Posts Tagged ‘meclizine’

Conquering Queasiness On A Cruise

Q:  I’m going on a cruise to Alaska this summer. Which motion sickness medicine should I take with me?

Even if you’ve never had trouble with motion sickness before, packing something to deal with seasickness is a smart idea.

You have several remedies to pick from: ginger root, over-the-counter remedies such as Dramamine® or Bonine®, and a prescription-only scopolamine patch called Transderm-Scop®. These differ from one another in 3 ways: how long the protective effect lasts, what type of side effects they can cause, and whether or not you actually will experience any side effects. Unfortunately, there’s no way to predict whether any medicine will give you side effects, so it’s best if you try it on yourself long before your ship casts off.

Ginger root is the safest option for preventing motion sickness. It has no side effects and is the best choice for children and pregnant women. I wish my parents had known about using ginger – it would have saved me so much misery riding in the back seat of my parents’ station wagon. Discovering it as an adult totally transformed my travel experience.

Ginger should be taken at least 30 minutes before you’ll need it to start working. Each dose is only effective for 4-6 hours, so be prepared to redose several times during the day. You can buy ginger as crystallized chunks of root (cooked with sugar) in the spice aisle, but if its intense hot/sweet taste is not for you, ginger capsules are widely available in the health food section of most grocery stores.

There are 2 antihistamines used for motion sickness prevention available without a prescription: meclizine and dimenhydrinate. Meclizine is my personal choice. It’s available as Bonine® and Dramamine® Less-Drowsy Formula in 25mg tablets, and also as generic meclizine in 2 different strengths, 12.5mg and 25mg. Meclizine works for 24 hours and is taken once a day. It can cause some drowsiness, but how much will vary from person to person. Most people don’t notice much drowsiness, but if you are one of the unlucky ones, one tablet can put you to sleep for the day! Also, watch out, neither antihistamine mixes well with alcohol causing significant drowsiness or confusion.

Buying Dramamine® for motion sickness can be confusing because it comes as two different products: Original and Less-Drowsy. The Less-Drowsy formula contains meclizine; the Original Formula has a shorter-acting antihistamine called dimenhydrinate. Your body turns dimenhydrinate into diphenhydramine, which you may recognize as the generic name of Benadryl®. Benadryl® commonly causes drowsiness and is even sold as a sleeping pills like Sominex-2 and Tylenol-PM. Just like Benadryl®, dimenhydrinate only lasts 4-6 hours, which means you’ll need to redose during the day.

The last motion sickness medicine is Transderm-Scop®, a small, round tan-colored patch applied behind your ear. This prescription-only patch contains scopolamine and lasts for 3 days, longer than any other motion sickness medicine. Scopolamine side effects include dry mouth, blurred vision, dizziness, confusion and even hallucinations, something you definitely want to check out BEFORE you’re depending on it to keep down your dinner. It also shouldn’t be cut or given to a child.

On a trip back home to Seattle from Orlando some years ago I lost track of how long it had been since my last dose of ginger because of the time changes heading westward. I didn’t realize the ginger had worn off until we hit turbulence heading over the Cascade Mountains on the last 30 minutes of the flight. After the very bumpy and utterly miserable descent into Seattle, I vowed to find another option. Today I take meclizine on every trip, although I also pack crystallized ginger pieces if I’m going on a boat. My small tube of chewable meclizine called Bonine® is easy to pack and I keep it refilled from a bottle of 100-count generic 25mg chewable tablets at home. Meclizine is my miracle motion sickness remedy because I only have to chew one tablet a day and I’ve never had drowsiness or any other side effects from it.

Whether you choose to take ginger, meclizine or a scopolamine patch on your cruise, be sure to try it out before you go to avoid getting on the wrong ship because of blurry vision, snoozing your vacation away in your cabin or seeing dancing elephants on the ceiling. Bon voyage!

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My Favorite Remedies

If you were stranded on a desert island, which remedies would you be sure to take? I’ve been thinking about my own “must haves” for that. Here are some of my favorites:

1.  Meclizine 25mg tablets.

Indispensable in controlling my motion sickness when riding in cars, planes or ships, meclizine is such a travel essential that I NEVER leave home without it. Sure, I do fine if I’m the driver, but if I’m a passenger I’ll get a headache, nausea or worse. One dose of 25mg meclizine lasts 24 hours, allowing me to travel comfortably, even in the back seat. I can even read a book or surf the Internet on my phone. Sure, I probably wouldn’t need it while ON the desert island, but what about the trip going TO and FROM it?

2. New Skin® liquid.

This stuff is absolutely wonderful to prevent ingrown toenails. Since I’ve been using it painful or ingrown toenails have not bothered me. I apply just a little bit just under the nail and to the skin immediately around the sides of my nail and it toughens the skin and helps keep my toenails from curling under and cutting into the tender skin underneath. It also protects small cuts from dirt, a nice bonus on a desert island. New Skin® now comes in a handy 15 ml bottle which takes up less space compared to its original 30 ml size bottle.

