Open Source Apothecary At Home / Household emergencies

Motion sickness

Ginger has real trials and is the safest option. The antihistamines work and sedate.

remedy

Motion sickness is a mismatch between what the inner ear reports and what the eyes report. The treatments fall into two groups with a clear trade-off.

Ginger has randomised trials in motion sickness and in post-operative nausea, and it is the option without sedation. It is effective taken before travel rather than after symptoms start, and it is safe in pregnancy at the doses with evidence.

Antihistamines — dimenhydrinate, cyclizine, meclizine, promethazine — work well and sedate, which matters for anyone driving or operating machinery. Promethazine is the most sedating and is used where sleep is acceptable. Anticholinergics (scopolamine patches) are effective and cause dry mouth, blurred vision and confusion, particularly in older adults, and should not be used without advice in that group.

The behavioural measures are underrated and free. Fix the gaze on a stable distant point — the horizon; sit where movement is least (front seat of a car, mid-ship on a boat, over the wing on a plane, facing forward on a train); lie down if possible and close the eyes; get fresh air; avoid reading and screens; avoid heavy or greasy food and alcohol before travel. Do not read in a moving vehicle — it sharpens the sensory mismatch.

The counter-intuitive point. For a child, the nausea is worst when the mismatch is largest, so the advice is the opposite of distraction: look out and forward at something far away rather than at something inside the vehicle.

When vomiting is not motion sickness. Vomiting with a severe headache, a stiff neck, a head injury, abdominal pain, or in an infant needs assessment. Vomiting in pregnancy to the point of being unable to keep fluids down is hyperemesis, which needs medical care. And vertigo with hearing loss or one-sided tinnitus is an inner-ear problem needing assessment.

What the studies found

Preparation

Ginger — the option without sedation

• 0.5-1 g of dried ginger powder, or a strong ginger tea, taken 30-60 minutes before travel
• The anti-emetic trials used around 1 g of dried ginger
• Works best before symptoms start; less effective once nausea is established
• Safe in pregnancy at trial doses

Antihistamines — effective and sedating

• Dimenhydrinate, cyclizine, meclizine: take before travel as directed
• Promethazine is the most sedating. Do not drive or operate machinery on any of them.
• Not for children under 2, and check the label for age limits

Scopolamine patch

• Effective; applied behind the ear hours before travel
• Causes dry mouth, blurred vision and confusion, particularly in older adults
• Do not use without advice in older adults, in glaucoma, or in urinary retention

Behavioural measures — free and underrated

• Fix the gaze on a stable distant point, such as the horizon
• Sit where movement is least: front seat of the car, mid-ship on a boat, over the wing on a plane, facing forward on a train
• Lie down and close the eyes if possible
• Fresh air; open a window
• Avoid reading and screens — they sharpen the sensory mismatch
• Avoid heavy, greasy or spicy food and alcohol before travel

Children

• Look out and forward at something far away, not at something inside the vehicle
• A child seat raised so they can see out helps
• Snacks and water; avoid a large meal before travel

A trial of measures before a long journey

• Test ginger and a behavioural measure on a short trip before a long one

When it is not motion sickness

• Vomiting with a headache, stiff neck, head injury, or abdominal pain — assessment
• Pregnancy: unable to keep fluids down for 24 hours — hyperemesis, medical care
• Vertigo with hearing loss or one-sided tinnitus — inner-ear assessment

Cautions and interactions

• Antihistamines and scopolamine cause sedation, dry mouth and confusion. Do not drive or operate machinery.
• Scopolamine and sedating antihistamines in older adults cause confusion and falls. Avoid without advice.
• Antihistamine anti-emetics are not for children under 2.
• Ginger has antiplatelet activity — check with the prescriber if on anticoagulants.
• Do not use alcohol or heavy food as a 'cure' before travel.

When this is not a self-care problem — get help

• Vomiting with a severe headache, a stiff neck, drowsiness, or after a head injury — emergency care.
• Vomiting blood, or vomiting with severe abdominal pain — urgent assessment.
• Vertigo with hearing loss, one-sided tinnitus, or weakness or numbness — assessment; the last can indicate a stroke.
• In pregnancy: unable to keep fluids down for 24 hours, weight loss, or dark scanty urine — hyperemesis, needs medical care.

Related

• Nausea and vomiting, including morning sickness
• Jet lag and shift work
• Pregnancy and breastfeeding: the honest position
• Fever: what it is for, and when it means something else

Sources

1. Efficacy and Safety of Ginger on Chemotherapy-Induced Nausea and Vomiting: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Cancer nursing 2025; doi:10.1097/NCC.0000000000001355 PubMed 38625733
2. The efficacy and safety of complementary and alternative medicine in the treatment of nausea and vomiting during pregnancy: A systematic review and meta-analysis. Frontiers in public health 2023; doi:10.1152/ajpregu.00344.2004 PubMed 36969661
3. [Update on PONV-What is new in prophylaxis and treatment of postoperative nausea and vomiting? : Summary of recent consensus recommendations and Cochrane reviews on prophylaxis and treatment of postoperative nausea and vomiting]. Der Anaesthesist 2022; doi:10.1097/00000542-198604000-00012 PubMed 34596699
4. Effects of Ginger Intake on Chemotherapy-Induced Nausea and Vomiting: A Systematic Review of Randomized Clinical Trials. Nutrients 2022; doi:10.1016/j.cbi.2010.02.017 PubMed 36501010
5. Effect of ginger in the treatment of nausea and vomiting compared with vitamin B6 and placebo during pregnancy: a meta-analysis. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 2022; doi:10.1080/14767058.2020.1712714 PubMed 31937153