Dimenhydrinate is an over- the-counter ‘combination’ anti-emetic which can be of use in end of life situations, especially if other anti- emetics are hard to obtain. Common brand names include Dramamine and Gravol. Marketed as 50mg tablets, for use in the end of life context,1 - 2 tablets should be taken an hour before ingesting the lethal drug.
While Dimenhydrinate is readily available, it can occasionally give rise to a number of unpleasant (anti-cholinergic) side effects. Note - This drug readily crosses into the brain. In larger doses, it can cause distortions in sight, sound, and perception, even confusion and amnesia. For this reason a prior test-dose is recommended.
Unless there are specific questions of hypersensitivity or al- lergy or evidence of significant side-effects, the anti-emetic Metoclopramide is the recommended end of life anti-emetic. The suggested dose for Metoclopramide is independent of the type or quantity of the lethal drug to be used. That is, the dse is independent of whether the drug is to be taken as a stat dose (30mg at one time) or over a continuous 48 hour period (10mg 3x/day for 2 days).