ﺑﺎﺯﮔﺸﺖ ﺑﻪ ﺻﻔﺤﻪ ﻗﺒﻠﯽ
خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
medimedia.ir

Meclizine: Drug information

Meclizine: Drug information
(For additional information see "Meclizine: Patient drug information" and see "Meclizine: Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Brand Names: US
  • Antivert;
  • Bonine [OTC];
  • Dramamine Less Drowsy [OTC] [DSC];
  • FT Motion Sickness [OTC];
  • Medi-Meclizine [OTC];
  • Motion-Time [OTC];
  • Travel Sickness [OTC] [DSC];
  • Travel-Ease [OTC]
Pharmacologic Category
  • Antiemetic;
  • Histamine H1 Antagonist;
  • Histamine H1 Antagonist, First Generation;
  • Piperazine Derivative
Dosing: Adult
Motion sickness

Motion sickness:

Oral: 12.5 to 25 mg every 6 to 8 hours as needed; administer first dose 30 to 60 minutes prior to exposure (Priesol 2021). Maximum dose: 100 mg/day (manufacturer’s labeling).

Vertigo, acute episodes

Vertigo, acute episodes:

Note: Reserve use for symptomatic relief of episodes lasting several hours to days (maximum duration: 3 days); chronic use may impede adaptation and recovery (Furman 2022).

Oral: Initial: 12.5 to 25 mg every 6 to 12 hours as needed; may increase to 50 mg per dose as needed based on response and tolerability; maximum dose: 100 mg/day (Furman 2022; Shih 2017; manufacturer’s labeling).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

The renal dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.

Altered kidney function:

eGFR ≥30 mL/minute/1.73 m2: No dosage adjustment necessary (Ref).

eGFR <30 mL/minute/1.73 m2: Use with caution; meclizine and its metabolites are excreted in the urine and may accumulate (Ref).

Hemodialysis, intermittent (thrice weekly): Unlikely to be significantly dialyzable (large Vd): Use with caution; meclizine and its metabolites are excreted in the urine and may accumulate (Ref).

Peritoneal dialysis: Unlikely to be significantly dialyzable (large Vd): Use with caution; meclizine and its metabolites are excreted in the urine and may accumulate (Ref).

CRRT: Unlikely to be significantly dialyzable (large Vd): No dosage adjustment provided in the manufacturer's labeling. Use with caution as meclizine and its metabolites may accumulate (Ref).

PIRRT (eg, sustained, low-efficiency diafiltration): Unlikely to be significantly dialyzable (large Vd): Use with caution; meclizine and its metabolites are excreted in the urine and may accumulate (Ref).

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer’s labeling (has not been studied); use with caution.

Dosing: Older Adult

Avoid use (Ref).

Dosing: Pediatric

(For additional information see "Meclizine: Pediatric drug information")

Motion sickness

Motion sickness: Children ≥12 years and Adolescents: Oral: 25 to 50 mg 1 hour before travel, repeat dose every 24 hours, if needed

Vertigo

Vertigo: Children ≥12 years and Adolescents: Oral: 25 to 100 mg/day in 3 or 4 divided doses (Wyllie 2016)

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer’s labeling (has not been studied); use with caution.

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer’s labeling (has not been studied); use with caution.

Adverse Reactions (Significant): Considerations
Anticholinergic effects

Meclizine causes anticholinergic effects, most commonly urinary retention and xerostomia (Ref). Blurred vision has also occurred (Ref). While these effects are not life-threatening, they may contribute to nonadherence. Severity is generally mild but may be augmented by additional medications with anticholinergic effects and in older adults (Ref). These effects are reversible with discontinuation of the drug.

Mechanism: Dose-related; antagonizes muscarinic receptors (Ref).

Risk factors:

• Higher doses (Ref)

• Concurrent medications with anticholinergic effects (Ref)

• Older patients (Ref)

CNS effects

CNS effects such as drowsiness (Ref) and short- and long-term memory impairment (Ref) may occur with the use of meclizine. Higher cumulative use is associated with an increased risk of dementia (including Alzheimer disease) (Ref). While these effects are not life-threatening, they may contribute to falls, motor vehicle accidents, nonadherence, and discontinuation. Older patients may be more affected (Ref). Memory impairment may not be fully reversible (Ref).

