What is the Best Medication for Motion Sickness? — Patches vs. Pills

Here’s what you should know about motion sickness and how to choose the best treatment for you.

How is motion sickness caused?

The most widely held explanation for why some of us experience motion sickness is called the “sensory conflict hypothesis.” Simply put, each person has an internal representation of bodily movement. This internal picture is continuously updated by information your body receives from your eyes, the balance system in your inner ear (aka. the vestibular system), and sensory receptors in your joints and muscles.

Motion sickness occurs when there is a mismatch. The body can’t figure out if it’s moving, the water is moving, or your legs are moving — and it’s not happy. Your brain receives conflicting sensory inputs and the results are nausea and vomiting.

What’s the best medication to prevent motion sickness?

Scopolamine patches (Transderm Scop) are the best way to prevent nausea associated with motion sickness. They require a prescription, but they’re preferred over popular over-the-counter alternatives.

Scopolamine patches are more effective than the motion sickness antihistamine meclizine (Antivert or Bonine). They’re also just as effective as Dramamine (dimenhydrinate), and unlike Dramamine, they don’t make you sleepy.

How do motion sickness patches work?

Scopolamine is prescribed as a transdermal patch (a patch you put on the skin). This helps make up for the short amount of time scopolamine works when it’s taken by mouth. One patch contains 1.5 mg of scopolamine and is meant to deliver 0.5 mg per day over a three-day period. So you change the patch every three days.

The proposed way that scopolamine patches work is complicated. Basically, they work by helping your body understand its environmental orientation, despite the irregular signals your inner ear might be sending to your brain.

The patch goes behind the ear because that area is highly permeable — it’s the place on your skin where the medication can get through the easiest. That’s also why scopolamine needs to be dosed at a lower quantity to be effective.

Are there any side effects to the motion sickness patch?

Dry mouth is a common complaint, and other side effects include some drowsiness, dilated pupils and rapid heartbeat. Generally though, the patch is very well tolerated.

How much does the motion sickness patch cost?

Transderm Scop is the brand-name version of the generic patch, scopolamine. It is covered by most insurance plans, often with a moderate co-pay, so it isn’t the most expensive drug out there if you’re insured. However, if you’re paying cash, you could be looking at about $85 for four patches — something to weigh against the drowsy side effects of Dramamine. The generic patches cost about the same out of pocket, but you may be able to find them for as low as $30 for four patches if you shop around.

What doesn’t work for motion sickness?

Ondansetron (Zofran) and the antihistamines cetirizine (Zyrtec) and fexofenadine (Allegra) do not reduce symptoms of motion sickness and should not be used.

Dr O.

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