Scopolamine vs. Compro for Nausea: Important Differences and Potential Risks.

Key takeaways

Scopolamine (Transderm Scop) and prochlorperazine (Compro) are both prescription medications used to treat nausea and vomiting, but they have some key differences. Scopolamine is an anticholinergic that comes as a patch applied behind the ear, while prochlorperazine is a phenothiazine available as a rectal suppository. Scopolamine is typically used to prevent nausea and vomiting from motion sickness or surgery, whereas prochlorperazine is used for severe nausea and vomiting. Scopolamine works by blocking acetylcholine in the brain, while prochlorperazine blocks dopamine. Scopolamine patches can be worn for up to 3 days, but they can cause side effects like dry mouth and dizziness. Prochlorperazine suppositories need to be inserted twice daily and can cause serious side effects like uncontrolled muscle movements and extreme sleepiness. Neither Scopolamine nor prochlorperazine are recommended for children under 18, but prochlorperazine must not be used in children under 2 years old or under 20 pounds. Both medications are available in generic forms, making them more affordable options.

Scopolamine

(Transderm Scop)

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Prochlorperazine

(Compro)

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Summary for Scopolamine

Prescription only

Scopolamine (Transderm Scop) is a prescription anticholinergic medication. It's used to prevent nausea and vomiting from motion sickness, as well as from anesthesia or pain medications used in surgery. Scopolamine (Transderm Scop) comes as a patch that you place behind your ear. You need to apply it at least 4 hours before any activities that might cause motion sickness, or the night before your surgery. Common side effects scopolamine (Transderm Scop) include dry mouth, sleepiness, and dizziness.

Indications for Scopolamine

Prevention of nausea and vomiting due to:
- Motion sickness
- Anesthesia or pain medications used in surgery

Pros and Cons for Scopolamine

Pros

Works well for preventing nausea and vomiting
Effects lasts for up to 3 days
Applied to skin, so a good choice for people who've trouble taking pills
Available as a lower-cost generic

Cons

Not for use in children younger than 18 years old
Takes about 4 hours to start working, so need to remember to take it ahead of time
Doesn't treat nausea and vomiting that's already happening
Can cause drowsiness, blurry vision, and confusion

Common Side Effects for Scopolamine

Dry mouth (29%)
Dizziness (12%)
Sleepiness (8%)
Agitation (6%)
Changes in vision (5%)

Warnings for Scopolamine

Angle-closure glaucoma
Brain and mental health problems
Risk of seizures in pregnant people with preeclampsia
Blockage in the stomach, intestines, or bladder
Withdrawal
Blurry vision
Skin burn from magnetic resonance imaging (MRI)

Summary for Compro

Prescription only

Prochlorperazine (Compro) rectal suppository is a typical antipsychotic. It's FDA-approved to treat severe nausea and vomiting in adults. But prochlorperazine (Compro) isn't a first-choice antiemetic because it can cause serious side effects, such as extreme sleepiness and uncontrolled muscle movements. While prochlorperazine (Compro) is a good option for people who can't take medications by mouth, some people might find it unpleasant or difficult to use because it needs to be inserted into the rectum, typically twice daily. Prochlorperazine (Compro) comes as a brand-name and generic medication.

Indications for Compro

Severe nausea and vomiting

Pros and Cons for Compro

Pros

Good option for people who have a hard time swallowing pills
Available as a generic medication
More convenient storage compared to some other suppositories because it doesn't need to be refrigerated

Cons

Might be hard for some people to insert the suppository
Not recommended for use in children
Might cause rare but permanent side effects, such as uncontrolled muscle movements

Common Side Effects for Compro

Drowsiness
Dizziness
Absent menstrual periods
Blurry vision
Low blood pressure

Warnings for Compro

Higher risk of death in older adults with dementia-related psychosis
Difficulty controlling muscle movements (tardive dyskinesia)
Other conditions with uncontrolled muscle movements (dystonia, Parkinsonian symptoms, and restlessness)
Neuroleptic malignant syndrome (NMS)
Cover up more serious health problems
Higher risk of infections
Higher risk of falls
Liver problems
Seizures
High prolactin levels
Difficulty maintaining normal body temperature