Mechanism: Dose- and time-related; antagonizes the histamine and muscarinic receptors (Ref). Cumulative use may cause changes in the brain similar to Alzheimer disease (Ref).

Onset: Varied; may occur rapidly or over time, depending on the CNS effect (Ref).

Risk factors:

• Higher doses (Ref)

• Higher cumulative use (Ref)

• Older patients (Ref)

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Adverse reactions reported in adults.

Frequency not defined:

Gastrointestinal: Vomiting, xerostomia (Babin 1984)

Hypersensitivity: Anaphylaxis

Nervous system: Drowsiness (Babin 1984), fatigue, headache

Ophthalmic: Blurred vision (Babin 1984)

Postmarketing:

Genitourinary: Urinary retention (Babin 1984)

Nervous system: Dizziness (Babin 1984), memory impairment (Gray 2015)

Contraindications

Hypersensitivity to meclizine or any component of the formulation

Warnings/Precautions

Disease-related concerns:

• Asthma: Use with caution in patients with asthma.

• Glaucoma: Use with caution in patients with narrow-angle glaucoma; condition may be exacerbated by cholinergic blockade.

• Hepatic impairment: Hepatic impairment may lead to drug accumulation (effects have not been evaluated); use with caution.

• Prostatic hyperplasia/urinary stricture: Use with caution in patients with prostatic hyperplasia, bladder neck obstruction, and/or urinary stricture (Drake 1998).

• Pyloric/duodenal obstruction: Use with caution in patients with pyloric or duodenal obstruction.

• Renal impairment: Renal impairment may lead to drug accumulation (effects have not been evaluated); use with caution.

Special populations:

• CYP2D6 polymorphism: Large inter-individual variability in meclizine exposure may occur in patients with CYP2D6 phenotypes that result in poor, intermediate, extensive, or ultra-rapid metabolism; monitor for adverse reactions and clinical effect accordingly.

• Older adult: Use with caution in older adults; may be more sensitive to adverse effects.

Dosage form specific issues:

• Phenylalanine: Some chewable tablets contain phenylalanine.

• Tartrazine: Some formulations may contain FD&C yellow #5 (tartrazine), which may cause allergic-type reactions (including bronchial asthma) in susceptible individuals, particularly those with aspirin sensitivity.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Tablet, Oral, as hydrochloride:

Antivert: 50 mg [contains corn starch, fd&c blue #1 (brilliant blue), fd&c yellow #6 (sunset yellow), quinoline yellow (d&c yellow #10)]

Dramamine Less Drowsy: 25 mg [DSC] [contains quinoline (d&c yellow #10) aluminum lake]

FT Motion Sickness: 25 mg [contains quinoline (d&c yellow #10) aluminum lake]

Medi-Meclizine: 25 mg [contains corn starch, quinoline (d&c yellow #10) aluminum lake]

Travel-Ease: 25 mg [contains corn starch, quinoline (d&c yellow #10) aluminum lake]

Travel-Ease: 25 mg [DSC] [contains quinoline (d&c yellow #10) aluminum lake]

Generic: 12.5 mg, 25 mg, 50 mg

Tablet Chewable, Oral, as hydrochloride:

Antivert: 25 mg [scored; contains corn starch, fd&c red #40 (allura red ac dye), saccharin sodium; raspberry flavor]

Bonine: 25 mg [contains fd&c red #40(allura red ac)aluminum lake, saccharin sodium]

Motion-Time: 25 mg [DSC] [contains corn starch, fd&c red #40(allura red ac)aluminum lake, saccharin sodium]

Motion-Time: 25 mg [scored; contains corn starch, fd&c red #40(allura red ac)aluminum lake, saccharin sodium; raspberry flavor]

Travel Sickness: 25 mg [DSC] [contains aspartame, fd&c red #40(allura red ac)aluminum lake]

Generic: 25 mg

Generic Equivalent Available: US

Yes

Pricing: US

Chewable (Antivert Oral)

