Can You Take Clonazepam While Wearing A Scopolamine Patch?

In our latest question and answer, the pharmacist discusses whether or not it is safe to take clonazepam if you are wearing a scopolamine patch.

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Jan 10, 2020

Michael asked

I have been prescribed a scopolamine patch for my upcoming flight, which I have never taken before. Can I take my anti-anxiety medicine (clonazepam 0.5 mg) while I have the patch on?

At a glance

  • Taking clonazepam while using a Transderm-Scop (scopolamine) patch can increase the risk of additive side effects, like dizziness and drowsiness.
  • However, they are commonly used together in certain situations, such as during a flight.
  • If they are used together, be aware you may be more tired than usual.

Answer

Fear of flying woman in plane airsick with stress headache and motion sickness or airsickness. Focus on bottle and tablet.

Hello and thanks for your question!

Your situation is not uncommon. While sources vary, it has been reported that between 30-40% of individuals anxious about flying and another 25-30% experience motion sickness.

With numbers like these, we can certainly assume that you are not alone in wondering if it is safe to combine drugs so both anxiety and motion sickness can be treated.

Now, there is an interaction to be aware of between these drugs (scopolamine and clonazepam), but they are often used together.

Most sources (including our own interaction checker) list the interaction as a 'moderate' one.

Basically, there is a risk of additive side effects with these two drugs, with the main ones being drowsiness and dizziness.

Clonazepam, a benzodiazepine, is certainly more well-known in causing these effects, but they both nonetheless do.

Most studies for clonazepam report that nearly 50% of individuals taking the drug will experience drowsiness. For scopolamine (specifically Transderm-Scop, which goes behind the ear), the prescribing information reports that drowsiness occurs in slightly less than 1/6th of individuals.

The prescribing information for both drugs warn of combining drugs with the same adverse effects. The following is from the prescribing information for Transderm-Scop:

Scopolamine should be used with caution in patients taking other drugs that are capable of causing CNS effects such as sedatives, tranquilizers, or alcohol.

I mentioned that these drugs are often used together, even though this interaction exists.

This is simply because if you are taking both while you are flying, it isn't much of an issue that you get drowsy. In fact, it may be preferred.

Nevertheless, it is important to know about this interaction and that when you combine them, you may feel the side effects more intensely than what either would cause alone.

To sum this answer up, the following is the 'drug interaction report' from one of the most trusted drug information resources, Clinical Pharmacology:

These drugs must be used together with caution. You may feel drowsy or more tired when taking these drugs together. Do not drive or operate machinery until you know how these drugs affect you.

Interestingly enough, some studies show that clonazepam can sometimes help to reduce the dizziness experience from motion sickness by itself, even though this isn't an FDA-approved indication. If you haven't tried to take only clonazepam to prevent motion sickness, it may be worth trying some time but be sure to ask your doctor first before using it for this.

As a final note, since you said that this is your first time using the scopolamine patch, I want to make sure you are using correctly!

In order for it to be most effective, be sure that you apply it at least 4 hours before your flight. Many people apply it too late (e.g. right before a flight), and it isn't nearly as effective as it could be.

Thanks again for your question and be sure to reach out to us with any more questions!

References
  1. Clonazepam in the pharmacological treatment of vertigo and tinnitus. PubMed
  2. Transderm-Scop Prescribing Information. AccessFDA
  3. Klonopin Prescribing Information. AccessFDA
  4. ClinicalKey Interaction Monograph. ClinicalKey (Subscription Required)
  5. Lots of Americans have a fear of flying. There are ways to overcome the anxiety disorder. Washington Post
  6. Managing motion sickness. BMJ

Ready for a more personal experience with your meds?