when exploring regional areas with winding roads. Dimenhydrinate is suitable for both adults and children (see dosing tables), but stronger alternatives may be needed for persistent vertigo or severe cases (consult your GP).
Dosing in the Morning vs Evening
- Morning: Can cause drowsiness. If you need to remain alert (e.g., driving), consider alternatives or adjust timing under pharmacist advice.
- Evening: May help if nausea or vertigo disrupt sleep, but monitor for lingering drowsiness the next day. Avoid combining with other sedatives or alcohol at night.
- Regular Dosing Tips: Take doses at the same times each day if using for persistent or regular issues (e.g., Ménière’s disease). Set reminders to avoid missed doses.
Taking with Food or on an Empty Stomach
- With Food: Taking Dimenhydrinate with or after a meal (like a sandwich or light English breakfast) can help reduce stomach upset. Routine meals—including toast, cereal, or tea—are suitable base foods.
- On an Empty Stomach: May lead to quicker onset and greater absorption, but higher risk of stomach discomfort or minor nausea.
- Australian Dietary Tips: Best to avoid heavy, greasy meals before travel; stick to small, bland foods for best tolerance.
Interaction Warnings
| Type | Interaction/Warning |
|---|---|
| Alcohol | Increases sedation and risk of drowsiness – avoid combined use. |
| Other Antihistamines | Higher risk of side effects (drowsiness, dry mouth). Avoid multiple antihistamines concurrently. |
| Sedatives/Antidepressants | May increase drowsiness. Consult your doctor before combining. |
| Monoamine Oxidase Inhibitors (MAOIs) | Dangerous interaction risk. Not recommended. |
| Food | No clinically significant food interactions, but meals may help tolerability. |
| Pregnancy/Breastfeeding | Consult your GP or pharmacist for assessment—limited safety data available. |
Indications: Official and Off-label Uses
| Indication | Official in Australia? | Description |
|---|---|---|
| Prevention & treatment of motion sickness | Yes | Most common use. Short trips, sea travel, amusement rides. |
| Management of vertigo (e.g., labyrinthitis, Ménière’s disease) | Yes | Used for short-term symptom relief pending GP assessment. |
| Nausea & vomiting (not related to travel) | Off-label | Sometimes used under medical supervision, but not primary antiemetic for chemotherapy or general illness. |
Dosing According to Clinical Indication
| Indication | Age Group | Usual Dose | Maximum Dose/24h |
|---|---|---|---|
| Prevention of motion sickness | Adults & Children >12 years | 50–100 mg 30–60 mins before travel, repeat every 4–6 h as needed | 400 mg |
| Children 6–12 years | 25–50 mg before travel, repeat every 6–8 h as needed | 150 mg | |
| Children 2–6 years | 12.5–25 mg before travel, repeat every 6–8 h as needed (only with healthcare advice) | 75 mg | |
| Vertigo | Adults | 50 mg every 4–6 h as needed | 400 mg |
| Nausea/vomiting (off-label) | Adults | 50–100 mg every 4–6 h as needed | 400 mg |
| Older adults (≥65 yrs) | Start at lower end (25–50 mg) | Reduce dose/frequency due to increased risk of side effects | Consult pharmacist/GP |
Safety Profile & Side Effects
- Common: Drowsiness, dry mouth, blurred vision, dizziness, constipation, difficulty urinating.
- Uncommon: Headache, palpitations, mild confusion.
- Rare/Serious: Severe allergic reaction (rash, swelling, difficulty breathing), hallucinations (especially in children), seizures (very rare).
- Warnings:
- May affect ability to drive or operate machinery—avoid until you know how Dimenhydrinate affects you.
- Use with caution in elderly, children, or those with liver/kidney impairment, prostate issues, glaucoma, or seizure disorders.
- Risk of increased sedation with alcohol or other CNS depressants.
Guidelines for Proper Use: Advice from Pharmacists and Clinics
- Use Dimenhydrinate only for short periods unless directed by your GP.
- If symptoms persist beyond 48 hours or worsen, seek medical advice for investigation of underlying causes.
- Monitor for excessive drowsiness—avoid mixing with alcohol or sedativemedications.
- If you forget a dose, take it when you remember only if needed for ongoing symptoms. Do not double up doses.
- Store below 25°C and protect from moisture—ideal for the Australian climate.
- Consult your GP before using in pregnancy or breastfeeding, or in children under 6 years old.
Alternative Treatment Options (for Australia)
- Hyoscine hydrobromide (Kwells): First-line for prevention of motion sickness; often preferred for shorter trips, but can cause dry mouth and blurred vision.
- Meclozine (Antivert, Bonine): Longer-acting, less sedating than Dimenhydrinate, but not suitable for young children.
- Promethazine (Phenergan): Used for severe motion sickness or persistent nausea; more sedating; prescription-only in some strengths.
- Non-medical: Ginger tablets, acupressure wristbands—some evidence for mild benefit in motion sickness without side effects.
Legal, Registration, and Reimbursement Status in Australia
- Legal Status: Schedule 2 (Pharmacy Only). No prescription needed but only sold in pharmacies with pharmacist oversight.
- Australian Registration: Registered by the Therapeutic Goods Administration (TGA) for the prevention and treatment of motion sickness.
- Reimbursement: Not routinely subsidised under the Pharmaceutical Benefits Scheme (PBS); patients usually pay full retail price.
Latest Research & Clinical Guidance (2022–2025)
- Recent reviews and guidelines (Therapeutic Guidelines Australia 2023, BMJ 2024) continue to recommend Dimenhydrinate as a first-line OTC option for mild-to-moderate motion sickness in the general population.
- Efficacy for short-term relief of vertigo is well supported, but ongoing or recurrent symptoms require specialist assessment (JAMA Otolaryngology, 2023).
- Children under 2 years should not use Dimenhydrinate; for children over 2, only use under pharmacist or GP supervision (Australian Medicines Handbook, 2024).
- No new safety concerns have arisen from recent post-marketing surveillance (TGA Reports, 2022–2024).
Availability and Delivery: Australia
| Pack Size | Typical Retail Price | Estimated Local Delivery Time | Availability |
|---|---|---|---|
| 10 tablets (50 mg each) | $8–$12 AUD | Same-day/next-day (most major cities) | In-stock at most pharmacies |
| 20 tablets | $14–$18 AUD | 1–2 days | Widely available |
| Pediatric liquid (120 mL) | $16–$22 AUD | 2–3 days | Pharmacy order required |
Frequently Asked Questions (FAQ)
Can I drive or use machinery after taking Dimenhydrinate?
No. Dimenhydrinate commonly causes drowsiness and slowed reaction time. Wait until you know how it affects you before driving or using heavy machinery.
Is Dimenhydrinate safe for children?
Yes, for children over 2 years, as long as the recommended dose is followed. Use only with pharmacist or GP advice, especially for young children.
Can I take Dimenhydrinate while pregnant or breastfeeding?
Safety is not fully established. Consult your GP or pharmacist for a personalised risk assessment in pregnancy or while breastfeeding.
Are there natural or non-drug alternatives?
Ginger, acupressure bands, and motion-friendly seating (front seat of a vehicle or mid-ship on a boat) may offer benefit for mild cases without side effects.
What should I do if I miss a dose?
If you miss a dose, take it when you remember, only if continuing symptoms require it. Do not double up or exceed the maximum daily dose.
