Motion sickness can often be ameliorated or avoided by use of prophylactic medications. The choice of a particular medication may depend on the type and severity of side effects.
Parameters affecting choice:
(1) duration of exposure
(2) intensity of the stimulus
Duration
Intensity
Common Medication Choices
short (< 6 hours)
mild to moderate
dimenhydrinate, meclizine, promethazine
severe
dimenhydrinate, scopolamine patch, promethazine
long (>= 6 hours)
mild
dimenhydrinate, scopolamine patch, meclizine, promethazine
moderate to severe
scopolamine patch; repeated doses of dimenhydrinate, meclizine, or promethazine
Other Concerns
Medication
need to sleep
diphenhydramine, promethazine
need to be alert
promethazine with amphetamine or ephedrine
pregnant
promethazine, meclizine, cyclizine, diphenhydramine, dimenhydrinate
The scopolamine patch is a popular option for many situations when a prolonged exposure is expected.
(1) It has a delayed onset of action (3 hours or more) and lasts at least 72 hours.
(2) A single patch is often all that is needed on a cruise since acclimatization occurs.
(3) It may have intolerable side effects with dry mouth, drowsiness, confusion and blurred vision.
(4) Contraindications to its use include glaucoma, pregnancy and advanced age.
(5) While it is often placed behind an ear, it can be placed on any patch of skin.
(6) Hands should be washed immediately after handling.
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Specialty: Emergency Medicine, Critical Care
