Scopolamine patch (Transderm Scop and others)

How Medicare covers it

Part D (transdermal patches applied at home taken at home). Part A during a covered inpatient stay. No Part B clinician-administered form in the CMS Part B spending file.

What it treats

Prevention of nausea and vomiting in adults — from motion sickness, and after surgery (post-operative nausea and vomiting linked to recovery from anesthesia and/or opiate pain medicines and surgery). This entry is based on the Transderm Scop transdermal patch label.

What it is for, in depth

Scopolamine as packaged here is a prescription patch for adults, sold as Transderm Scop and as generic scopolamine transdermal systems, that prevents — rather than treats after the fact — nausea and vomiting from two situations: motion sickness, and the nausea and vomiting that can follow surgery, anesthesia, and opiate pain medicines. It is a single form and strength: a round, tan transdermal system that delivers about 1 mg of scopolamine through the skin over 3 days, worn behind one ear. Because it is put on hours ahead (at least 4 hours before travel, or the evening before surgery), it fits planned trips and scheduled operations, not sudden nausea. The label limits it to adults and to one patch at a time.

How it works

Scopolamine is an anticholinergic belladonna alkaloid. It blocks muscarinic receptors where the parasympathetic nervous system uses acetylcholine, and the label says it is thought to act in the brain by blocking cholinergic signals from the balance center (vestibular nuclei) and the reticular formation to the vomiting center. It can also slow stomach and gut movement, reduce saliva, cause drowsiness, dilate the pupils, and raise heart rate.

How it is taken

A patch (transdermal system) worn on the hairless skin behind one ear. Each system delivers 1 mg of scopolamine over 3 days. Wear only one at a time and do not cut it. For motion sickness, apply it at least 4 hours before the effect is needed, for up to 3 days; if more than 3 days are needed, remove it and put a new one behind the other ear. For surgery other than cesarean section, apply it the evening before surgery and remove it 24 hours after surgery. Wash hands well with soap and water after applying and after removing it, do not touch it while wearing it, and on removal fold it sticky side together and throw it away where children and pets cannot get it.

Common side effects

For motion sickness, the most common effects (more than 15%) are dry mouth, drowsiness, blurred vision, and dilated pupils — dry mouth happened in about two thirds of people and drowsiness in less than one sixth. After surgery, effects in at least 3% were dry mouth (29%), dizziness (12%), sleepiness (8%), agitation (6%), visual impairment (5%), confusion (4%), dilated pupils (4%), and sore throat (3%).

Serious warnings

This label has no boxed warning. Serious warnings are: acute angle-closure glaucoma — remove the patch and get care for eye pain, blurred vision, halos, or red eyes; neuropsychiatric effects including worsening psychosis, acute toxic psychosis, agitation, hallucinations, paranoia, delusions, seizures, disorientation, and confusion — remove the patch at once for psychiatric reactions; eclamptic seizures reported in pregnant women with severe preeclampsia after injected scopolamine, so avoid use with severe preeclampsia; slowed gut and urinary retention, with stopping the patch if urination becomes difficult; hyperthermia (dangerous overheating, including fatal cases reported after marketing) — remove the patch and contact a healthcare provider if body temperature rises or sweating stops in warm conditions; withdrawal symptoms 24 hours or more after removal after several days of use, including balance problems, dizziness, nausea, vomiting, cramps, sweating, headache, confusion, muscle weakness, slow heart rate, and low blood pressure; blurred vision if the drug touches the eyes; and skin burns during an MRI — remove the patch before an MRI scan.

Who should be careful

Do not use it if you have angle-closure glaucoma, or an allergy to scopolamine, other belladonna alkaloids, or any part of the patch. Be careful and expect closer monitoring if you have open-angle glaucoma, a history of seizures, psychiatric illness, suspected intestinal obstruction or pyloric obstruction, prostate or bladder-neck problems that impede urine flow, or severe preeclampsia in pregnancy. Older adults may be more sensitive to its brain and psychiatric effects. It is not approved for use in children. Do not drive, operate machinery, or do underwater sports until you know how it affects you.

Major interactions

Other drugs that cause drowsiness, dizziness, or disorientation — alcohol, sedatives, hypnotics, opiates, and anxiety medicines — and drugs with anticholinergic effects (other belladonna alkaloids, sedating antihistamines, meclizine, tricyclic antidepressants, and muscle relaxants) can add to these effects; the label says to choose one drug or monitor closely. Other anticholinergic drugs also raise the risk of intestinal obstruction and urinary retention. Because scopolamine slows stomach movement, it can change how oral drugs absorbed in the stomach work, so watch the effect of oral drugs with a narrow therapeutic index. Stop the patch 10 days before a gastric secretion test because it interferes with that test.

