Motion sickness affects a significant proportion of travellers, particularly on boats, winding roads and in the back seats of cars. While oral antihistamines remain the most commonly dispensed OTC option, hyoscine hydrobromide transdermal patches (marketed as Scopoderm TTS) offer a longer-acting alternative that many travellers prefer for journeys lasting more than a few hours.
How Scopoderm patches work
Scopoderm TTS delivers hyoscine hydrobromide (scopolamine) 1mg transdermally over approximately 72 hours. The patch is applied to the hairless area of skin behind the ear, where absorption is most consistent.
According to the summary of product characteristics, the patch should be applied the evening before travel, or at least 5–6 hours before the anti-emetic effect is needed, because transdermal absorption takes several hours to reach therapeutic plasma levels.
Key pharmacokinetic points
The patch delivers a priming dose from an adhesive layer, followed by sustained release from the reservoir. Peak plasma levels are reached approximately 24 hours after application. A single patch provides protection for up to 72 hours. If travel continues beyond 72 hours, the old patch should be removed and a new one applied behind the opposite ear.
Who can use them
Scopoderm patches are licensed for adults and children aged 10 years and over, according to BNF guidance. They are available on prescription (POM) in the UK — they are not available over the counter, unlike oral hyoscine (Kwells) or antihistamine-based travel sickness tablets.
Contraindications include:
- Glaucoma (angle-closure) — hyoscine's anticholinergic effects can precipitate an acute attack
- Myasthenia gravis
- Known hypersensitivity to hyoscine or any patch component
- Children under 10 years
Caution is needed in:
- Elderly patients (increased susceptibility to anticholinergic side effects)
- Patients with urinary retention, intestinal obstruction or pyloric stenosis
- Patients taking other anticholinergic medicines (additive effects)
Application and counselling points
Correct application is crucial for efficacy:
- Clean, dry skin. Apply to the hairless area behind one ear. Do not apply over cuts, irritation or areas treated with creams.
- Wash hands after handling. Hyoscine absorbed through the fingertips can cause pupil dilation if transferred to the eyes — a common complaint pharmacists encounter.
- Do not cut the patch. Cutting disrupts the controlled-release mechanism and can cause dose dumping.
- Removal. After removing the patch, fold it in half (adhesive sides together), discard safely and wash the application site and hands thoroughly.
- Withdrawal effects. Nausea, headache and dizziness can occur for 24–48 hours after removal if the patch was worn for more than 24 hours. Warn patients about this.
Side effects
Common anticholinergic effects include dry mouth (very common), drowsiness, blurred vision and dizziness. Less commonly: urinary retention, confusion (especially in elderly patients) and contact dermatitis at the application site.
Drowsiness can impair driving ability. The SmPC advises patients not to drive or operate machinery until they know how the patch affects them — a point particularly relevant for travellers planning to drive at their destination.
How patches compare with oral alternatives
| Feature | Scopoderm patch | Hyoscine tablets (Kwells) | Cinnarizine | Cyclizine |
|---|---|---|---|---|
| Active ingredient | Hyoscine 1mg TD | Hyoscine 300mcg oral | Cinnarizine 15mg | Cyclizine 50mg |
| Availability | POM | P (pharmacy) | P (pharmacy) | P (pharmacy) |
| Duration | Up to 72 hours | 4–6 hours per dose | 8 hours per dose | 6–8 hours per dose |
| Onset | 5–6 hours | 20–30 minutes | 1–2 hours | 30 minutes |
| Age (licensed) | ≥10 years | ≥4 years (Joy-Rides) | ≥5 years | ≥6 years |
| Drowsiness | Moderate | Moderate | Mild-moderate | Moderate |
| Best for | Long sea crossings, multi-day travel | Short journeys, rapid onset needed | Moderate journeys | Moderate journeys |
When to recommend the patch route
Patients most likely to benefit from Scopoderm include those taking long ferry crossings (North Sea, Channel, Mediterranean cruises), people who have failed oral antihistamines or cannot tolerate the frequent dosing schedule, and travellers prone to vomiting early in travel who may not absorb oral tablets.
Pharmacists can advise patients that a GP or prescribing pharmacist consultation is needed to obtain Scopoderm, and that the prescription should ideally be arranged at least a week before departure.
Finding pharmacy travel advice
Many community pharmacies offer travel health consultations and can supply OTC motion sickness medicines directly. For pharmacy job opportunities in travel health services, visit PharmSee's jobs board.
Sources: BNF Hyoscine Hydrobromide monograph, EMC Scopoderm TTS SmPC, NICE CKS Motion Sickness guidance.