travel sickness tablets bnf

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Nausea and labyrinth disorders

Drug treatment.

Antiemetics are generally only prescribed when the cause of vomiting is known because otherwise, they may delay diagnosis, particularly in children. If antiemetic drug treatment is indicated, the drug is chosen according to the aetiology of vomiting.

Antihistamines (e.g. cinnarizine , cyclizine , promethazine hydrochloride , promethazine teoclate ) are effective against nausea and vomiting resulting from many underlying conditions. The duration of action and incidence of adverse effects, such as drowsiness and antimuscarinic effects, differ between antihistamines.

The phenothiazines (e.g. chlorpromazine hydrochloride , prochlorperazine , trifluoperazine ) are dopamine antagonists and act centrally by blocking the chemoreceptor trigger zone. Severe dystonic reactions sometimes occur with phenothiazines, especially in children. Prochlorperazine is less sedating and available as a buccal tablet for children aged 12 years and over, which can be useful in patients with persistent vomiting or with severe nausea.

Other antipsychotic drugs including haloperidol [unlicensed use] and levomepromazine are used for the relief of nausea and vomiting in palliative care. A Strength of recommendation: High For information on the use of antiemetics in palliative care, see Prescribing in palliative care .

Metoclopramide hydrochloride is an effective antiemetic and its activity closely resembles that of the phenothiazines. Metoclopramide hydrochloride also acts directly on the gastric smooth muscle stimulating gastric emptying and it may be superior to the phenothiazines for emesis associated with gastro-intestinal and biliary disease. It is licensed for use in children only as a second-line option for the prevention of delayed chemotherapy-induced nausea and vomiting, and the treatment of established postoperative nausea and vomiting. There is an increased risk of neurological side-effects in children.

Domperidone acts at the chemoreceptor trigger zone. It has the advantage over metoclopramide hydrochloride and the phenothiazines of being less likely to cause central effects, such as sedation and dystonic reactions, because it does not readily cross the blood-brain barrier.

The 5HT 3 -receptor antagonists, granisetron and ondansetron , are used in the management of nausea and vomiting in children receiving cytotoxics. A Strength of recommendation: High

Dexamethasone has antiemetic effects and is used in the management of chemotherapy-induced nausea and vomiting. A Strength of recommendation: High

The neurokinin 1-receptor antagonist, aprepitant , is used to prevent nausea and vomiting associated with chemotherapy. It is usually given in combination with a 5HT 3 -receptor antagonist (with or without a corticosteroid). A Strength of recommendation: High For further information on the prevention of nausea and vomiting caused by chemotherapy, see Cytotoxic drugs .

Nabilone is a synthetic cannabinoid with antiemetic properties. There is limited evidence for nabilone use in children for nausea and vomiting caused by cytotoxic chemotherapy unresponsive to conventional antiemetics.

Nausea and vomiting during pregnancy

Nausea and vomiting in the first trimester of pregnancy is common and will usually resolve spontaneously within 16 to 20 weeks. For pregnant females who have nausea and vomiting, offer appropriate self-care advice (such as rest, oral hydration and dietary changes), and inform them about other available support (e.g. self-help information and support groups) and when to seek urgent medical advice. Take into consideration that a number of interventions may have already been tried. Antiemetics should be considered for females with persistent symptoms where self-care measures have been ineffective. If a non-pharmacological option is preferred, ginger may be helpful for mild to moderate nausea. A Strength of recommendation: High

For females who choose pharmacological treatment, offer an antiemetic considering the advantages and disadvantages of each drug, as well as patient preference, and their experience with treatments in previous pregnancies. Although few drug options are specifically licensed for nausea and vomiting associated with pregnancy, their use is established practice. Antiemetic options include: cyclizine , prochlorperazine , promethazine hydrochloride , promethazine teoclate , and ondansetron . For further information on antiemetic options, see NICE guideline: Antenatal care (available at: https://www.nice.org.uk/guidance/ng201 ). Assess response to treatment after 24 hours; if the response is inadequate, switch to an antiemetic from a different therapeutic class. Reassess after 24 hours and if symptoms have not settled, specialist opinion should be sought. For females who have moderate to severe nausea and vomiting, consider intravenous fluids and adjunctive treatment with acupressure. A Strength of recommendation: High

