What is the drug of choice for motion sickness?

October 12, 2025 •

4 min read

About 1 in 3 people are considered highly susceptible to motion sickness, a condition that can turn travel into a miserable experience [1.8.1]. When behavioral strategies aren't enough, many wonder, 'What is the drug of choice for motion sickness?'

Quick Summary

Scopolamine is a first-line medication for preventing motion sickness, valued for its effectiveness [1.2.1]. First-generation antihistamines like dimenhydrinate and meclizine are also effective, though they can cause drowsiness [1.2.1].

Key Points

Scopolamine is a first-line drug: The prescription scopolamine patch is considered one of the most effective medications for preventing motion sickness, especially for long trips [1.2.1, 1.3.1].
Antihistamines are effective OTC options: First-generation antihistamines like dimenhydrinate (Dramamine) and meclizine (Bonine) are widely used and effective for motion sickness prevention [1.2.1].
Drowsiness is a major side effect: The primary drawback of most motion sickness medications, particularly first-generation antihistamines, is drowsiness [1.3.3]. Meclizine is generally less sedating than dimenhydrinate [1.4.4].
Prevention is key: Medications are significantly more effective when taken before travel begins, rather than after symptoms have already started [1.2.4].
Duration varies: A scopolamine patch lasts up to 3 days, meclizine lasts for 24 hours, and dimenhydrinate must be taken every 4-6 hours [1.11.1, 1.4.4].
Behavioral changes help: Non-drug strategies like looking at the horizon, choosing a stable seat, and getting fresh air can significantly reduce symptoms [1.7.1].
Avoid Alcohol: Combining alcohol with motion sickness medication dramatically increases drowsiness and dizziness and is not recommended [1.10.1, 1.10.2].

Understanding Motion Sickness

Motion sickness occurs when your brain receives conflicting signals from your inner ears, eyes, and body about your state of motion [1.8.1]. For example, inside a ship's cabin, your inner ear feels the vessel's movement, but your eyes see a stationary room. This sensory mismatch is believed to trigger symptoms like nausea, dizziness, cold sweats, and vomiting [1.8.1, 1.2.1]. While nearly anyone can experience it given a strong enough stimulus, some individuals are more susceptible, including women, children aged 2 to 15, and those with migraines [1.8.2, 1.2.1]. Fortunately, prevention is much more effective than treating symptoms after they've started [1.2.4].

First-Line Pharmacological Treatments

When it comes to preventing motion sickness, medication is a highly effective strategy. The two primary classes of drugs used are anticholinergics and first-generation antihistamines [1.2.4].

Scopolamine: The Prescription-Strength Patch

Scopolamine, an anticholinergic medication, is considered a first-line drug for the prevention of motion sickness, especially for those who need to remain awake [1.2.1]. It is most commonly available as a transdermal patch (e.g., Transderm Scōp), which is applied behind the ear [1.2.2].

How it works: Scopolamine functions by blocking acetylcholine, a neurotransmitter involved in communication between the inner ear's vestibular system and the brain [1.3.1, 1.2.3]. This helps to prevent the sensory conflict that leads to nausea.
Efficacy: Clinical studies have consistently shown scopolamine to be superior to placebo and more effective than some antihistamines like meclizine for preventing motion sickness [1.3.1, 1.3.2].
Application and Duration: The patch should be applied to a clean, dry, hairless area of skin behind the ear at least four hours before travel [1.11.2]. A single patch provides protection for up to 72 hours (3 days), making it a convenient option for longer journeys like cruises [1.11.1].
Side Effects: The most common side effect is dry mouth [1.3.1]. Other potential side effects include drowsiness, blurred vision, dizziness, and dilated pupils [1.5.2]. Due to its potency, it's available by prescription only and is generally not recommended for children [1.3.5, 1.9.1].

First-Generation Antihistamines: The Over-the-Counter Options

First-generation antihistamines are widely used, effective, and easily accessible over-the-counter (OTC) [1.3.1]. Their anti-motion sickness effect comes from their central-acting anticholinergic properties, not just histamine blockade [1.3.1]. Second-generation antihistamines like Zyrtec and Allegra are not effective for motion sickness [1.3.1].

Dimenhydrinate (Dramamine Original Formula): This is one of the most studied and commonly used OTC motion sickness drugs [1.3.1]. It is effective but known for causing significant drowsiness [1.4.4, 1.6.5]. It's available for adults and children over the age of two [1.9.3]. Dosing is typically required every 4 to 6 hours [1.4.3].
Meclizine (Bonine, Dramamine Less Drowsy): Meclizine is another popular OTC choice, known for causing less drowsiness than dimenhydrinate [1.4.2]. It also has a longer duration of action, requiring only one dose per day [1.4.4]. However, some studies suggest it may be slightly less effective than dimenhydrinate [1.3.1]. It is generally recommended for adults and children 12 years and older [1.9.3].
Promethazine: This is a prescription-only antihistamine and is considered the most effective in its class, with efficacy only slightly less than scopolamine [1.3.1]. However, it is also highly sedating [1.2.1].

