What is the role of antihistamines in the prevention of motion sickness?

Updated: Oct 22, 2018
  • Author: Andrew Brainard, MD, MPH; Chief Editor: Selim R Benbadis, MD  more...
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Answer

Many antihistamines are also commonly taken for motion sickness. They are available over the counter and can be used for pediatrics at the recommended doses. They should also be used to prevent motion sickness rather than treating it.

Their effectiveness is likely due to both their central antihistamine and central anticholinergic properties. The nonsedating antihistamines like cetirizine that do not cross the blood-brain barrier are not effective in either preventing or treating motion sickness.

Common side effects can include: dry mouth/nose/throat, drowsiness and sensitivity to bright light (secondary to mydriasis). Less common include palpitations, urinary retention, bloating, constipation, headache and confusion. They should be taken 1 hour prior to departure.

  • Cinnarizine  (Stugeron) is an antihistamine (not marketed in the US), that is reported to be effective if administered at a 50mg oral dose before a rough voyage. [27] Although cinnarizine is not licensed by the FDA in the United States, several studies report cinnarizine as the most effective antihistamine with the fewest side effects. [28]

  • Dimenhydrinate  (Dramamine, Gravol, Driminate), Meclizine  (Bonine, Bonamine, Antivert, Postafen, and Sea Legs), and Cyclizine ( Marezine, Bonine For Kids, Cyclivert) are long-acting piperazine antihistamines and generally cause less sedation than other antihistamines.

  • Promethazine (Phenergan) is prescribed for treating nausea or vomiting, motion sickness, and allergic reactions, but causes more sedation than other antihistamines.


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