How Effective is Dramamine for Motion Sickness?
Dramamine (dimenhydrinate) is moderately effective for preventing motion sickness, reducing symptoms in approximately 40% of susceptible individuals compared to 25% with placebo, though it causes significant sedation and is less effective than scopolamine. 1
Efficacy for Motion Sickness Prevention
Dimenhydrinate demonstrates proven effectiveness under natural motion conditions (air, sea, and land travel), with an 81% increased likelihood of preventing motion sickness symptoms compared to placebo (RR 1.81,95% CI 1.23 to 2.66). 1
The FDA has approved dimenhydrinate specifically for the prevention and treatment of nausea, vomiting, or vertigo associated with motion sickness. 2
Antihistamines like dimenhydrinate work by suppressing the central emetic center to relieve nausea and vomiting, with approximately 40% prevention effectiveness under natural conditions. 3
Comparative Effectiveness
Dimenhydrinate is somewhat less effective than scopolamine for motion sickness prevention, though the evidence comparing them directly is of very low certainty (symptoms prevented: 81% scopolamine vs. 71% dimenhydrinate). 1
When compared head-to-head with cyclizine (Marezine), both drugs suppress overall motion sickness symptoms with equal effectiveness, though dimenhydrinate causes more CNS effects while Marezine acts more directly on the stomach. 4
Dimenhydrinate was somewhat more effective against nausea than a single transdermal scopolamine patch in experimental studies, and significantly reduced vertigo compared to placebo. 5
Adverse Effects Profile
Dimenhydrinate causes significantly more sedation than placebo, with 66% of users experiencing drowsiness compared to 44% with placebo (RR 1.51,95% CI 1.12 to 2.02). 1
The medication results in little or no difference in blurred vision (14% vs. 12.5% placebo) or impaired cognition (29% vs. 33% placebo) compared to placebo. 1
Dimenhydrinate causes more drowsiness than cyclizine (Marezine) at 30 minutes post-ingestion, and is associated with greater increases in gastric dysrhythmias during motion exposure. 4
Clinical Recommendations and Limitations
First-generation antihistamines like dimenhydrinate are recommended as second-line agents when scopolamine cannot be used due to contraindications or side effects, with typical dosing of 50 mg. 3, 6
Scopolamine remains the first-line medication for motion sickness prevention and should be administered transdermally several hours before anticipated motion exposure. 6
Long-term use of vestibular suppressant medications is not recommended, as they can interfere with central compensation in vestibular conditions. 3
Important Clinical Pitfalls
Dimenhydrinate is ineffective in highly susceptible individuals - studies show no difference from placebo in preventing motion sickness in people with frequent, severe motion sickness history. 7
The medication must be taken prophylactically before motion exposure for optimal effectiveness; evidence for treating existing symptoms is lacking. 1
Anticholinergic medications like dimenhydrinate are independent risk factors for falls, particularly in elderly patients, requiring careful consideration in this population. 3