From the Guidelines
The best medication for motion sickness and nausea is an antihistamine like dimenhydrinate (Dramamine) or meclizine (Bonine), which should be taken 30-60 minutes before travel. When considering medication options, it's essential to weigh the benefits and risks, prioritizing morbidity, mortality, and quality of life as the primary outcomes. For adults, the standard dose of dimenhydrinate is 50-100mg every 4-6 hours (maximum 400mg daily), while meclizine is usually 25-50mg once daily 1. Scopolamine patches are another effective option, applied behind the ear 4 hours before travel and lasting up to 3 days. These medications work by blocking signals to the brain's vomiting center and reducing inner ear sensitivity. Some studies suggest that ginger has antinausea properties and is useful in the management of motion sickness, however, its effectiveness during chemotherapy treatment is limited because it acts on the stomach rather than on the central nervous system 1. Non-medication strategies include:
- Sitting in the front seat or middle of a boat
- Focusing on the horizon
- Avoiding heavy meals before travel
- Using ginger supplements (250mg capsules) Side effects may include drowsiness, dry mouth, and blurred vision, so it's crucial to avoid alcohol and driving when using these medications. Children and pregnant women should consult a healthcare provider before use. It's also important to note that while ginger may have some benefits, its antiplatelet activity and potential to prolong bleeding time should be considered, especially when taken in large doses 1.
From the FDA Drug Label
SCOPOLAMINE transdermal system is an anticholinergic indicated in adults for the prevention of: • nausea and vomiting associated with motion sickness. (1) • post-operative nausea and vomiting (PONV) associated with recovery from anesthesia and/or opiate analgesia and surgery. (1)
The best medication for motion sickness and nausea, according to the FDA drug label, is scopolamine transdermal system.
- The recommended dosage for motion sickness is to apply one transdermal system to the hairless area behind one ear at least 4 hours before antiemetic effect is required for use up to 3 days.
- Common adverse reactions include dry mouth, drowsiness, blurred vision, and dilation of the pupils. 2
From the Research
Medications for Motion Sickness and Nausea
- Scopolamine is considered a first-line medication for the prevention of motion sickness and should be administered transdermally several hours before the anticipated motion exposure 3.
- First-generation antihistamines, although sedating, are also effective in preventing motion sickness 3.
- Dimenhydrinate has been shown to be effective against nausea and vertigo in experimentally induced motion sickness, and its effectiveness is comparable to that of scopolamine 4.
- Anticholinergics, antihistamines, and sympathomimetics are medications that are effective in the prophylaxis and/or treatment of motion sickness 5.
Ineffective Medications for Motion Sickness and Nausea
- Nonsedating antihistamines are not effective in the prevention and treatment of motion sickness 3.
- Ondansetron is not effective in preventing motion sickness in highly susceptible subjects, despite its proven prophylactic effect on post-operative nausea and chemotherapy-induced nausea and vomiting 6.
- Ginger root is not effective in the prevention and treatment of motion sickness 3.
Behavioral Strategies for Motion Sickness and Nausea
- Watching the true visual horizon, steering the vehicle, tilting the head into turns, or lying down with eyes closed can help reduce symptoms of motion sickness 3.
- Avoiding difficult conditions while traveling, positioning oneself in the most stable part of the vehicle, and reducing other sources of physical, mental, and emotional discomfort can also help minimize motion sickness symptoms 3.