Brand names: Antivert, Bonine, Dramamine Less Drowsy, Meni-D
Drug class: Antihistamines

Medically reviewed by Drugs.com on Oct 10, 2024. Written by ASHP.

Introduction

Antiemetic; piperazine-derivative antihistamine.^{a b c}

Uses for Meclizine Hydrochloride

Motion Sickness

Self-medication for prevention and treatment of nausea, vomiting, and/or dizziness associated with motion sickness.^{b c e}

Vertigo

Symptomatic management of vertigo^e associated with diseases affecting the vestibular system (e.g., labyrinthitis, Ménière’s disease).^{a b}

Other Uses

Use in allergic states not evaluated.^a

Meclizine Hydrochloride 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.^{101 102 d}

Dosage

Available as meclizine hydrochloride; dosage expressed in terms of meclizine.^{b c d}

Pediatric Patients

Motion Sickness

Oral

For self-medication in children ≥12 years of age, 25–50 mg once daily or as directed by clinician.^{a b c d e}

Adults

Motion Sickness

Oral

For self-medication, 25–50 mg once daily or as directed by clinician.^{a b c d}

Vertigo

Oral

25–100 mg daily, administered in divided doses, depending on clinical response.^{a b}

Cautions for Meclizine Hydrochloride

Contraindications

• Known hypersensitivity to meclizine.^b

Warnings/Precautions

Warnings

CNS Effects

Possible drowsiness.^{b e}

Possible additive CNS depression with other CNS depressants.^{b e}

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.^{b c d e}

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.^d Incidence of tartrazine sensitivity is low, but it frequently occurs in patients who have aspirin hypersensitivity.^d

Specific Populations

Pregnancy

Category B.^b

Lactation

Antihistamines may inhibit lactation and small amounts appear to be distributed into milk.^f Due to potential for serious adverse effects (e.g., CNS effects) in nursing infants, discontinue nursing or the drug.^f

Pediatric Use

Safety and efficacy not established in children <12 years of age.^{a b c e}

Common Adverse Effects

Drowsiness, fatigue, dry mouth.^{a b c}

Drug Interactions

Specific Drugs

Meclizine Hydrochloride Pharmacokinetics

Absorption

Onset

About 1 hour.^a

Duration

Effects persist for 8–24 hours following a single oral dose.^a

Distribution

Extent

Distributed throughout most body tissues; crosses placenta.^a

Elimination

Metabolism

Metabolic fate in humans is unknown.^a In rats, metabolized (probably in the liver) to norchlorcyclizine.^a

Elimination Route

Excreted in feces as unchanged drug and in urine as norchlorcyclizine.^a

Half-life

6 hours.^a

Stability

Storage

Oral

Capsules and Tablets

Tight, light-resistant container at 15–30°C.^{a c d}

Actions

• Exhibits CNS depressant, anticholinergic, antiemetic, antispasmodic, and local anesthetic effects in addition to antihistaminic activity.^a

• Depresses labyrinth excitability and conduction in vestibular-cerebellar pathways.^a

• Antiemetic and antimotion-sickness actions result, at least in part, from central anticholinergic and CNS depressant properties.^a

Advice to Patients

• Risk of drowsiness; use caution when driving or operating machinery.^{b c d}

• Importance of avoiding alcohol during therapy.^{b c d}

• Importance of patients informing clinicians of existing or contemplated therapy, including prescription and OTC drugs, as well as any concomitant illnesses.^{b c d}

• Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.^{b c d}

• Importance of informing patients of other important precautionary information.^{b c d}

Additional Information

The American Society of Health-System Pharmacists, Inc. represents that the information provided in the accompanying monograph was formulated with a reasonable standard of care, and in conformity with professional standards in the field. Readers are advised that decisions regarding use of drugs are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and that the information contained in the monograph is provided for informational purposes only. The manufacturer’s labeling should be consulted for more detailed information. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information contained in the monograph is not a substitute for medical care.

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

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