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82 - Meclizine

Published online by Cambridge University Press:  06 October 2020

Stephen D. Silberstein
Affiliation:
Thomas Jefferson University, Philadelphia
Michael J. Marmura
Affiliation:
Thomas Jefferson University, Philadelphia
Hsiangkuo Yuan
Affiliation:
Thomas Jefferson University, Philadelphia
Stephen M. Stahl
Affiliation:
University of California, San Diego
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Summary

THERAPEUTICS

Brands

• Antivert, Bonine

Generic?

• Yes

Class

• Antiemetic

Commonly Prescribed for

(FDA approved in bold)

Motion sickness

Vertigo

How the Drug Works

• Antihistamine and anticholinergic drug

How Long Until It Works

• 30 minutes

If It Works

• Continue to use as needed, especially in shortterm disorders, such as viral labyrinthitis

If It Doesn't Work

• Treat the underlying disorder with appropriate agents for that disorder

• Benzodiazepines (Valium) may be effective for vertigo; antiemetics, such as promethazine, help also treat motion sickness

Best Augmenting Combos for Partial Response or Treatment-Resistance

• Benzodiazepines (Valium) may be effective for vertigo

• Meniere's disease: diuretics, antiemetics, and low-salt diet

• Vestibular rehabilitation may be helpful

Tests

• None

ADVERSE EFFECTS (AEs)

How the Drug Causes AEs

• Antihistamine and anticholinergic actions

Notable AEs

• Dry mouth, sedation are most common

• Paradoxical excitation (nervousness, agitation), blurred vision, rash, tinnitus

• Hypotension, tachycardia

Life-Threatening or Dangerous AEs

• May precipitate narrow-angle glaucoma

• Risk of heat stroke, especially in elderly patients

• Can precipitate tachycardia, cardiac arrhythmias, and hypotension

• May cause urinary retention in patients with prostate hypertrophy

Weight Gain

• Common

Sedation

• Common

What to Do About AEs

• Sedation: give at night or lower dose

• Dry mouth: chewing gum or water

Best Augmenting Agents to Reduce AEs

• Most AEs cannot be reduced with the use of an augmenting agent

DOSING AND USE

Usual Dosage Range

• Vertigo: 25–100mg/day

Dosage Forms

• Tablets: 12.5, 25, 50mg

• Chewable: 25mg

• Capsules: 25mg

How to Dose

• Motion sickness: 25–50mg 1 hour before travel

• Vertigo: 25–50mg 2–3 times daily (maximum 100mg/day)

Dosing Tips

• Taking with meals may reduce AEs

Overdose

• Large overdoses may cause convulsions, hallucinations, or respiratory depression

Long-Term Use

• Unknown, usually a short-term medication

Habit Forming

• No

How to Stop

• No need to taper

Type
Chapter
Information
Essential Neuropharmacology
The Prescriber's Guide
, pp. 305 - 307
Publisher: Cambridge University Press
Print publication year: 2015

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  • Meclizine
  • Stephen D. Silberstein, Thomas Jefferson University, Philadelphia, Michael J. Marmura, Thomas Jefferson University, Philadelphia, Hsiangkuo Yuan, Thomas Jefferson University, Philadelphia
  • Edited in consultation with Stephen M. Stahl, University of California, San Diego
  • Book: Essential Neuropharmacology
  • Online publication: 06 October 2020
  • Chapter DOI: https://doi.org/10.1017/9781316161753.083
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Save book to Dropbox

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  • Meclizine
  • Stephen D. Silberstein, Thomas Jefferson University, Philadelphia, Michael J. Marmura, Thomas Jefferson University, Philadelphia, Hsiangkuo Yuan, Thomas Jefferson University, Philadelphia
  • Edited in consultation with Stephen M. Stahl, University of California, San Diego
  • Book: Essential Neuropharmacology
  • Online publication: 06 October 2020
  • Chapter DOI: https://doi.org/10.1017/9781316161753.083
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Meclizine
  • Stephen D. Silberstein, Thomas Jefferson University, Philadelphia, Michael J. Marmura, Thomas Jefferson University, Philadelphia, Hsiangkuo Yuan, Thomas Jefferson University, Philadelphia
  • Edited in consultation with Stephen M. Stahl, University of California, San Diego
  • Book: Essential Neuropharmacology
  • Online publication: 06 October 2020
  • Chapter DOI: https://doi.org/10.1017/9781316161753.083
Available formats
×