25 mg (per each): $2.40

Chewable (Bonine Oral)

25 mg (per each): $0.39

Chewable (Meclizine HCl Oral)

25 mg (per each): $0.02 - $0.06

Tablets (Antivert Oral)

50 mg (per each): $4.31

Tablets (Meclizine HCl Oral)

12.5 mg (per each): $0.02 - $0.53

25 mg (per each): $0.09 - $0.55

50 mg (per each): $3.45

Tablets (Medi-Meclizine Oral)

25 mg (per each): $0.13

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Administration: Adult

Oral:

Chewable tablets: Chew or crush completely before swallowing.

Tablets: Swallow whole.

Administration: Pediatric

Oral: Administer without regard to food

Chewable tablets: May be chewed or swallowed whole

Use: Labeled Indications

Motion sickness: Prevention and treatment of nausea, vomiting, or dizziness associated with motion sickness.

Vertigo, acute episodes: Treatment of vertigo associated with diseases affecting the vestibular system.

Medication Safety Issues
Sound-alike/look-alike issues:

Antivert may be confused with Anzemet

Dramamine (meclizine) may be confused with Dramamine (dimenhydrinate), Dramamine (ginger root)

Older Adult: High-Risk Medication:

Beers Criteria: Meclizine, a first-generation antihistamine, is identified in the Beers Criteria as a potentially inappropriate medication to be avoided in patients 65 years and older (independent of diagnosis or condition) due to its potent anticholinergic properties resulting in increased risk of confusion, dry mouth, constipation, and other anticholinergic effects or toxicity; use should also be avoided due to reduced clearance with advanced age and tolerance associated with use as a hypnotic. Exposure to concurrent anticholinergic drugs also increases risk of falls, delirium, and dementia; consider total anticholinergic burden when conducting medication reviews (Beers Criteria [AGS 2023]).

International issues:

Antivert [US] may be confused with Axert brand name for almotriptan [Puerto Rico]

Metabolism/Transport Effects

Substrate of CYP2D6 (minor); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Acetylcholinesterase Inhibitors: May diminish the therapeutic effect of Anticholinergic Agents. Anticholinergic Agents may diminish the therapeutic effect of Acetylcholinesterase Inhibitors. Risk C: Monitor therapy

Aclidinium: May enhance the anticholinergic effect of Anticholinergic Agents. Risk X: Avoid combination

Alcohol (Ethyl): CNS Depressants may enhance the CNS depressant effect of Alcohol (Ethyl). Risk C: Monitor therapy

Alizapride: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Amantadine: May enhance the anticholinergic effect of Anticholinergic Agents. Risk C: Monitor therapy

Amezinium: Antihistamines may enhance the stimulatory effect of Amezinium. Risk C: Monitor therapy

Anticholinergic Agents: May enhance the adverse/toxic effect of other Anticholinergic Agents. Risk C: Monitor therapy

Azelastine (Nasal): May enhance the CNS depressant effect of CNS Depressants. Risk X: Avoid combination

Benzylpenicilloyl Polylysine: Antihistamines may diminish the diagnostic effect of Benzylpenicilloyl Polylysine. Management: Suspend systemic H1 antagonists for benzylpenicilloyl-polylysine skin testing and delay testing until systemic antihistaminic effects have dissipated. A histamine skin test may be used to assess persistent antihistaminic effects. Risk D: Consider therapy modification

Betahistine: Antihistamines may diminish the therapeutic effect of Betahistine. Betahistine may diminish the therapeutic effect of Antihistamines. Risk C: Monitor therapy

Blonanserin: CNS Depressants may enhance the CNS depressant effect of Blonanserin. Management: Use caution if coadministering blonanserin and CNS depressants; dose reduction of the other CNS depressant may be required. Strong CNS depressants should not be coadministered with blonanserin. Risk D: Consider therapy modification

Botulinum Toxin-Containing Products: May enhance the anticholinergic effect of Anticholinergic Agents. Risk C: Monitor therapy

Brexanolone: CNS Depressants may enhance the CNS depressant effect of Brexanolone. Risk C: Monitor therapy