Hyperemesis gravidarum is a more serious condition, which requires regular antiemetic therapy, intravenous fluid and electrolyte replacement, and sometimes nutritional support. For females with severe or persistent hyperemesis gravidarum, antiemetics given by the parenteral or rectal routes may be more suitable than the oral route. Supplementation with thiamine must be considered in order to reduce the risk of Wernicke’s encephalopathy. A Strength of recommendation: High

Postoperative nausea and vomiting

The incidence of postoperative nausea and vomiting depends on many factors including the anaesthetic used, and the type and duration of surgery. Other risk factors include post-pubertal female sex, over 3 years of age, a history or family history of postoperative nausea and vomiting or motion sickness, and postoperative use of long-acting opioids. Therapy to prevent postoperative nausea and vomiting should be based on the assessed risk of postoperative nausea and vomiting in each patient. A combination of antiemetic drugs that have different mechanisms of action is often indicated in those at moderate and high risk of postoperative nausea and vomiting. When a prophylactic antiemetic drug has failed, postoperative nausea and vomiting should be treated with an antiemetic drug from a different therapeutic class. A Strength of recommendation: High

Drugs used include 5HT 3 -receptor antagonists (e.g. ondansetron ), dexamethasone, and droperidol . A Strength of recommendation: High Cyclizine is licensed for the prevention and treatment of postoperative nausea and vomiting caused by opioids and general anaesthetics. Prochlorperazine is licensed for the prevention and treatment of nausea and vomiting.

Opioid-induced nausea and vomiting

Expert sources advise that cyclizine , ondansetron, and prochlorperazine are used to relieve opioid-induced nausea and vomiting; ondansetron has the advantage of not producing sedation.

Motion sickness

Antiemetics should be given to prevent motion sickness rather than after nausea or vomiting develop. Hyoscine hydrobromide is licensed to prevent motion sickness symptoms such as nausea, vomiting, and vertigo. For children aged 10 years and over, a transdermal hyoscine patch provides prolonged activity but it needs to be applied several hours before travelling. Antihistamine drugs may also be effective; the less sedating antihistamines include cinnarizine and cyclizine , and the more sedating antihistamines include promethazine hydrochloride and promethazine teoclate . Domperidone, metoclopramide hydrochloride, 5HT 3 -receptor antagonists, and the phenothiazines (except promethazine—an antihistamine phenothiazine) are ineffective in motion sickness.

Nausea and vomiting associated with migraine

For information on the use of antiemetics in migraine attacks, see Migraine .

Related drugs

• Chlorpromazine hydrochloride
• Cinnarizine
• Domperidone
• Granisetron
• Haloperidol
• Hyoscine hydrobromide
• Levomepromazine
• Metoclopramide hydrochloride
• Ondansetron
• Prochlorperazine
• Promethazine hydrochloride
• Promethazine teoclate
• Trifluoperazine

Related treatment summaries

• Cytotoxic drugs

The content on the NICE BNFC site (BNFC) is the copyright of BMJ Publishing Group Ltd, the Royal Pharmaceutical Society of Great Britain, and RCPCH Publications Ltd. By using BNFC, you agree to the licence set out in the BNF Publications End User Licence Agreement .

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Cyclizine for sickness

Peer reviewed by Sid Dajani Last updated by Michael Stewart, MRPharmS Last updated 24 Jun 2022

Meets Patient’s editorial guidelines

Cyclizine helps to reduce sickness (nausea) and dizziness.

It can be taken by adults and by children over 6 years of age.

The most common side-effects are a dry mouth and feeling drowsy.

