Dimenhydrinate is best used prophylactically for motion sickness and acutely for nausea in the emergency department. These pearls help clinicians counsel families on safe, effective use.
Administer 30–60 minutes before travel to allow central vestibular blockade before motion stimuli begin; repeat every 6 hours for long trips.
Standard pediatric dose is 1–1.5 mg/kg (max 50 mg) every 6 hours as needed; avoid repeated doses in children <2 years unless directed by a clinician.
Avoid dimenhydrinate in children with narrow-angle glaucoma, urinary retention, or severe asthma—anticholinergic effects can exacerbate these conditions.
Young children may become irritable, agitated, or dizzy instead of sedated—stop the medicine and consider ondansetron or non-pharmacologic strategies if this occurs.
Encourage small sips of clear fluids, cool airflow, and fixed visual points; these significantly reduce breakthrough nausea when paired with dimenhydrinate.