Brimonidine (Topical): May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Bromopride: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Bromperidol: May enhance the CNS depressant effect of CNS Depressants. Risk X: Avoid combination

Buprenorphine: CNS Depressants may enhance the CNS depressant effect of Buprenorphine. Management: Consider reduced doses of other CNS depressants, and avoiding such drugs in patients at high risk of buprenorphine overuse/self-injection. Initiate buprenorphine at lower doses in patients already receiving CNS depressants. Risk D: Consider therapy modification

Cannabinoid-Containing Products: Anticholinergic Agents may enhance the tachycardic effect of Cannabinoid-Containing Products. Risk C: Monitor therapy

Cannabinoid-Containing Products: CNS Depressants may enhance the CNS depressant effect of Cannabinoid-Containing Products. Risk C: Monitor therapy

Chloral Betaine: May enhance the adverse/toxic effect of Anticholinergic Agents. Risk C: Monitor therapy

Chlormethiazole: May enhance the CNS depressant effect of CNS Depressants. Management: Monitor closely for evidence of excessive CNS depression. The chlormethiazole labeling states that an appropriately reduced dose should be used if such a combination must be used. Risk D: Consider therapy modification

Chlorphenesin Carbamate: May enhance the adverse/toxic effect of CNS Depressants. Risk C: Monitor therapy

Chlorprothixene: Anticholinergic Agents may enhance the anticholinergic effect of Chlorprothixene. Risk C: Monitor therapy

Cimetropium: Anticholinergic Agents may enhance the anticholinergic effect of Cimetropium. Risk X: Avoid combination

CloZAPine: Anticholinergic Agents may enhance the constipating effect of CloZAPine. Management: Consider alternatives to this combination whenever possible. If combined, monitor closely for signs and symptoms of gastrointestinal hypomotility and consider prophylactic laxative treatment. Risk D: Consider therapy modification

CNS Depressants: May enhance the adverse/toxic effect of other CNS Depressants. Risk C: Monitor therapy

Daridorexant: May enhance the CNS depressant effect of CNS Depressants. Management: Dose reduction of daridorexant and/or any other CNS depressant may be necessary. Use of daridorexant with alcohol is not recommended, and the use of daridorexant with any other drug to treat insomnia is not recommended. Risk D: Consider therapy modification

DexmedeTOMIDine: CNS Depressants may enhance the CNS depressant effect of DexmedeTOMIDine. Management: Monitor for increased CNS depression during coadministration of dexmedetomidine and CNS depressants, and consider dose reductions of either agent to avoid excessive CNS depression. Risk D: Consider therapy modification

Difelikefalin: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Dimethindene (Topical): May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Doxylamine: CNS Depressants may enhance the CNS depressant effect of Doxylamine. Risk C: Monitor therapy

DroPERidol: May enhance the CNS depressant effect of CNS Depressants. Management: Consider dose reductions of droperidol or of other CNS agents (eg, opioids, barbiturates) with concomitant use. Risk D: Consider therapy modification

Eluxadoline: Anticholinergic Agents may enhance the constipating effect of Eluxadoline. Risk X: Avoid combination

Esketamine: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Flunarizine: CNS Depressants may enhance the CNS depressant effect of Flunarizine. Risk X: Avoid combination

Flunitrazepam: CNS Depressants may enhance the CNS depressant effect of Flunitrazepam. Management: Reduce the dose of CNS depressants when combined with flunitrazepam and monitor patients for evidence of CNS depression (eg, sedation, respiratory depression). Use non-CNS depressant alternatives when available. Risk D: Consider therapy modification

Gastrointestinal Agents (Prokinetic): Anticholinergic Agents may diminish the therapeutic effect of Gastrointestinal Agents (Prokinetic). Risk C: Monitor therapy

Glucagon: Anticholinergic Agents may enhance the adverse/toxic effect of Glucagon. Specifically, the risk of gastrointestinal adverse effects may be increased. Risk C: Monitor therapy

Glycopyrrolate (Oral Inhalation): Anticholinergic Agents may enhance the anticholinergic effect of Glycopyrrolate (Oral Inhalation). Risk X: Avoid combination

