Drama

Dramine (dimenhydrinate) is a drug that is often used to prevent and treat motion sickness (sea sickness), dizziness, nausea, and vomiting caused by movement (as when traveling by car, ship, or plane). It can also be used in the treatment of vertinebrobasilar insufficiency.

Dimenhydrinate is a histamine H1 receptor antagonist and blocks the action of histamine in the central nervous system, which reduces nausea and vomiting associated with movement.

In addition, Dramamine can also be used as an adjuvant in the treatment of motion sickness and other types of kinetosis (movement causing nausea) and in combination with other drugs to enhance its effect.

Indications Dramas

1. Prevention and treatment of motion sickness (sea sickness), dizziness, nausea and vomiting caused by movement (for example, when traveling by car, ship or plane).
2. Treatment of vertebrobasilar insufficiency associated with dizziness and nausea.

Release form

• Tablets: This is the most common form of release. The tablets are intended for oral administration; they have a standard dosage of the active substance.
• Tablets for children: This form contains a reduced dose of the active substance, suitable for children.

Pharmacodynamics

Mechanism of action:

• Dimenhydrinate blocks the action of histamine at peripheral H1 receptors, preventing or reducing the symptoms of an allergic reaction.
• This leads to a reduction in various allergic manifestations, such as itching, runny nose, redness of the skin and others.
• In addition, Dramamine has anticholinergic properties, which contribute to its antiemetic and antiemetic effects.

Pharmacokinetics

1. Absorption: Dimenhydrinate is usually rapidly and completely absorbed from the gastrointestinal tract after oral administration.
2. Bioavailability: The bioavailability of dimenhydrinate is about 50-60% due to the first pass effect through the liver.
3. Distribution: Dimenhydrinate is distributed throughout the body and penetrates the blood-brain barrier, which may cause sedation.
4. Metabolism: Dimenhydrinate is primarily metabolized in the liver to form active metabolites, including 8-phenytrophenylethanol.
5. Half-life: The half-life of dimenhydrinate from the body varies widely and can range from 3 to 6 hours.
6. Excretion: About 50-70% of dimenhydrinate is excreted from the body in the urine in the form of metabolites.
7. System concentration: The concentration of dimenhydrinate in the blood usually reaches its maximum 1-3 hours after administration.
8. Interactions: Dimenhydrinate may interact with other drugs, especially other centrally acting drugs such as hypnotics, sedatives, or alcohol, which may increase sedation.
9. Metabolism: The metabolism of dimenhydrinate may be slower in older adults or people with impaired liver function, which may lead to increased concentrations in the blood and increased side effects.

Dosing and administration

Method of application:

• Tablets are intended for oral administration.
• The tablet should be taken with plenty of water.

Dosage:

For adults and children over 12 years old:

• The recommended dose is 50-100 mg (1-2 tablets) 2-3 times a day.
• The maximum daily dose should not exceed 400 mg (8 tablets).

For children from 6 to 12 years old:

• The recommended dose is 25-50 mg (half - 1 tablet) 2-3 times a day.
• The maximum daily dose should not exceed 150 mg (3 tablets).

For children from 2 to 6 years old:

• The recommended dose is 12.5-25 mg (a quarter to a half tablet) 2-3 times a day.
• The maximum daily dose should not exceed 75 mg (1.5 tablets).

Prevention of motion sickness:

• The drug should be taken 30-60 minutes before the start of the trip.

Special instructions:

• It is not recommended to exceed the specified dosage.
• If a dose is missed, do not take a double dose to make up for the missed dose.
• The drug may cause drowsiness, so you should avoid driving vehicles and operating machinery that requires increased concentration.
• Before starting to use the drug, it is recommended to consult a doctor, especially if you have chronic diseases or are taking other medications.

Use Dramas during pregnancy

Using dimenhydrinate (Dramine) during pregnancy may be effective in treating morning sickness and vomiting, although it should be used with caution and under medical supervision. Here are some conclusions from scientific research:

1. Efficacy compared to other agents: Dimenhydrinate is effective in reducing the symptoms of morning sickness and vomiting, and its effect is comparable to substances such as vitamin B6 and Ginger, while it has fewer side effects such as drowsiness than other antiemetics, for example Ondansetron (Babaei & Foghaha, 2014).
2. Safety: Studies have shown no significant risk of teratogenicity in infants born to mothers who used dimenhydrinate in the first trimester of pregnancy (Czeizel & Vargha, 2005).

