meclozine
meclizine hydrochloride (meclozine (UK))
Pharmacologic class: Anticholinergic
Therapeutic class: Antiemetic, antivertigo drug
Pregnancy risk category B
Action
Decreases excitability of middle-ear labyrinth and depresses conduction in vestibular-cerebellar pathways
Availability
Tablets: 12.5 mg, 25 mg, 50 mg
Tablets (chewable): 25 mg
Indications and dosages
➣ Motion sickness
Adults: 25 to 50 mg P.O. 1 hour before travel. May repeat q 24 hours for duration of travel.
➣ Vertigo associated with diseases affecting the vestibular system
Adults: 25 to 100 mg P.O. daily in divided doses
Contraindications
• Hypersensitivity to drug
Precautions
Use cautiously in:
• prostatic hypertrophy, stenosing peptic ulcer, bladder neck obstruction, pyloroduodenal obstruction, arrhythmias, angle-closure glaucoma, bronchial asthma
• pregnant or breastfeeding patients
• children (younger than age 12).
Administration
• Know that tablets may be chewed or swallowed whole.
Adverse reactions
CNS: drowsiness, fatigue, confusion, excitement, euphoria, nervousness, restlessness, insomnia, vertigo, visual and auditory hallucinations, seizures
CV: hypotension, palpitations, tachycardia
EENT: blurred vision, diplopia, tinnitus, dry nose, dry throat
GI: nausea, vomiting, diarrhea, constipation, dry mouth, anorexia
GU: difficulty urinating, urinary retention, urinary frequency
Skin: rash, urticaria
Interactions
Drug-drug. Anticholinergics (including some antihistamines, antidepressants, atropine, haloperidol, phenothiazines): additive anticholinergic effects
Antihistamines, CNS depressants (such as opioids, sedative-hypnotics): additive CNS depression
Drug-diagnostic tests. Skin tests using allergen extracts: false-negative results
Drug-behaviors. Alcohol use: additive CNS depression
Patient monitoring
• Discontinue drug, as ordered, at least 4 days before skin testing.
• Know that drug has anticholinergic effects.
Patient teaching
• Tell patient to take as prescribed to minimize adverse effects.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• Advise patient to relieve dry mouth with hard candy or frequent sips of fluids.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and behaviors mentioned above.
meclizine
An antihistamine and anticholinergic used to manage motion sickness and vertigo caused by vestibular (inner ear) disease.Adverse effects
Allergic reaction, blurred vision, dry mouth, constipation, drowsiness.