BoatUS.com - Seaworthy Magazine

Seasick Remedies

Meclizene (Bonine, Dramine II)

Originally developed to treat vertigo, Meclizine (generic Antivert) is available as a stronger prescription drug in 50mg dosages and over the counter in 25mg dosages for adults and 12.5mg for children. Several readers noted that Meclizine has a tendency to make you sleepy, especially the prescription version, which, as one reader said, “puts me to sleep and keeps me there.” Alcohol exacerbates the tendency to make people drowsy.

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I'd like to share my methodology for effectively coping with my severe tendency to get seasick. After many different trials of drugs and gadgets, I have found that taking Meclizine (Bonine) at least 18 hours before motion begins is KEY! Thereafter, I take 1/2 of a 25 mg Meclizine tablet every morning and evening until reaching shore. The directions on most pills for seasickness prevention speak of 2 - 4 hours before exposure. This simply is not enough time for the drug to get fully distributed in your body. This works so well, that I remained "under control" during a flight in a twin-engine DASH 8
flying through a severe frontal passage with serious-looking thunderheads all around us. My wife who is motion sickness-resistant, didn't use my Meclizine, got very ill on that flight.

Another item of interest is that the Scopolamine patch, for a few (unlucky) individuals, can CAUSE one to suffer seasickness symptoms. Back in the early '90s, I spent 3-1/2 days bringing a 25-foot sailboat from New London, CT to Chelsea, NY. During that time I wore a Scopolamine patch with no negative results. Immediately after this, we flew to the BVI to begin a week of bareboat sailing. At this point, I was on my second patch (I get airsick too). When we left the dock, I began to feel that familiar unease, and thinking the patch had gone flat, put another one on. Unfortunately, the nausea did not recede, and the only time I felt comfortable was when I was snorkeling, or sleeping. Fighting the nausea finally became too much,
and we aborted our vacation trip. The nausea, and some vertigo, persisted even after I arrived home, and my wife called Ciba-Geigy, the manufacturer of the Scop Transdermic patch. The authority there told her that I was one in 100,000 that develops this side-effect from this drug. I was told to get on a tranquilizer, and drink lots of water. It took about 10 days to fully rid myself of the side-effects' symptoms, and never considered using the patch again.

BTW: I believe the problems related to the patch's temporary withdrawal was with too great a variance in the dosage being passed through the patch membrane to the skin. I don't think my problem was related to Ciba-Geigy's manufacturing problem.

Herm Schiller
New Bern, North Carolina

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I have been a boater since age 6. I am no stranger to motion sickness, both car and seasickness. I am an Otolaryngologist (Ear,Nose,Throat) specialist who deals heavily with inner ear problems since 1980.

I enjoyed your article on seasickness. There is no ultimate treatment. The problem is the balance and motion apparatus of the inner ear. Even seasoned sailors can get seasickness.

Medical therapy works the best, regardless of anecdotal reports of Relief Bands, copper bracelets, etc. There is no medical evidence to support efficacy. Accupuncture works, but my acupuncturist is seldom around when the seas get rough. The quickest and most effective drug is scopolamine, applied by a transdermal patch delivery system. Hallucinations were mentioned in your article, but these are rare. Most troublesome is the blurred vision side effect, which could affect a skipper's ability to function. Dry mouth is also common. Meclizine (generic Antivert) works well for most people, is available in a 12.5mg dose for children and seniors, and a 25mg dose for adults. It does sedate heavily. So does over the counter Dramamine or Bonine. In a pinch, even benadryl can be used efficaciously, since the previously mentioned three drugs are antihistamine in configuration.

There are exercises that can be used for "vestibular habituation". My daughter is a figure skater, and can spin around twenty or thirty revolutions, and come out to glide backward on one skate. I would be flat on the floor/deck. Her balance canals are habituated to the motion. I have used these "Cawthorne exercises" on numerous patients, and they do work. Although not invented for seasickness, they do work in most cases to make seasick-prone people less susceptible.

Keep up your great publication!