Glycopyrronium (Topical): May enhance the anticholinergic effect of Anticholinergic Agents. Risk X: Avoid combination

Hyaluronidase: Antihistamines may diminish the therapeutic effect of Hyaluronidase. Risk C: Monitor therapy

HydrOXYzine: May enhance the CNS depressant effect of CNS Depressants. Management: Consider a decrease in the CNS depressant dose, as appropriate, when used together with hydroxyzine. Increase monitoring of signs/symptoms of CNS depression in any patient receiving hydroxyzine together with another CNS depressant. Risk D: Consider therapy modification

Ipratropium (Oral Inhalation): May enhance the anticholinergic effect of Anticholinergic Agents. Risk X: Avoid combination

Itopride: Anticholinergic Agents may diminish the therapeutic effect of Itopride. Risk C: Monitor therapy

Ixabepilone: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Kava Kava: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Kratom: May enhance the CNS depressant effect of CNS Depressants. Risk X: Avoid combination

Lemborexant: May enhance the CNS depressant effect of CNS Depressants. Management: Dosage adjustments of lemborexant and of concomitant CNS depressants may be necessary when administered together because of potentially additive CNS depressant effects. Close monitoring for CNS depressant effects is necessary. Risk D: Consider therapy modification

Levosulpiride: Anticholinergic Agents may diminish the therapeutic effect of Levosulpiride. Risk X: Avoid combination

Lisuride: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Lofexidine: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Magnesium Sulfate: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Methotrimeprazine: CNS Depressants may enhance the CNS depressant effect of Methotrimeprazine. Methotrimeprazine may enhance the CNS depressant effect of CNS Depressants. Management: Reduce the usual dose of CNS depressants by 50% if starting methotrimeprazine until the dose of methotrimeprazine is stable. Monitor patient closely for evidence of CNS depression. Risk D: Consider therapy modification

Metoclopramide: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

MetyroSINE: CNS Depressants may enhance the sedative effect of MetyroSINE. Risk C: Monitor therapy

Mianserin: May enhance the anticholinergic effect of Anticholinergic Agents. Risk C: Monitor therapy

Minocycline (Systemic): May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Mirabegron: Anticholinergic Agents may enhance the adverse/toxic effect of Mirabegron. Risk C: Monitor therapy

Nabilone: May enhance the CNS depressant effect of CNS Depressants. Risk X: Avoid combination

Nitroglycerin: Anticholinergic Agents may decrease the absorption of Nitroglycerin. Specifically, anticholinergic agents may decrease the dissolution of sublingual nitroglycerin tablets, possibly impairing or slowing nitroglycerin absorption. Risk C: Monitor therapy

Olopatadine (Nasal): May enhance the CNS depressant effect of CNS Depressants. Risk X: Avoid combination

Opioid Agonists: CNS Depressants may enhance the CNS depressant effect of Opioid Agonists. Management: Avoid concomitant use of opioid agonists and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. Risk D: Consider therapy modification

Orphenadrine: CNS Depressants may enhance the CNS depressant effect of Orphenadrine. Risk X: Avoid combination

Oxatomide: May enhance the anticholinergic effect of Anticholinergic Agents. Risk X: Avoid combination

Oxomemazine: May enhance the CNS depressant effect of CNS Depressants. Risk X: Avoid combination

Oxybate Salt Products: CNS Depressants may enhance the CNS depressant effect of Oxybate Salt Products. Management: Consider alternatives to this combination when possible. If combined, dose reduction or discontinuation of one or more CNS depressants (including the oxybate salt product) should be considered. Interrupt oxybate salt treatment during short-term opioid use Risk D: Consider therapy modification

OxyCODONE: CNS Depressants may enhance the CNS depressant effect of OxyCODONE. Management: Avoid concomitant use of oxycodone and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. Risk D: Consider therapy modification

Paraldehyde: CNS Depressants may enhance the CNS depressant effect of Paraldehyde. Risk X: Avoid combination

