Safety of Bonine or Dramamine with Mirtazapine for Seasickness
Yes, you can safely take Bonine (meclizine) or Dramamine (dimenhydrinate) in the morning while taking mirtazapine at night, with no significant contraindications between these medications. 1
Key Safety Considerations
No Major Drug Interactions
- Mirtazapine has been shown to be safe in cardiovascular patients and has minimal drug-drug interactions reported 1, 2, 3
- Neither meclizine nor dimenhydrinate have documented serious interactions with mirtazapine 2, 3
- The primary concern is additive sedation, as both antihistamines and mirtazapine can cause drowsiness 1, 2
Additive Sedation Risk
- Mirtazapine causes sedation in approximately 19-23% of patients, particularly when first starting therapy 2, 3
- Antihistamine-based motion sickness medications (Bonine/Dramamine) also cause drowsiness 4
- Take your motion sickness medication in the morning and mirtazapine at night to minimize overlapping sedative effects 1, 3
Timing Recommendations
When to Start Taking Motion Sickness Medication
Begin taking your chosen medication 1-2 hours before boarding the ship for optimal protection 4
- Meclizine (Bonine) reaches peak effectiveness within 1-2 hours 4
- Dimenhydrinate (Dramamine) has a similar onset 4
- Taking it "only if needed" after symptoms start is less effective than prophylactic use 4
Continue Throughout the Cruise
- Take daily in the morning while at sea, as motion sickness prevention works better than treatment after symptoms develop 4
- Your nighttime mirtazapine schedule remains unchanged 3
Choosing Between Bonine and Dramamine
Bonine (meclizine) is the better choice for a cruise because:
- Longer duration of action (12-24 hours vs 4-6 hours) 4
- Less frequent dosing needed (once or twice daily vs every 4-6 hours) 4
- Comparable efficacy to Dramamine with potentially less sedation 4
Important Caveats
Monitor for Excessive Sedation
- Watch for increased drowsiness, especially in the first few days when combining these medications 1, 2
- Avoid alcohol, which can worsen sedation with both mirtazapine and antihistamines 2
- Be cautious with activities requiring alertness (particularly important on a ship) 4
Why Scopolamine Patches Caused Double Vision
- Your previous double vision with scopolamine patches was likely due to anticholinergic effects causing pupil dilation and impaired accommodation 4, 5
- This is a known adverse effect occurring in up to 20-30% of users 4
- Meclizine and dimenhydrinate have much lower anticholinergic activity and are unlikely to cause the same visual problems 4
No Cardiovascular Concerns
- Mirtazapine is safe in patients with cardiovascular disease 1, 6
- Antihistamine-based motion sickness medications do not pose significant cardiac risks in healthy individuals 4