3. Docusate 250mg capsules.

I struggle with earwax buildup and often end up in my doctor’s office getting my ears flushed out. I used to use Debrox® liquid made my ears go “snap, crackle and pop” caused an unbearable tickling sensation. This year I decided to try docusate, because docusate liquid is what most doctor’s offices use to soften impacted earwax before flushing it out. However, it’s not sold as earwax remover in the United States.

Last month my left ear became completely blocked with earwax, to the point I couldn’t hear at all. I cut off the end of a 250mg docusate capsule with kitchen scissors and squeezed the contents into my left ear. The capsule had just the perfect amount of liquid for my ear canal and unlike Debrox® it didn’t crackle or tickle. I followed that up with another capsule 12 hours later and waited another couple of hours then used my little blue bulb syringe to gently flush it out. I could hear again! The bulb syringe even helped me draw out the leftover water out of my ear.

I prefer the convenience of the capsules (buy 250mg instead of 100mg capsules), but you can also buy an empty dropper bottle and fill it with docusate liquid (not the syrup), both available from your pharmacist.

4.  Butterfly bandages.

These would be very useful on a desert island. Ever since my training as an Emergency Medical Technician, I keep both large and small butterfly bandages in my medicine cabinet and in my car. They work really well to match up the edges of medium to large cuts and help avoid getting stitches. Sometimes I cut the big ones in half lengthwise and use them extra close together to help seal up the edges.

Last week I dropped a full jar of molasses onto my husband’s empty deep green glass coffee mug. CRASH! As I reached over to carefully pick up the green shards, my thumb brushed up against the newly razor-sharp edge of a clear 4-cup glass Pyrex pitcher also broken in the crash. Thank goodness for those butterfly bandages! HOWEVER, if you can see bone or have any trouble moving your fingers get medical attention immediately, as you may have nicked a tendon which can cause permanent disability if not treated.

5. Calendula cream.

For dry or irritated skin, I’ll be sure to pack my favorite Arbordoun’s Abundantly Herbal Calendula Cream® that contains calendula and lavender in an olive oil base. Although it’s a little greasy when I first put it on, it soaks in completely in just a couple of minutes.

6. My pillbox.

Since I’ve been using a pillbox I’m SO much more consistent in taking my medicine. It’s the number one strategy I recommend to everyone for taking your medicine safely.

What are some of YOUR favorite remedies?

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Which Medicines to Pack?

Q: What medicines should I travel with? We have several vacations planned this summer and I want to make sure I pack the right stuff.

Vacations are wonderful opportunities to get away from your usual routine and see new horizons. Just because you are on vacation doesn’t mean you can’t get injured or sick. Motion sickness, aches and pains and intestinal disturbances can derail your vacation if you aren’t prepared.

First, before you walk out the door make sure you’ve packed all of your regular prescription medicines plus a current list of all your medications and your doctor’s name. Using pillboxes for taking your medicines on the road keeps your main bottles at home (less hassle in case you accidently leave your pills behind) and takes up less space. Filling up your pillboxes before you leave also alerts you to whether you’ll need any refills before you return.

If you’re going to need a refill before you get back into town you can either ask for a larger quantity from your doctor or ask if your pharmacist could refill your medicine a little early. Some insurance programs have a grace period of one “vacation refill” per year. If you take prescription pain or anxiety medicines, talk with your doctor or pharmacist beforehand about what to do about refills during the time you will be gone. Some medicine requires a new printed prescription each time you get it filled, which can be very difficult to get if you need another fill while out of town.

When traveling outside the United States, you can avoid spending your vacation visiting the local bathrooms instead of the beaches or museums by being extra cautious about your food and drinks. My daughter made it through 9 months as an exchange student in Bangkok, Thailand with no sickness until buying a snack from a street vendor. She got so sick her host family had to take her to a hospital. Avoid unpeeled fruits, uncooked veggies like salads, and prepared meals that may have been stored at improper temperatures or not completely cooked. With beverages, “boil it, cook it, open it, or forget it”. And watch out for ice cubes or shaved ice: don’t drink a freshly opened bottle of water or soda that has been poured over ice!

If you do end up with nausea, vomiting or diarrhea, DON’T take NSAIDs (non-steroidal anti-inflammatory drugs) such as naproxen (Aleve®) or ibuprofen (Advil®, Motrin-IB®) for pain, swelling or fever. Taking an NSAID like naproxen or ibuprofen while dehydrated can damage your kidneys. Take acetaminophen (Tylenol®) instead.

Along with your prescription medicines be sure to pack some non-prescription medications for common conditions.