Perampanel: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Piribedil: CNS Depressants may enhance the CNS depressant effect of Piribedil. Risk C: Monitor therapy

Pitolisant: Antihistamines may diminish the therapeutic effect of Pitolisant. Risk X: Avoid combination

Potassium Chloride: Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Chloride. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium chloride. Risk X: Avoid combination

Potassium Citrate: Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Citrate. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium citrate. Risk X: Avoid combination

Pramipexole: CNS Depressants may enhance the sedative effect of Pramipexole. Risk C: Monitor therapy

Pramlintide: May enhance the anticholinergic effect of Anticholinergic Agents. These effects are specific to the GI tract. Risk X: Avoid combination

Procarbazine: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Ramosetron: Anticholinergic Agents may enhance the constipating effect of Ramosetron. Risk C: Monitor therapy

Revefenacin: Anticholinergic Agents may enhance the anticholinergic effect of Revefenacin. Risk X: Avoid combination

Rivastigmine: Anticholinergic Agents may diminish the therapeutic effect of Rivastigmine. Rivastigmine may diminish the therapeutic effect of Anticholinergic Agents. Management: Use of rivastigmine with an anticholinergic agent is not recommended unless clinically necessary. If the combination is necessary, monitor for reduced anticholinergic effects. Risk D: Consider therapy modification

Ropeginterferon Alfa-2b: CNS Depressants may enhance the adverse/toxic effect of Ropeginterferon Alfa-2b. Specifically, the risk of neuropsychiatric adverse effects may be increased. Management: Avoid coadministration of ropeginterferon alfa-2b and other CNS depressants. If this combination cannot be avoided, monitor patients for neuropsychiatric adverse effects (eg, depression, suicidal ideation, aggression, mania). Risk D: Consider therapy modification

ROPINIRole: CNS Depressants may enhance the sedative effect of ROPINIRole. Risk C: Monitor therapy

Rotigotine: CNS Depressants may enhance the sedative effect of Rotigotine. Risk C: Monitor therapy

Rufinamide: May enhance the adverse/toxic effect of CNS Depressants. Specifically, sleepiness and dizziness may be enhanced. Risk C: Monitor therapy

Secretin: Anticholinergic Agents may diminish the therapeutic effect of Secretin. Management: Avoid concomitant use of anticholinergic agents and secretin. Discontinue anticholinergic agents at least 5 half-lives prior to administration of secretin. Risk D: Consider therapy modification

Suvorexant: CNS Depressants may enhance the CNS depressant effect of Suvorexant. Management: Dose reduction of suvorexant and/or any other CNS depressant may be necessary. Use of suvorexant with alcohol is not recommended, and the use of suvorexant with any other drug to treat insomnia is not recommended. Risk D: Consider therapy modification

Thalidomide: CNS Depressants may enhance the CNS depressant effect of Thalidomide. Risk X: Avoid combination

Thiazide and Thiazide-Like Diuretics: Anticholinergic Agents may increase the serum concentration of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy

Tiotropium: Anticholinergic Agents may enhance the anticholinergic effect of Tiotropium. Risk X: Avoid combination

Topiramate: Anticholinergic Agents may enhance the adverse/toxic effect of Topiramate. Risk C: Monitor therapy

Trimeprazine: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Umeclidinium: May enhance the anticholinergic effect of Anticholinergic Agents. Risk X: Avoid combination

Valerian: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Zolpidem: CNS Depressants may enhance the CNS depressant effect of Zolpidem. Management: Reduce the Intermezzo brand sublingual zolpidem adult dose to 1.75 mg for men who are also receiving other CNS depressants. No such dose change is recommended for women. Avoid use with other CNS depressants at bedtime; avoid use with alcohol. Risk D: Consider therapy modification

Zuranolone: May enhance the CNS depressant effect of CNS Depressants. Management: Consider alternatives to the use of zuranolone with other CNS depressants or alcohol. If combined, consider a zuranolone dose reduction and monitor patients closely for increased CNS depressant effects. Risk D: Consider therapy modification

Pregnancy Considerations

Based on epidemiologic studies, maternal meclizine use has generally not resulted in an increased risk of fetal abnormalities.