In this article :

About cyclizine, before taking cyclizine, how to take cyclizine, getting the most from your treatment, can cyclizine cause problems, how to store cyclizine, important information about all medicines.

Continue reading below

Cyclizine is used to treat sickness (nausea), such as that caused by problems affecting the inner ear and balance (including dizziness ), and travel sickness . It is an antihistamine.

Cyclizine helps reduce the feelings of nausea and vertigo caused by problems such as these. It is available from a pharmacy, without a prescription, and can be taken by adults and by children over the age of 6 years.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking cyclizine it is important that your doctor or pharmacist knows:

If you are pregnant or breastfeeding.

If you have any problems with the way your liver works, or if you have heart failure.

If you have increased pressure in your eye, a condition called glaucoma.

If you have epilepsy.

If you have prostate problems, or have been experiencing difficulty passing urine.

If you know you have a blockage in your small intestines.

If you have a rare inherited blood disorder called porphyria.

If you are taking any other medicines. This includes any medicines which are available to buy without a prescription, as well as herbal and complementary medicines.

If you have ever had an allergic reaction to a medicine.

Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about cyclizine, and it will also provide you with a full list of the side-effects which you could experience from taking it.

Take cyclizine exactly as your doctor or pharmacist tells you to. It can be taken up to three times a day.

If you are taking cyclizine to prevent travel sickness, take the first tablet 1-2 hours before you are due to travel. If you are going on a long journey, you can then take further doses every eight hours if needed. The tablets can be crushed to make them easier to swallow. If you are giving cyclizine to a child, check the label carefully to make sure you are giving the correct dose for the age of your child - the dose for children aged 6-12 years is half a tablet.

Cyclizine can cause drowsiness and blurred vision. Although this is rare following a single dose of cyclizine, it can occur if it is taken more regularly. If this happens, do not drive and do not use tools or machines. Alcohol will make the drowsiness worse, so it is best not to drink alcohol while you are on cyclizine.

If you are having an operation or any treatment (particularly if it is to test for an allergy), please tell the person carrying out the treatment that you are taking cyclizine.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the ones associated with cyclizine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.

Keep all medicines out of the reach and sight of children.

Store in a cool, dry place, away from direct heat and light.

Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.

If you buy any medicines 'over the counter', always check with a pharmacist that they are suitable to take with your other medicines.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

Report side effects to a medicine or vaccine

If you experience side effects, you can report them online through the Yellow Card website .

Further reading and references

• Manufacturer's PIL, Cyclizine 50 mg tablets ; ADVANZ Pharma; The electronic Medicines Compendium. Dated June 2018.
• Medicines Complete BNF 87th Edition ; British Medical Association and Royal Pharmaceutical Society of Great Britain, London.

Article History

The information on this page is written and peer reviewed by qualified clinicians.

Next review due: 23 Jun 2025

24 jun 2022 | latest version.

Last updated by

Peer reviewed by

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• Kwells 300 microgram tablets
• Kwells Kids 150 microgram tablets
• Travel Sickness
• Motion Sickness
• Sea Sickness
• Car Sickness

Kwells can help you travel happy

Works fast on travel sickness

We believe everyone should enjoy the journey…

From day trips and fun-filled family holidays to long-haul dream destinations, we’ve been helping to prevent and control travel sickness since 1949.

Travel sickness (or motion sickness) can be both miserable and distressing, filling sufferers – and those caring for travel sick-prone youngsters – with dread. So, no matter what bumps lie on the road ahead, ride the wave, fight the turbulence and get back on track with Kwells.

Our Products

Short trips or big adventures, you can help end the misery and unhappiness of travel sickness..

Kwells 300 microgram tablets and Kwells Kids 150 microgram tablets are used for the fast and effective prevention and control of travel sickness.