Regards,
Joseph P Gavron MD
Palos Park, Illinois

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There are two remedies we use, but prevention is the best cure; for this we use BONINE, an OTC medication with very few side effects.

If the unfortunate happens, and illness sets in, try the two old standards:
1) Ginger ale, not the clear kind, but the brown kind, or ginger beer (non-alcoholic). The stronger the ginger flavor the better.
2) This sounds cruel, but split pea soup works well. when we were on a cruise in the Caribbean, the weather was bad, and many passengers felt ill, so the cook came up with pea soup as a first course for dinner. When I teased him about being cruel, he said that the soup works well to settle, and calm the stomach.

Also get out of the cabin, and focus on the horizon, as it does not move, and will settle your mind.

R. Duda
S.V. SNAFU (Sailing Normal, all FOULED up).....at least that's what I told my wife.
Roscoe, Illinois
Sail mostly on Lake Mendota, by Madison Wis.

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As a liscened captain who works on boats year round and also someone who gets seasick almost always I've found a solution that works for me. I take one Bonine tablet every twelve hours. Since I began doing this, I have not gotten any symptoms of seasickness.

Regards
Sean Sullivan
Marblehead, Massachusetts

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I think that is what Bonine recommends, but a fellow delivery skipper with a worse case than mine suggested it. Prior to that I used the wrist bands which worked fine up to about 8-10' seas which is the worst time for seasickness to come rushing in. And prior to that i just tried to boot and get over it quickly for longer passages. I had pretty much sworn off offshore stuff until I started on the Bonine. However I always tell people to try everything and use what works for you as it seems most people who deal with it a lot eventually find their own cocktail of drugs and voodoo that works.

Good luck with the article,
-Sean

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This letter is in response to a request from Seaworthy Magazine for info on seasickness cures. My husband Don and I both fish at least once a week. We are also terribly prone to seasickness. The best remedy that we have come up with so far (besides staying home), is Meclizine HCI 25 mg. We first started using this under the name of Bonine. I have since found out that I can buy 100 tablets at a time, for a greatly reduced price, by asking for it at the pharmacy counter. Like I said, we fish a lot. I tried a patch behind the ear once, but all I wanted to do all day was sleep.

When we went to Alaska to catch halibut, we were prepared for the bad seas there. We took one tablet each before bed and another in the morning, and he took another one in the late morning. The seas getting out of the inlet at Homer, Ak, the first morning were seven feet. Don stood outside the back door to insure that he did not get ill, (fresh air helps) while I was able to remain in the cabin. The rest of the day was moderate swells, but we were both fine.

Other tips that I can offer is to eat a muffin or toast for breakfast when going on the water. Do not drink beer or wine the night before. Keep crackers or potato chips, etc. to munch on if stomach feels funny. Even with the Bonine, I will occasionally get queasy if I try to read anything. I program our GPS, and I threaten mutiny if Don tries to leave the dock before I have our info entered for the day. We also pre-rig our tackle the night before so it can be snapped on and baited, with plenty of extras available. Do not look down if at all possible. If I have to do or undo a knot or tangle of any type, I hold it up at eye level. Stay out of the cabin as much as possible. I keep a small container on board so I do not have to go below for restroom facilities.

If you are drifting to fish and feel bad, start the motor and drive for a while until you feel better. The driving and having the boat moving without the rocking always seems to help. With all of these precautions, I have occasionally felt bad for a short period of time. I watch the horizon and concentrate on breathing slowly until the feeling passes. I have never thrown up on a boat.

Melanie Bayford
Gloucester, Virginia

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Although I have spent most of my life being seasick -- even when I walked on floating docks--, I was forced to come to terms with it when I married a woman who loves to sail. A doctor who also loves to sail prescribed a combination of SeaBands applied to the wrists and the pill Bonine. Be sure to take only 1/2 a Bonine or you will become too drowsy to enjoy the sail. The combination of SeaBands and 1/2 a Bonine works for me and I recommend it to others.