Breastfeeding Considerations

It is not known if meclizine is present in breast milk.

Drowsiness and irritability have been reported in breastfed infants exposed to other antihistamines (Ito 1993). According to the manufacturer, the decision to breastfeed during therapy should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and benefits of treatment to the mother. In general, if a breastfed infant is exposed to a first-generation antihistamine via breast milk, they should be monitored for irritability or drowsiness (Butler 2014).

When treatment with an antihistamine is needed in breastfeeding women, second-generation antihistamines are preferred (Butler 2014).

Antihistamines may decrease maternal serum prolactin concentrations when administered prior to the establishment of lactation (Messinis 1985).

Monitoring Parameters

Mental alertness.

Mechanism of Action

Antihistamine that suppresses vestibular end-organ receptors and inhibits activation of central cholinergic pathways (Oosterveld 1985)

Pharmacokinetics (Adult Data Unless Noted)

Onset of action: ~1 hour (Wang 2012)

Duration: ~24 hours (Wang 2012)

Distribution: Vd: 7 L/kg (Wang 2012)

Metabolism: Hepatic to norchlorcyclizine (Wang 2012)

Half-life elimination: 5.2 ± 0.8 hours (Wang 2011; Wang 2012)

Time to peak, plasma: 3.1 ± 1.4 hours (Wang 2011; Wang 2012)

Excretion: Urine and feces as unchanged drug and metabolites (Wang 2012)