Here’s what I bring with me when I travel:

1. Acetaminophen (Tylenol®). Good for tension headache from staring at maps, backache from riding all day in a car, or fever.
2. Meclizine (Bonine®, Dramamine® Non-Drowsy Formula). The chewable 25mg tablets are my go-to motion sickness medicine for trains, planes, boats and cars. Also helpful for amusement park roller coasters that go backwards and upside down.
3. Loperamide (Imodium®-AD). This is the very best way to stop diarrhea in its tracks. I NEVER leave home without it.
4. Pseudoephedrine (Sudafed®). Since my ears can really plug up when traveling by plane, I make sure I have the original (most effective) formulation with me since in some states it’s now only available by prescription.
5. Diphenhydramine (Benadryl®). This is a miracle worker for bee stings, bug bites, minor rashes and allergic reactions. If you have any swelling around your face or tongue, though, seek medical help immediately.
6. Naproxen, 220mg tablets. This NSAID is great for emergencies like tooth pain or muscle aches. Avoid if you take a blood thinner (like aspirin, warfarin or clopidogrel), have serious heart failure, are allergic to aspirin, or have had a bleeding ulcer. Use acetaminophen (Tylenol®) for aches and pains if you can’t safely take an NSAID like naproxen or ibuprofen.
7. Dried Prunes. Prunes, you ask? I pack these as insurance against constipation. It’s been shown that eating 5 prunes is just as effective as taking a stool softener, and I can adjust the “dose” up or down according to my needs. You can pack your favorite laxative instead. I recommend Miralax® because it’s powerful yet gentle on the body.
Bon voyage and safe travels!

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Trains, Boats and Automobiles

Q: I’ve tried looking straight ahead when riding in cars to avoid motion sickness, but it doesn’t seem to help. I’m still miserable. Is there something else you can recommend?

Summer is a traditional time for vacations and travel. According to Robert Louis Stevenson, author of Treasure Island, “To travel hopefully is a better thing than to arrive.” When you suffer from motion sickness it’s a relief to arrive because it means you’ve finally stopped moving!

When I was in grade school, my parents would pack up our Pontiac station wagon with six kids, various changes of clothing, sleeping bags, and a picnic basket of fried chicken. We’d drive over rivers and through cities and woods to visit my grandparents who lived 4 miles north of Ocean Shores on the Washington coast. Although I have fond memories of good times playing along the Pacific Ocean, getting there was hours and hours of agonizing nausea punctuated with frantic cries of “Dad, Dad, pull over!” Even today, I still avoid KFC fried chicken.

I was liberated from my back seat misery when Varro Tyler, Ph.D. came to Seattle in 1983 to speak at a pharmacy conference. He was one of the authors of my pharmacy textbook called Pharmacognosy, which is the study of drugs from natural sources, and at that time he was  writing a monthly column on herbs and natural products for Prevention magazine and had just published his book The Honest Herbal.

Dr. Tyler changed my life by suggesting ginger for prevention of motion sickness. I went home and immediately bought some crystallized ginger I found in the spice section of my local grocery store and used my apothecary scale to determine the appropriate size for an adult dose, which turned out to be just slightly bigger than a full size tablet of aspirin. Because it was chewable I could take it anywhere, and I found its sweet-hot taste pleasant. With ginger I no longer turned 10 shades of green when flying from Yakima to Seattle over the Cascade Mountains, and could even read a book in a moving car.

Along with ginger for motion sickness there is also acupressure, three different oral medicines available without a prescription and a scopolamine patch. Each of the medicines works best if taken at least 30 minutes before you start moving.

Sea-Bands® are elastic bands worn around your wrist that activate a pressure point inside your wrist that can prevent motion sickness. Ginger can be used as fresh root, capsules, or in the crystallized form. Ginger is given as 500mg-1000mg of powdered root every 4-6 hours as needed. Crystalized ginger is twice the weight of the powdered form so 1000mg would be the equivalent dose. Ginger ale, ginger tea and gum don’t have enough ginger to provide reliable relief.

Dramamine® has two different formulations, the original one and a less drowsy formula. The original formula of Dramamine® contains dimenhydrinate, a close cousin of diphenhydramine, commonly known as Benadryl®. Either one can be useful for motion sickness prevention but cause drowsiness and need to be taken every 4 to 6 hours.

Meclizine is the best tolerated medicine for motion sickness. It is sold as Bonine®, the  less drowsy formulation of Dramamine® and as generic meclizine. When buying meclizine be careful to select the 25mg of the two strengths on the shelf. Meclizine is inexpensive, chewable, only rarely causes drowsiness and has convenient once daily dosing. I now prefer meclizine 25mg chewable tablets when I travel.

If these non-prescription options don’t quell your queasiness, the scopolamine patch (Transderm Scop®) is also available. Worn behind the ear for 2-3 days at a time, it is more effective for motion sickness but causes more side effects like fatigue, blurred vision, dry mouth, constipation and urinary retention. Talk to your medical provider if it is safe for you, especially if you take medicine for nerve pain or overactive bladder.

According to T.S. Eliot, “The journey not the arrival matters.” I hope one of these options help you enjoy your journeys by plane, boat or automobile unencumbered by the distress of  nausea from motion sickness.

 

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