Brand names: Antivert, Bonine, Dramamine Less Drowsy, Meni-D
Drug class: Antihistamines
VA class: CN550
CAS number: 31884-77-2
Introduction
Antiemetic; piperazine-derivative antihistamine.
Uses for Meclizine
Motion Sickness
Self-medication for prevention and treatment of nausea, vomiting, and/or dizziness associated with motion sickness.
Vertigo
Symptomatic management of vertigo associated with diseases affecting the vestibular system (e.g., labyrinthitis, Ménière’s disease).
Other Uses
Use in allergic states not evaluated.
Meclizine Dosage and Administration
Administration
Oral Administration
For prevention of motion sickness, administer orally 1 hour before exposure to motion; may repeat every 24 hours for duration of journey.
Dosage
Available as meclizine hydrochloride; dosage expressed in terms of meclizine.
Pediatric Patients
Motion Sickness
Oral
For self-medication in children ≥12 years of age, 25–50 mg once daily or as directed by clinician.
Adults
Motion Sickness
Oral
For self-medication, 25–50 mg once daily or as directed by clinician.
Vertigo
Oral
25–100 mg daily, administered in divided doses, depending on clinical response.
Cautions for Meclizine
Contraindications
-
Known hypersensitivity to meclizine.
Warnings/Precautions
Warnings
CNS Effects
Possible drowsiness.
Possible additive CNS depression with other CNS depressants. (See Specific Drugs under Interactions.)
Anticholinergic Effects
Due to potential anticholinergic activity, use with caution in patients with breathing problems (e.g., asthma, emphysema, chronic bronchitis), angle-closure glaucoma, or prostatic hypertrophy.
Sensitivity Reactions
Tartrazine Sensitivity
Some formulations contain tartrazine dye (FD&C; yellow No. 5), which may cause allergic reactions (i.e., bronchial asthma) in susceptible individuals. Incidence of tartrazine sensitivity is low, but it frequently occurs in patients who have aspirin hypersensitivity.
Specific Populations
Pregnancy
Category B.
Lactation
Antihistamines may inhibit lactation and small amounts appear to be distributed into milk. Due to potential for serious adverse effects (e.g., CNS effects) in nursing infants, discontinue nursing or the drug.
Pediatric Use
Safety and efficacy not established in children <12 years of age.
Common Adverse Effects
Drowsiness, fatigue, dry mouth.
Interactions for Meclizine
Specific Drugs
Drug |
Interaction |
Comments |
---|---|---|
CNS depressants (e.g., alcohol, barbiturates, tranquilizers) |
Additive CNS depression |
Avoid alcoholic beverages; use other CNS depressants with caution |
Meclizine Pharmacokinetics
Absorption
Onset
About 1 hour.
Duration
Effects persist for 8–24 hours following a single oral dose.
Distribution
Extent
Distributed throughout most body tissues; crosses placenta.
Elimination
Metabolism
Metabolic fate in humans is unknown. In rats, metabolized (probably in the liver) to norchlorcyclizine.
Elimination Route
Excreted in feces as unchanged drug and in urine as norchlorcyclizine.
Half-life
6 hours.
Stability
Storage
Oral
Capsules and Tablets
Tight, light-resistant container at 15–30°C.
Actions
-
Exhibits CNS depressant, anticholinergic, antiemetic, antispasmodic, and local anesthetic effects in addition to antihistaminic activity.
-
Depresses labyrinth excitability and conduction in vestibular-cerebellar pathways.
-
Antiemetic and antimotion-sickness actions result, at least in part, from central anticholinergic and CNS depressant properties.
Advice to Patients
-
Risk of drowsiness; use caution when driving or operating machinery.
-
Importance of avoiding alcohol during therapy.
-
Importance of patients informing clinicians of existing or contemplated therapy, including prescription and OTC drugs, as well as any concomitant illnesses.
-
Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.
-
Importance of informing patients of other important precautionary information. (See Cautions.)
Preparations
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Routes |
Dosage Forms |
Strengths |
Brand Names |
Manufacturer |
---|---|---|---|---|
Oral |
Capsules |
25 mg |
Meni-D |
Seatrace |
Tablets |
12.5 mg* |
Antivert |
Pfizer |
|
25 mg* |
Antivert |
Pfizer |
||
Dramamine Less Drowsy |
Pfizer |
|||
50 mg* |
Antivert (scored) |
Pfizer |
||
Tablets, chewable |
25 mg* |
Bonine (scored) |
Insight |
AHFS DI Essentials™. © Copyright 2023, Selected Revisions July 1, 2006. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.
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