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Ancolan;
  • (AR) Argentina: Zenelis mareos;
  • (BD) Bangladesh: Acliz | Anosea | Avert | Clizin | Emego | Emenil | Nomosic | Vertina | Vomec;
  • (BE) Belgium: Postafene;
  • (BR) Brazil: Meclin | Mezyac;
  • (CI) Côte d'Ivoire: Agyrax;
  • (CL) Chile: Bonamina;
  • (CO) Colombia: Vertinon;
  • (DK) Denmark: Postafen;
  • (DO) Dominican Republic: Noxadrel | Termex | Zodivan;
  • (ES) Spain: Navicalm;
  • (FI) Finland: Postafen;
  • (FR) France: Agyrax;
  • (GB) United Kingdom: Ancolan | Sea legs | Sea legs mv/;
  • (GR) Greece: Emetostop | Postafene;
  • (HK) Hong Kong: Gericare Travel Ease | Meclizine hydrochloride | Postafene | Qualizine;
  • (IE) Ireland: Sea legs;
  • (IN) India: Vominos;
  • (JP) Japan: Bonamine | Pord | Shasen | Taizer | Travela | Tribra;
  • (KR) Korea, Republic of: Antoron | Bominain | Meclizine;
  • (LT) Lithuania: Bonine | Meclizine;
  • (LU) Luxembourg: Postafene;
  • (LV) Latvia: Bonine | Postafene;
  • (MX) Mexico: Chiclida;
  • (NL) Netherlands: Suprimal;
  • (NO) Norway: Postafen;
  • (NZ) New Zealand: Sea legs;
  • (PH) Philippines: Bonamine | Bonazil | Dizitab | Meclitab | Nodiz;
  • (PR) Puerto Rico: Bonine | Meclizine | Meclizine HCL | Meclizine hydrochloride | Medi-meclizine | Motion time | Travel ease | Verticalm | Vertin-32;
  • (PT) Portugal: Navicalma;
  • (PY) Paraguay: Meclimine | Vertigol;
  • (RO) Romania: Emetostop;
  • (RU) Russian Federation: Bonine;
  • (SE) Sweden: Postafen;
  • (TH) Thailand: Meclizine;
  • (TW) Taiwan: Bonamine | Clipine | Clizine | Liga | Lipan | Luyun | Meclizin | Meclizine | Semper | Souriree Vomiseda | Tinyuen | Travezin | Tribra | Yonyun | Yungisumin | Zithine;
  • (UA) Ukraine: Bonine
  1. 2019 American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2019;67(4):674-694. doi:10.1111/jgs.15767 [PubMed 30693946]
  2. 2023 American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052-2081. doi:10.1111/jgs.18372 [PubMed 37139824]
  3. Antivert (meclizine) [prescribing information]. East Brunswick, NJ: Casper Pharma LLC; October 2022.
  4. Babin RW, Balkany TJ, Fee WE. Transdermal scopolamine in the treatment of acute vertigo. Ann Otol Rhinol Laryngol. 1984;93(1 Pt 1):25-27. doi:10.1177/000348948409300106 [PubMed 6703595]
  5. Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: part II. Lactation. J Am Acad Dermatol. 2014;70(3):417. [PubMed 24528912]
  6. Cohen MA, Alfonso CA, Mosquera M. Development of urinary retention during treatment with clozapine and meclizine. Am J Psychiatry. 1994;151(4):619-620. [PubMed 8147469]
  7. Dahl E, Offer-Ohlsen D, Lillevold PE, Sandvik L. Transdermal scopolamine, oral meclizine, and placebo in motion sickness. Clin Pharmacol Ther. 1984;36(1):116-120. doi:10.1038/clpt.1984.148 [PubMed 6734040]
  8. Drake MJ, Nixon PM, Crew JP. Drug-induced bladder and urinary disorders. Incidence, prevention and management. Drug Saf. 1998;19(1):45-55. [PubMed 9673857]
  9. Dramamine Less Drowsy tablet (meclizine) [prescribing information]. Irvington, NY: Medtech Products Inc; August 2011.
  10. Expert opinion. Senior Renal Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.
  11. Furman JM, Barton, JJ. Treatment of vertigo. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed November 28, 2022.
  12. Gray SL, Anderson ML, Dublin S, et al. Cumulative use of strong anticholinergics and incident dementia: a prospective cohort study. JAMA Intern Med. 2015;175(3):401-407. doi:10.1001/jamainternmed.2014.7663 [PubMed 25621434]
  13. Ito S, Blajchman A, Stephenson M, Eliopoulos C, Koren G. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993;168(5):1393-1399. [PubMed 8498418]
  14. Meclizine chewable tablets [prescribing information]. Commack, NY: PlusPharma; September 2015.
  15. Meclizine [prescribing information]. Chestnut Ridge, NY: Par Pharmaceutical Companies Inc; July 2015.
  16. Messinis IE, Souvatzoglou A, Fais N, et al, "Histamine H1 Receptor Participation in the Control of Prolactin Secretion in Postpartum," J Endocrinol Invest, 1985, 8(2):143-6. [PubMed 3928731]
  17. Oosterveld WJ, “Vertigo: Current Concepts in Management,” Drugs, 1985, 30(3):275-83. [PubMed 3876202]
  18. Priesol AJ. Motion sickness. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed April 28, 2021.
  19. Refer to manufacturer’s labeling.
  20. Shih RD, Walsh B, Eskin B, et al. Diazepam and meclizine are equally effective in the treatment of vertigo: an emergency department randomized double-blind placebo-controlled trial. J Emerg Med. 2017;52(1):23-27. doi:10.1016/j.jemermed.2016.09.016 [PubMed 27789115]
  21. Wang Z, Lee B, Pearce D, et al, "Meclizine Metabolism and Pharmacokinetics: Formulation on Its Absorption," J Clin Pharmacol, 2012, 52(9):1343-9. [PubMed 21903894]
  22. Wang Z, Qian S, Zhang Q, et al, "Quantification of Meclizine in Human Plasma by High Performance Liquid Chromatography-Mass Spectrometry," J Chromatogr B Analyt Technol Biomed Life Sci, 2011, 879(1):95-9. [PubMed 21163711]
  23. Weerts AP, Pattyn N, Van de Heyning PH, Wuyts FL. Evaluation of the effects of anti-motion sickness drugs on subjective sleepiness and cognitive performance of healthy males. J Psychopharmacol. 2014;28(7):655-664. doi:10.1177/0269881113516201. [PubMed 24346808]
  24. Wyllie R, ed. Pediatric Gastrointestinal and Liver Disease. 5th ed. Elsevier, Inc; 2016.
Topic 9597 Version 670.0

آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