Comparison of Common Motion Sickness Medications


Medication	Active Ingredient	Type	Availability	Dosing Frequency	Key Feature
Transderm Scōp	Scopolamine	Anticholinergic	Prescription	Every 72 hours	Long-lasting, highly effective [1.2.1, 1.11.1]
Dramamine Original	Dimenhydrinate	Antihistamine	OTC	Every 4-6 hours	Fast-acting, for adults and kids 2+ [1.4.2, 1.9.3]
Bonine / Dramamine Less Drowsy	Meclizine	Antihistamine	OTC	Once daily	Less drowsy, long-acting [1.4.2, 1.4.4]
Phenergan	Promethazine	Antihistamine	Prescription	Every 12 hours	Highly effective but very sedating [1.3.1, 1.2.1]

Non-Pharmacological Strategies and Other Remedies

Before turning to medication, or in combination with it, several behavioral strategies can significantly reduce the risk of motion sickness [1.7.1]:

Focus on the Horizon: Fix your gaze on a stable, distant point. Avoid reading or looking at screens [1.2.1].
Positioning: Sit in a place with the least motion, such as the front seat of a car, over the wings of an airplane, or in a central cabin on a ship near the water level [1.2.5].
Fresh Air: Good ventilation or directing an air vent toward your face can help [1.2.5].
Diet: Avoid heavy, greasy, or spicy foods before and during travel. Stay hydrated with water [1.2.1, 1.2.4]. Alcohol should be avoided as it can worsen symptoms and dangerously increase the sedative effects of medications [1.10.2].
Ginger: Some studies and many users report that ginger can help curb nausea [1.7.2]. However, clinical trial results have been mixed, with some showing it is not effective [1.2.1].
Acupressure Bands: These bands apply pressure to the P6 point on the wrist. While some small studies have shown a benefit, larger reviews suggest they are no more effective than a placebo [1.7.1, 1.2.4].

Conclusion

Ultimately, what is the drug of choice for motion sickness depends on the individual's needs, the duration of travel, and tolerance for side effects. For multi-day trips where convenience and effectiveness are paramount, the prescription scopolamine patch is often the top choice [1.2.1, 1.3.1]. For shorter trips, over-the-counter antihistamines are excellent options. Meclizine (Bonine) offers a less drowsy, once-a-day alternative, while dimenhydrinate (Dramamine) provides reliable relief but with more sedation [1.4.4]. It's crucial to take any medication before symptoms start, as prevention is far more successful than treatment [1.2.4]. Always consult with a healthcare professional to determine the best and safest option for your specific health profile and travel plans.

For further reading, see the AAFP's guide on Prevention and Treatment of Motion Sickness. [1.2.1]

Frequently Asked Questions

Both dimenhydrinate (Dramamine Original Formula) and meclizine (Bonine, Dramamine Less Drowsy) are effective over-the-counter options. Meclizine tends to cause less drowsiness and its effects last longer (24 hours), while dimenhydrinate may be slightly more potent but requires more frequent dosing and causes more sedation [1.4.4, 1.6.4].

A single scopolamine patch, applied behind the ear, is effective for up to 72 hours (3 days), making it ideal for longer journeys like cruises or multi-day travel [1.11.1].

Yes, but options are more limited. Dimenhydrinate (Dramamine for Kids) is approved for children ages 2 and up [1.9.3]. Meclizine and scopolamine are generally recommended only for children 12 and older [1.9.3]. Always consult a doctor before giving medication to a child [1.9.1].

For best results, all motion sickness medications should be taken before you begin traveling. Scopolamine patches should be applied at least 4 hours beforehand, while oral antihistamines like Dramamine or Bonine should be taken 30 to 60 minutes prior to departure [1.11.2, 1.2.5].

While ginger is a popular natural remedy, scientific evidence is mixed. Some studies and anecdotal reports suggest it can help reduce nausea, but other controlled trials have found it to be no more effective than a placebo [1.2.1, 1.7.2].

No, it is strongly advised not to mix alcohol with motion sickness medications like Dramamine, Bonine, or scopolamine. The combination can dangerously increase side effects such as drowsiness, dizziness, and impaired coordination [1.10.1, 1.10.2].

The main difference is the active ingredient. Dramamine Original contains dimenhydrinate, which is effective but can cause significant drowsiness [1.9.3]. Dramamine Less Drowsy contains meclizine, which also prevents motion sickness but is formulated to be less sedating and longer-lasting [1.4.2, 1.9.3].