Remedies for Mal de Mer
Seasick pills are commonly used both by novices and circumnavigators, but you should take them well in advance. Being alert on watch is imperative, it is important to find a brand that controls nausea but does not cause drowsiness. There are many types on the market and trying out different ones is really worthwhile. Once you find a brand that suits you, buy a large supply as you might not find them in the next port let alone the next country! Always check dosages and restrictions carefully. Here's a list of the most common treatments available:
Cinnarizine (Stugeron®) Manufactured in Britain, this is probably the most popular and sucessful medication among cruisers. It is also sold in Mexico and in many ex-British protectorates such as the British Virgin Islands. We also found it in Australia and South Africa under different generic (brand) names. It is not available in the US or Canada. The dosage guidelines call for 30 mg taken one to two hours before exposure, and 15 mg every six to eight hours thereafter. It appears to be effective in all conditions and most users claim that they find it as effective as a scopalamine patch.
Dimenhydrinate (Dramamine® ,Gravol®) Most in-house brands of these over-the-counter preparations come as regular tablets, chewable tablets, long-acting capsules, liquid preparations, suppositories, and injectable preparations. Although popular among travelers, the main disadvantage for cruisers is the tendency to cause drowsiness, feelings of vertigo, and the fact that it may not be as effective as other medications in extreme conditions.
Meclizine (Bonamine,® New Dramamine®) This has long been used by cruisers for less-severe conditions, but make sure that you test it for drowsiness before heading over the horizon. It is available in a tablet that can be chewed, swallowed, or dissolved in the mouth.
Cyclizine Commonly sold as Marzine® in the US and used as an oral preparation, it is only available as an intra-muscular preparation in Canada. This also does not seem to be as effective in rough conditions.
Promethazine (Phenergan®) Available in tablet and syrup form, Promethazine is often used in severe conditions, but due to its disadvantage of causing extreme drowsiness, it may be taken with an amphetamine-like agent. Such is the ‘Navy cocktail’ of Phenergan and Ephedrine, which was developed for the astronaut program and now used by cruisers. Available in tablet and syrup form, once nausea has begun, Phenergan® suppositories can be used.
Dextroamphetamine (Dexedrine®) Although amphetamines have significant effects on motion sickness, as with Promethazine, their main use appears to be only for severe situations when they are used in conjunction with other medications, (available in short or long lasting preparations).
Scopolamine Patch (Transderm-V®) Scopolamine is very popular among cruisers for long trips in preventing seasickness as well as reducing irritability produced by a constantly moving, hot, humid environment. The Scopolamine patch is placed behind the ear at least eight hours before exposure and is replaced after 72 hours. Only the concurrent use of two patches is recommended. (As the transderm V relies on a controlled release, the whole patch should be used.) Although the long period of coverage is convenient for cruisers, the delay in effectiveness is a disadvantage if a decision is made to leave without advance warning. If departing port earlier than expected, taking another medication to ‘tide you over’ is not recommended as mixing drugs can cause a severe case of malaise. In many places, Scopolamine patches are only sold under prescription for this reason. Conversely, a delay in departure, with much of the patch being used up while still in port, can make this an expensive resource. Like most medications, Scopolamine patches can have side effects, typically dryness of the mouth and temporary blurring of vision, so check this out in advance of an ocean passage.
Pressure-point bands Commonly sold in drug stores ‘travel bands’ or Dea pressure-point wristbands, developed from Chinese acupuncture principles, are very successful in suppressing seasickness for some cruisers.