Gravol (Dimenhydrinate) Age Guidelines for Children
Gravol can be given to children starting at 2 years of age, though safety data exists for use in children as young as 6 months in specific clinical contexts.
Age-Specific Recommendations
Children Under 2 Years
- Dimenhydrinate is generally not recommended for routine use in children under 2 years of age due to limited safety and efficacy data in this population 1, 2.
- For children under 6 years who experience acute ingestion of at least 7.5 mg/kg of dimenhydrinate, emergency department referral is warranted due to toxicity concerns 1.
Children 2 Years and Older
- Dimenhydrinate appears to be safe for use in the pediatric population aged 2 years and older 2.
- The medication can be used for treatment of nausea and vomiting in this age group 2.
Critical Safety Considerations
Pre-Treatment Assessment
- Identify the underlying cause of vomiting before administering dimenhydrinate, as the drug's effectiveness depends on the etiology 2.
- Ensure no contraindications or potential drug interactions exist with other medications the child may be taking 2.
Dosing Principles for Children
- For children under 6 years of age, doses should be carefully calculated based on weight, with particular attention to the 7.5 mg/kg threshold that warrants medical evaluation if exceeded 1.
- Children 6 years and older who ingest at least 7.5 mg/kg or 300 mg (whichever is less) should be referred for emergency evaluation 1.
Toxicity Monitoring
Symptoms Requiring Emergency Care
- Any patient experiencing moderate to severe symptoms should be referred to an emergency department, including agitation, hallucinations, abnormal muscle movements, loss of consciousness, seizures, or respiratory depression 1.
- Mild drowsiness or mild stimulation may be observed at home with close monitoring 1.
Observation Timeframes
- If a child has no symptoms and more than 6 hours have elapsed since dimenhydrinate ingestion, emergency department referral is not necessary 1.
- For asymptomatic patients with subtherapeutic doses, home observation with poison center follow-up at approximately 6 hours post-ingestion is appropriate 1.
Important Clinical Caveats
- Do not induce emesis following oral dimenhydrinate exposure due to the potential for rapid onset of altered consciousness or seizures 1.
- Activated charcoal should not be administered en route to an emergency department for the same reason 1.
- While dimenhydrinate is available over-the-counter, its use requires careful consideration of the child's age, weight, and clinical presentation 2.