Peter Noble, MA, MD, FRCP
The list of medication that could be carried on an offshore cruising yacht is almost endless. The following information is intended only as a guide and lists examples of standard medications and doses for common conditions. In addition, crew members should take adequate personal medical supplies to treat any preexisting conditions such as diabetes or heart disease. Medication for minor ailments is likely to be used repetitively, so take enough for several episodes. Any boat embarking on an ocean crossing should take at least two weeks supply of all major emergency items such as antibiotics. Whenever possible, both English and American generic names are listed, those marked with an asterisk being the names commonly used in the USA.
The injection of a local anaesthetic (lidocaine/xylocaine 20 ml. ampoules) may assist the cleaning and suturing of a wound. The eye requires a specific anaesthetic such as Amethocaine eye drops.
Chloromycetin ointment or eye drops. Gentamycin or Tobramycin (triple dose)
Infections of the ear canal (otitis externa)
Gentamycin drops (may also be used for eye infections)
Eczema and localised allergic rashes: hydrocortisone cream 1%
Bacterial skin infections: neomycin sulphate cream or powder.
Fungal infections and athlete’s foot: clotrimazole as an ointment or dusting powder.
Cold sores on the lips: Zovirax cream
Allergies and itchy reactions to bites and stings
Promethazine hydrochloride tablets (Phenergan 25 mgm.) or chlorpheniramine (piriton/clortrimeton* 4 mgm). Acrivastine (semprex 8 mgm.) is less sedative
There are dozens of remedies and every skipper has views on what does, or does not, work. Cyclizine/Meclizine 50 mgm and hyosine 300 micrograms are two standard preparations. Hyosine skin patches (scopoderm/Transderm scop) may help those who are too nauseous to swallow and retain tablets.
Analgesics (pain relievers)
Aspirin 300 mgm. and paracetamol 500mgm. are helpful for pain, fever and inflammation. Aspirin, for those who are not allergic to it, is a most useful drug and may also be used to prevent complications following a stroke or heart attack.
Ibuprofen (Motrin) 200-400 mgm is used particularly for joint and muscular pain.
Naproxen 250 mgm is an effective analgesic.
Tramadol (50 mgm by mouth, but also available as an ampoule for injection) is a strong analgesic.
It is recommended to carry two weeks supply of each of the following three powerful antibiotics:
Clarithromycin 250mgm, 2-4 tablets daily. Alternatively, a dose of Biaxin XL* 1000 mgm once a day only.
Co-amoxyclav 250 mgm,3-6 tablets daily or Augmentin*
Ciprofloxacin (urinary tract infections) 250 mgm, 2-6 tablets daily
Vaginal candidiasis (Thrush)
Canesten (Nystatin*) cream or pessaries
Vomiting and diarrhoea
Most episodes are due to food poisoning and settle within 24 hours without treatment. Anti-Seasickness remedies will help nausea and vomiting. Anti-diarrhoea preparations include codeine phosphate 15 mgm, Lomotil 2-4 tablets. Vomiting and diarrhoea may produce dehydration, particularly in children, which needs to be corrected by fluids by mouth. Sips of water (with a cup of fruit juice and a pinch of salt added to a pint of water to replace lost minerals) or rice water (water in which rice has been boiled) are helpful.
Valium 5 mgm may be used for anxiety and insomnia. Valium is a muscle relaxant and is particularly helpful in insomnia secondary to muscle and joint pain.
Take plenty of sunblock and also calamine lotion for sunburn. Antihistamines will help allergic reactions to sunburn.
Fortunately, the mosquitoes that carry malaria do not fly out to sea. If you intend to explore countries where malaria is endemic seek up-to-date advice on the best antimalarial preventative. Mefloquine * (Lariam) 250 mgm is a common antimalarial preventative. It should be taken one per week as prophylaxis starting one week prior to, and for four weeks after potential exposure. Quinine sulphate 200 mgm may be used in an emergency to treat a serious malaria attack, but should only be used with other antimalarials. Other recommended treatments:
- Pyrimethamine (Sulfadoxine) or Fansidar* 2-3 tablets taken only once;
- Chloroquine sulfate 500 mgm. One tablet followed by another tablet 6 hours later, then one tablet daily for two days.