Tuesday, September 13, 2016

Meclizine Hydrochloride


Class: Antihistamines
VA Class: CN550
CAS Number: 31884-77-2
Brands: Antivert, Bonine, Dramamine Less Drowsy, Meni-D

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 vertigoe 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 (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.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


Interactions for Meclizine Hydrochloride


Specific Drugs









Drug



Interaction



Comments



CNS depressants (e.g., alcohol, barbiturates, tranquilizers)



Additive CNS depressionb e



Avoid alcoholic beverages;b e use other CNS depressants with cautiona


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


ActionsActions



  • 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 (See Cautions.)



Preparations


Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.


* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name






































Meclizine Hydrochloride

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


Comparative Pricing


This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 03/2011. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.


Antivert 12.5MG Tablets (PFIZER U.S.): 30/$30.99 or 90/$69.97


Antivert 25MG Tablets (PFIZER U.S.): 30/$46.99 or 90/$112.97


Antivert 50MG Tablets (PFIZER U.S.): 30/$67.99 or 90/$194.98


Meclizine HCl 12.5MG Tablets (RUGBY): 30/$12.99 or 60/$14.98


Meclizine HCl 25MG Tablets (PAR): 30/$19.99 or 60/$30.97


Travel Sickness 25MG Chewable Tablets (RUGBY): 100/$14.99 or 200/$18.97



Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.


The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions July 2006. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.




References



100. Food and Drug Administration. Antiemetic drug products for over-the-counter human use; final monograph. Fed Regist. 1987; 52:15886-93.



101. Leeming Division. Bonine (meclizine hydrochloride) chewable tablets prescribing information. In: Huff BB, ed. Physicians’ desk reference for nonprescription drugs. 9th ed. Oradell, NJ: Medical Economics Company Inc; 1988:569.



102. Roerig. Antivert tablets, Antivert25 tablets, Antivert25 chewable tablets, and Antivert50 tablets prescribing information. In: Huff BB, ed. Physicians’ desk reference. 43rd ed. Oradell, NJ: Medical Economics Company Inc; 1989:1774.



103. Food and Drug Administration. Over-the-counter drug products; final monographs for antiemetic, antitussive, bronchodilator, and antihelmintic drug products; updating and technical changes. Fed Regist. 1988; 53:35808-10.



a. AHFS drug information 2004. McEvoy GK, ed. Meclizine hydrochloride. Bethesda, MD: American Society of Health-System Pharmacists; 2004:2787-8.



b. Antivert (meclizine hydrochloride) tablets prescribing information. In: PDR.net [database online]. Montvale, NJ: Thomson Healthcare; 2003. Updated 1996 Jun.



c. Bonine (meclizine hydrochloride) tablets prescribing information. In: PDR.net [database online]. Montvale, NJ: Thomson Healthcare; 2003.



d. Par Pharmaceutical, Inc. Meclizine hydrochloride tablets prescribing information. Spring Valley, NY; 2000 Apr.



e. Department of Health and Human Services, Food and Drug Administration. Antiemetic drug products for over-the-counter human use. (21CFR336). 2001 Apr; 5:231-3.



f. AHFS drug information 2004. McEvoy GK, ed. Antihistamines. Bethesda, MD: American Society of Health-System Pharmacists; 2004:2-9.



More Meclizine Hydrochloride resources


  • Meclizine Hydrochloride Side Effects (in more detail)
  • Meclizine Hydrochloride Use in Pregnancy & Breastfeeding
  • Drug Images
  • Meclizine Hydrochloride Drug Interactions
  • Meclizine Hydrochloride Support Group
  • 47 Reviews for Meclizine Hydrochloride - Add your own review/rating


  • Meclizine Prescribing Information (FDA)

  • Meclizine Professional Patient Advice (Wolters Kluwer)

  • Antivert MedFacts Consumer Leaflet (Wolters Kluwer)

  • Antivert Prescribing Information (FDA)

  • Antivert Consumer Overview



Compare Meclizine Hydrochloride with other medications


  • Motion Sickness
  • Nausea/Vomiting
  • Vertigo

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