Lloyd Hirsch
Ossining, New York

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Even though you did ask for "cures" I wasn't exactly sure what you wanted. In my opinion, a guaranteed technique to "prevent" sickness is to pop a couple of Dramamine 45 minutes before you sail. However, in my opinion also (and I have never tried Scopolamine) the only "cure" is to head for land. I tell all my guests to take Dramamine - some do and some won't. I also tell them that, if anyone gets sick, I will head for land immediately and I "have" done it 2 or 3 times. Fortunately, I have power. I would subject no one to this terrible feeling regardless of accidental or carelessness caused attacks. I will always head for land immediately.

Steve Radez
Tiara 5200 pilot

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In response to your July issue on Seasickness, I would like to submit the following information about my adventures.

I am an avid sailor and diver who has suffered from motion sickness my entire life and has fed many fish.

However, thanks to different types of "boat drugs" on the market - Meclazine and Scopolamine - I almost always enjoy these activities with no problem. While meclazine is available via prescription and OTC, I use only OTC. The prescription version is way too strong. It puts me to sleep, and keeps me there.

However, there have been times when I've forgotten to take my boat drug, or the experience was so incredibly difficult (going down below in a hot sailboat to pull in a spinnaker while traveling through large 8+ ft. waves, or standing on a rolling boat in 90 degrees carrying 50 lbs. of dive gear on my back) that the drug just didn't work.

One of the biggest problem with boat drugs however, is they tend to make you very drowsy and/or thirsty.

My cure for that is to cut everything in half: cut the circle patch of scopolamine in half or cut the Meclazine tablet in half. They both still works.

However, if you are planning to be on the water for several days at a time (7 days or more), or are participating in a race, you may want to take the full dose, BUT, do it the night before so that the drowsiness is much less of a factor.

And, if you do find yourself becoming seasick - with or without boat drug assistance - the best thing to do is to eat something salty - crackers, pretzels, etc. - which will cause the stomach to calm down.

Julie Phillips-Turner
Queenstown, Maryland

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I tried just a half patch of Scopolamine on a cruise to the Yucatan once and I was so miserable with severe dry mouth that I would have gladly traded for the actual seasickness. I will never take it again. My brother-in-law tried the other half patch and had blurred vision for two days! (It was at least 10 years ago, so most assuredly the old formulation.)

I have since used Bonine and it has worked fine with no adverse side effects.

Jerry Dawson
Hot Springs Village, Arkansas

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I have just read the comments on the back cover of the recent issue of Seaworthy regarding seasickness.

Yes, everybody has their favorite trick and in enough cases it must work or they would not use it. I have mine, which I have found --- in my experience – to never fail. I have been in boating for more years than I care to remember, starting in power and transiting to sail where I am now. I have been in gently rolling swells to seas breaking over the bridge. I have crossed the Straits of Magellan, etc. So much for my credentials; I use Meclizne 50mg strength. There are several different brand names. Over the counter it comes as 25mg. The 50mg is prescription. Simple – just take two (2) 25’s. The trick is in the use. Fortunately, this is an extremely safe medication, both for adults and or children and with almost all existing medical conditions. I have used it for my family at all ages.

For an ADULT, take 50mg at least a couple of hours before going out. (Reduced dose for non adults based on age and body weight) The sedation experienced can usually be passed off by not allowing yourself to go to sleep. It usually passes within an hour after it appears, again, in my experience. Now, the magic part, if you are still nauseous, take another 50mg (adults) and 20-30 minutes later another if no lessening of symptoms. The sedation level does not change. If you cannot swallow because of the nausea or vomiting crunch up the tablet and put it in your mother between the cheek and the gum (very bitter) or under your tongue. There will be absorption and a favorable response. Don’t give up! Once working, the overall response can be good from six to 12 hours before repeating, usually a single tablet. Other than the original sedation there are no significant side effects. Because of the extra tablets, I do not use this protocol in conjunction with other prescription sea sick medications.

I utilize this approach, and it always works (for me). There is no doubt that there are physiologic and emotogenic variables that can also contribute. I speak both as a licensed professional and experienced mariner. However, this is not to be taken as anything other than a suggestion and AT ALL TIMES should be supported by the judgment of a personal physician.

Norm Carabet
West Hills, California

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