From the Research
Scopolamine transdermal patches are not FDA-approved for motion sickness in pediatric patients under 12 years of age, and for children 12 years and older, the recommended dose is one transdermal patch (1.5 mg) applied behind the ear at least 4 hours before travel, with effects lasting approximately 72 hours. The patch should be placed on clean, dry, hairless skin behind the ear. Parents should be aware that scopolamine can cause significant side effects in children including drowsiness, blurred vision, dry mouth, and confusion 1, 2, 3. Due to these concerns and limited safety data in younger children, alternative motion sickness medications like dimenhydrinate (Dramamine) or meclizine are often preferred for pediatric patients.
The mechanism of action for scopolamine involves blocking muscarinic acetylcholine receptors in the vestibular apparatus and vomiting center, which helps reduce the sensory conflict that causes motion sickness 1. If using scopolamine in adolescents, careful handwashing after handling the patch is important to avoid inadvertent eye contact which can cause pupil dilation and blurred vision. A study on double-dose transdermal scopolamine found that it may improve treatment in patients who fail to respond to a single patch by increasing the plasma scopolamine concentration, without aggravating systemic, visual, or cognitive adverse effects 4. However, this study was conducted in adults, and its findings may not be directly applicable to pediatric patients.
Some key points to consider when using scopolamine transdermal patches in pediatric patients include:
- The patch should be applied at least 4 hours before travel to allow for adequate absorption and onset of action
- The patch should be placed on clean, dry, hairless skin behind the ear to minimize skin irritation and ensure adequate absorption
- Parents should be aware of the potential side effects of scopolamine, including drowsiness, blurred vision, dry mouth, and confusion, and monitor their child for these effects
- Alternative motion sickness medications may be preferred for pediatric patients due to limited safety data and potential side effects of scopolamine.