Cost and saving notes

Scopolamine patches are sold as generics as well as under the Transderm Scop brand, so ask the pharmacist whether a generic patch is the lower-cost option on your plan. Medicare facts: if your Part D plan places this drug on a higher tier, you or your prescriber can ask the plan for a tier exception when a lower-tier drug would not work as well for you. If you qualify for Extra Help (the Part D Low-Income Subsidy), your premiums and copays drop a lot. In 2027, what you pay out of pocket for Part D drugs is capped at $2,400 for the year, and the Medicare Prescription Payment Plan lets you spread those costs into monthly payments instead of paying large amounts at the pharmacy counter. Ask your pharmacist or plan which option lowers your cost most.

Why it is in its tier

Scopolamine patch (Transderm Scop and others) sits on Tier 4 in 80.25% of the plans that list it (4410 of 5495 listing plans). Tier 4 is the non-preferred tier — higher copays or coinsurance. The data-visible drivers: It is a generic product, and the CMS dashboard puts its average Part D spending at about $136 per beneficiary for 2024 — a relatively low-cost drug, which matches where plans place it. It is listed by 100.0% of Part D plans. The tier shown is the most common one; individual plans vary.

Sources

• TRANSDERM SCOP (SCOPOLAMINE) PATCH, EXTENDED RELEASE [BAXTER HEALTHCARE CORPORATION] — DailyMed
• MedlinePlus — National Library of Medicine
• MedlinePlus — Scopolamine Transdermal Patch

What official patient guides say

The patch is placed on the hairless skin behind your ear. For motion sickness, apply it at least 4 hours before you need it and leave it in place for up to 3 days; if you need it longer, remove it and put a new patch behind the other ear. For surgery, apply it as your doctor directs and leave it for 24 hours after surgery. To apply, wash the area behind the ear, wipe it dry, peel off the clear strip without touching the sticky side, press the sticky side to the skin, then wash your hands well. Do not cut the patch. Try to limit water contact while swimming or bathing, and if it falls off, throw it away and put a new one behind the other ear. If you miss a patch, apply it as soon as you remember, but never wear more than one at a time. Store patches upright at room temperature, away from heat and moisture, and out of reach of children.

Source: MedlinePlus — Scopolamine Transdermal Patch

Part D formulary coverage

Source: CMS Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files — Monthly file 2026-10-15 (plan year 2027), file 2027_20261008.zip (data.cms.gov dataset ed1496ea-23e7-41f1-9292-172fa842ccfb): basic drugs formulary file + plan information file, both dated 20261031 inside the zip; downloaded and aggregated 2026-10-30. Medication RxCUI sets resolved through the NLM RxNav (RxNorm) API.

What you pay

Without insurance, the cash benchmark is 4.22263 per unit (SCOPOLAMINE 1 MG/3 DAY PATCH) — about nan for 30 units. NADAC benchmark — the average price pharmacies pay (CMS, as of 2026-11-04). Pharmacy shelf prices vary.

A tier is not a price; what you pay depends on your plan, pharmacy, and benefit stage; Extra Help or Medicaid can lower it further.

Sources: CMS Plan Benefit Package + formulary data; CMS NADAC · Checked 2026-11-08

Coverage by plan and tier

Of the 5,495 Medicare drug plans we track for 2027, 5,495 list Scopolamine patch (Transderm Scop and others) — 100% of plans. Most of those plans put it on Tier 4: 4,410 plans, 80.2% of the plans that list it. Other plans place it on Tier 3 (705 plans), Tier 2 (253 plans) or Tier 1 (127 plans). For example: Aetna Medicare Dual Extra (HMO D-SNP) puts it on Tier 4; Aetna Medicare Dual Extra Care (PPO D-SNP) puts it on Tier 4; Aetna Medicare Value Plus (PPO) puts it on Tier 4. You can compare these plans side by side on our Medicare Advantage hub. A tier is not a price. What you pay also depends on whether you have met your plan';s deductible, whether the drug costs a flat copay or a share of the price, and whether you get Extra Help or Medicaid.

Read next

• Part D in 2027: The $700 Deductible, the $2,400 Cap, and the $35 Insulin Rule
• Extra Help in 2027: Lower Drug Copays and Who Qualifies
• Checking Medicare Savings Programs and Extra Help

Part D spending averages (2024)

Source: CMS Medicare Part D Spending by Drug (Drug Spending Dashboard), release RY26 P04 V10, data through 2024 (DSD_PTD_RY26_P04_V10_DY24_BGM.csv), downloaded 2026-10-30

Companies covering this drug

Part D and Medicare Advantage plan sponsors that list this drug on a formulary, 50 at a time.