It is important to note that these doses are higher than doses used for antiallergic purposes and can result in Over-sedation of young children
Some children have paradoxical agitation with these medicines, a test dose should be given at home before departure.
Transdermal Patches are not easily available in India at retail stores, however they are available from online stores without a prescription.
Transdermal Patch is available as 1.5 mg patches, stick one patch just behind ear 5-6 hours before the start of journey and remember to remove it after arrival. The effect of the patch can last up to 72 hours, so it is suitable for people taking long journeys.
Transdermal Patches are not approved for use in age group < 12 years age.
Oral Hyoscine Hydrobromideis approved for pediatric use but is Not available in India. It should be noted that it is different from Hyoscine butyl bromide (Buscopan*) which is an antispasmodic medicine
Recommended doses of oral Hyoscine hydrobromide : For adults and children over 10 years of age: 150-300 micrograms. 4-10 years: 75-150 micrograms. Age 3-4 years: 75 micrograms. Not approved for < 3 yrs age.
Metoclopramide(Perinorm*), helps only little due to its blockage effect on dopamine and serotonin receptors at higher doses of 0.3 mg/kg/dose. At these doses, Extrapyramidal effects in younger children may be seen.
Ondansetron- Recent Studies have failed to prove any benefit with Ondansetron,as it acts on vagal afferent pathways and has no effect on vestibular afferents
Depending upon the individual susceptibility, these Pharmacological measures can be used in solo or in combination and should be given 45 min – 60 min before travel and repeated every 6 hours during the trip.
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