Dimenhydrinate may be considered as an option for the treatment of nausea and vomiting during pregnancy, but it should be used under strict medical supervision to avoid possible side effects and evaluate the risks.

Contraindications

1. Glaucoma: Dramamine may cause dilated pupils and increased intraocular pressure, which can worsen the symptoms of glaucoma, so the drug is not recommended if you have glaucoma without consulting your doctor.
2. Asthma: Dimenhydrinate may cause worsening of asthma symptoms in some people, so its use may be contraindicated in patients with asthma.
3. Diseases of the gastrointestinal tract: Dramamine may cause irritation of the gastric mucosa, so its use may be contraindicated in patients with gastric or duodenal ulcers.
4. Urinary problems: Patients with impaired renal or urinary tract function may require dimenhydrinate dosage adjustments or additional medical monitoring.
5. Hypersensitivity to the drug: People with a known allergy to dimenhydrinate or any other component of the drug should avoid its use.
6. Pregnancy and breastfeeding: The safety of Dramamine during pregnancy and breastfeeding has not been established, and its use in these cases should be discussed with a physician.
7. Children: Dramamine is not recommended for children under 2 years of age without consulting a doctor.

Side effects Dramas

1. Drowsiness or fatigue.
2. Dry mouth.
3. Rarely - irritability or restlessness.
4. Difficulty urinating.
5. Vision problems.
6. Rapid heartbeat.
7. Constipation.

Overdose

1. Drowsiness and general weakness: Overdose can cause significant depression of the central nervous system, leading to severe drowsiness and general weakness.
2. Intestinal paralysis: This may manifest as constipation or urinary retention.
3. Dry mucous membranes: Including dry mouth and difficulty swallowing.
4. Heart rhythm disorders: Heart rhythm disturbances such as tachycardia or arrhythmia may occur.
5. Loss of coordination and dizziness: This can lead to injuries and falls.
6. Visual disturbances: Including dilated pupils, changes in focus, or double vision.

Measures in case of overdose:

1. Immediate medical attention: If overdose is suspected, seek immediate medical attention. Call an ambulance or go to the nearest medical facility.
2. Stopping the medication: If possible, stop taking Dramamine.
3. Symptomatic treatment: Treatment of overdose will be aimed at relieving symptoms and maintaining vital functions. This may include the use of an antidote or symptomatic treatment.
4. Monitoring: The patient may need to be observed and monitored for some time after overdose is treated.
5. Individual measures: Depending on the symptoms and severity of overdose, additional medical treatments and support measures may be required.

Interactions with other drugs

1. Central-acting drugs: Dimenhydrinate has a sedative effect, so concomitant use with other centrally acting drugs, such as hypnotics, sedatives or alcohol, may increase sedation and depression of the central nervous system.
2. Anticholinergic drugs: Dimenhydrinate is an anticholinergic drug, so concomitant use with other anticholinergic drugs, such as antidepressants, antihistamines, antiparkinsonian drugs and some antihistamines, may increase the effects of anticholinergic therapy, such as dry mouth, constipation and urinary problems.
3. Drugs that Increase Cardiotoxicity: Concomitant use of dimenhydrinate with drugs that can also cause arrhythmias or increase cardiotoxicity, such as some antiarrhythmic drugs, anticonvulsants, or antidepressants, may increase the risk of cardiac side effects.
4. Drugs that enhance the hypotensive effect: Dimenhydrinate may cause hypotension. Therefore, concomitant use with drugs such as antihypertensive drugs, alpha-blockers or other drugs that lower blood pressure may enhance this effect and lead to orthostatic hypotension.
5. Drugs that enhance the somnolent effect: Dimenhydrinate may cause drowsiness. Therefore, concomitant use with other hypnotics or sedatives may enhance this effect and increase the risk of respiratory depression or other undesirable somatic effects.

Storage conditions

Dramamine should be stored in a dry place at room temperature, usually not higher than 25°C. The product should be kept away from direct light and heat to avoid its decomposition. It is also important to ensure that the medicine is out of reach of children. It is generally recommended to store medications in their original packaging until the time of use to protect them from moisture and other external factors that may affect their effectiveness.