• Contains Hyoscine Hydrobromide
• Helps prevent travel sickness

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Kwells 300 microgram tablets. For the prevention of travel sickness, suitable for adults and children aged 10+. Contains Hyoscine Hydrobromide 300 microgram. Kwells Kids 150 microgram tablets. For the prevention of travel sickness, suitable for children aged 4+. Contains Hyoscine Hydrobromide 150 microgram. Always read the label

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Promethazine teoclate

Interactions.

View interactions for promethazine

Medicinal forms and pricing

There can be variation in the licensing of different medicines containing the same drug.

View medicinal form and pricing information

Indications and dose

For promethazine teoclate, nausea, vomiting, labyrinthine disorders for promethazine teoclate, motion sickness prevention for promethazine teoclate, motion sickness treatment for promethazine teoclate, important safety information, important safety information for promethazine teoclate, mhra/chm advice: over-the-counter cough and cold medicines for children (april 2009).

Children under 6 years should not be given over-the-counter cough and cold medicines containing promethazine.

Contra-indications

Contra-indications for promethazine teoclate.

Should not be given to children under 2 years, except on specialist advice (potential for fatal respiratory depression) (in children)

Cautions For promethazine teoclate

Asthma; bronchiectasis; bronchitis; epilepsy; prostatic hypertrophy (in adults); pyloroduodenal obstruction; Reye's syndrome; severe coronary artery disease; susceptibility to angle-closure glaucoma; susceptibility to QT interval prolongation; urinary retention

Side-effects

Side-effects for promethazine teoclate, frequency not known.

Anticholinergic syndrome; anxiety; appetite decreased; arrhythmia; blood disorder; bronchial secretion viscosity increased; confusion; dizziness; drowsiness; dry mouth; epigastric discomfort; fatigue; haemolytic anaemia; headache; hypotension; jaundice; movement disorders; muscle spasms; nightmare; palpitations; photosensitivity reaction; urinary retention; vision blurred

Side-effects, further information

Elderly patients are more susceptible to anticholinergic side-effects. In children paradoxical stimulation may occur, especially with high doses.

Pregnancy For promethazine teoclate

Most manufacturers of antihistamines advise avoiding their use during pregnancy; however, there is no evidence of teratogenicity.

Use in the latter part of the third trimester may cause adverse effects in neonates such as irritability, paradoxical excitability, and tremor.

Breast feeding

Breast feeding for promethazine teoclate.

Most antihistamines are present in breast milk in varying amounts; although not known to be harmful, most manufacturers advise avoiding their use in mothers who are breast-feeding.

Hepatic impairment

Hepatic impairment for promethazine teoclate.

Manufacturer advises caution.

Renal impairment

Renal impairment for promethazine teoclate.

Use with caution. M

Patient and carer advice

Patient and carer advice for promethazine teoclate, driving and skilled tasks.

Drowsiness may affect performance of skilled tasks (e.g. cycling or driving); sedating effects enhanced by alcohol.

Medicinal forms

Related treatment summaries.

• Antihistamines, allergen immunotherapy and allergic emergencies
• Nausea and labyrinth disorders

Other drugs in class

Other drugs in class sedating antihistamines.

• Alimemazine tartrate
• Chlorphenamine maleate
• Cinnarizine
• Cinnarizine with dimenhydrinate
• Cyproheptadine hydrochloride
• Hydroxyzine hydrochloride
• Paracetamol with buclizine hydrochloride and codeine phosphate
• Promethazine hydrochloride

The content on the NICE BNF site (BNF) is the copyright of BMJ Publishing Group Ltd and the Royal Pharmaceutical Society of Great Britain. By using BNF, you agree to the licence set out in the BNF Publications End User Licence Agreement .

Brand name: Valoid. Find out how cyclizine treats nausea and vomiting, and how to take it.

• About cyclizine
• Who can and cannot take it
• How and when to take it
• Side effects
• Pregnancy, breastfeeding and fertility
• Taking cyclizine with other medicines and herbal supplements
• Common questions

Related conditions

• Ménière's disease
• Motion sickness
• Vomiting and morning sickness in pregnancy