Sea Sickness and Cruise Medication

[RooFlyer]

Possible sea-sickness seems a popular reason not to cruise.

I have taken meclizine for the period where it might be a bit rough (starting the day before), with success (haven't become nauseous in high seas). Not available in Australia, so I ordered some from the USA via eBay. Order was cancelled a week later by eBay - 'can't ship internationally' - which surprised me.

Went to GP for recommendations, prescribed or OTC.

He has prescribed prochlorperazine, which seems to be an anti-nausea medication rather than sea-sickness prevention (maybe the same thing?). Those who may know - would you take it as a preventative, or only when nauseous feeling starts? I note its a sedative.

Also prescribed ondansetron - wafers to be dissolved under the tongue if vomiting occurs.

 

[Quickstatus]

would you take it as a preventative,

Yes

 

[kpc]

Having just come off a 138 pax with 80+ crew expedition ship after 18 nights, +1 and I agree that we are not cruisers. I got seasick for the first time ever (had to lie in bed with eyes closed to get some relief), food became a bit monotonous after a while and we witnessed a fair bit of entitled and selfish behaviour on board ..and no we did not make lifelong friends!

Did I mention the gastro outbreak and the widespread respiratory type infections both the crew and the other passengers got? We miraculously avoided both!

If, and only if, there was a destination we really wanted to go to and the only way to get there is by ship, we would then reconsider!

 

[RooFlyer]

Having just come off a 138 pax with 80+ crew expedition ship after 18 nights

Spill! ( please). Gastro etc ( lack of control) useful to know about

Yes

Thanks. Canary Islands and then around Sicily coming up not expecting much drama, but always want to be prepared.

 

[Quickstatus]

meclizine

prochlorperazine

ondansetron

The other one is Scopolamine Gel (but requires a compounding pharmac_ - which means short expiry date - about 2 weeks or so), or Scopolamine patches from NZ with a NZ prescripton (not available in Australia)

 

[RooFlyer]

The other one is Scopolamine Gel (but requires a compounding pharmac_ - which means short expiry date - about 2 weeks or so), or Scopolamine patches from NZ with a NZ prescripton (not available in Australia)

Ondansetron is different, isn't it? A remedy when vomiting is occurring, rather as a preventative?

 

[Quickstatus]

Ondansetron ...as a preventative

Also yes mainly for nausea from chemotherapy. Ondansetron has poor efficacy against motion sickness.
You really need one of the "..ine"


Edited @RooFlyer

 

[kpc]

The other one is [Scopolamine patches from NZ with a NZ prescripton (not available in Australia)

I bought this online for +1 without the need of any prescription.

https://www.nz-online-pharmac_.com/...pack-of-10.html?searchid=891427&search_query=

 

[zig]

I have always found Meclazine to be available at the reception desk, or at the Medical centre. Just ask for it and they provide it.

 

[RooFlyer]

I have always found Meclazine to be available at the reception desk, or at the Medical centre. Just ask for it and they provide it.

Which reception/medical centre?

 

[Quickstatus]

bought this online for +1 without the need of any prescription

Hmm maybe they have become non prescription- thanks

 

[zig]

Which reception/medical centre?

Reception desk and medical centre on both Silversea and Crystal. Staff hand them over without questions at no charge.

 

[zig]

Which reception/medical centre?

From a previous Silversea cruise. Contains 4 tablets.

 

[love_the_life]

Bonine (Meclazine) is usually available to buy on board - ships that are not based 100% in AU I am thinking - have seen it on Princess, NCL and I think Silversea. I usually pick up a packet for 'future' emergencies.

 

[drron]

Everyone seems to have forgotten ginger. Both Silversea and Crystal have bowls of it out as you exit the restaurant.
I always take it but because I just like it not for sea sickness.

https://www.sciencedirect.com/science/article/pii/S0011393X20300175

 

[MEL_Traveller]

Ondansetron is different, isn't it? A remedy when vomiting is occurring, rather as a preventative?

Ondansetron is another name for zofran. It was prescribed by our vet as a preventative (anti nausea).

 

[MelMel]

Personal experience - I take prochlorperazine intermittently for Vestibular Neuritis (inner ear problems) it can give me a dry mouth and sometimes a headache the next day. Tried Ondansetron it stopped the nausea but knocked me out completely.
I know of someone who was given scopolamine on a cruise and ended up with blurred vision and had to leave the cruise and be hospitalised
Depending how severe the nausea is sometimes the seabands wristbands work

 

[kpc]

I know of someone who was given scopolamine on a cruise and ended up with blurred vision and had to leave the cruise and be hospitalised

The scopolamine patches were discontinued in Australia because of side effects....+1 suffered from (quite bad) blurred vision and could not read, dry mouth and drowsiness from the scopolamine patches but did not get sea sick. There are many contraindications to using the scopolamine patch so I myself cannot use them!

 

[AuSammy]

After spending time on a 100ft wooden sailing ship in a force eleven gale and getting violently ill, I learned a few things from seasoned sailors. Never have an empty stomach, at the first sign of queasiness lie down flat and try and chill out (very unlikely you will get worse or vomit), keep up non alcoholic fluids, fresh cool air if available. Been on lots of cruises, do sometimes get queasy in very rough seas and follow the rules, not vomited or taken medication yet.

 

[Quickstatus]

The scopolamine patches were discontinued in Australia because of side effects....

No
The original drug delivery system (the patch) was causing issues - IIRC it was not releasing enough of the medicine as designed. It was then pulled off the market worldwide for some years but not because of side effects.

The improved version is what is available now.
It is not banned in Australia. Rather, the manufacturers did not seek approval for the new drug delivery system in Australia because of the length of time for drug approval in Australia and Australia is a very small market. In fact Scopolamine is available in oral form in Australia. The brand name is Kwells - the active ingredient is "hyoscine" which is another name for Scopolamine. It is also available under the TGA Special Access Scheme in Australia for the individual patient, but this requires some paperwork

It is available on prescription in Canada, USA and apparently pharmac_ medicine non prescription in NZ possibly because their drug approval systems are not as strict??

The reason the "...ine" dugs work for motion sickness is due to something called the "anticholinergic" effect. The reason ondansetron is not as good for motion sickness is because ondansetron does not have any anticholinergic effect. The problem however, is that the side effects of any of the "..ine" medicines are also related to the "anticholinergic" effect. Basically 2 sides of the same coin.

The anticholergic side effects include:
- blurred vision
- pupil dilation - difficulty reading. Same reason why you can't drive after you had your eyes dilated using an anticholinergic drops by the eye doctor.
- drowsiness
- dry mouth
- dizziness
- constipation
- inability to urinate (big problem for blokes with enlarged prostates)
- confusion especially in the elderly
- hallucination especially in the elderly