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meclizine (Antivert)

Tradenames: Antivert. Indications: 1) antihistamine 2) prevention & treatment of nausea & vomiting 3) treatment of motion sickness 4) management of vestibular toxicity caused by morphine 5) vertigo 6) Meniere's disease [4] Contraindications: - pregnancy category: B Dosage: 1) vertigo: 25 mg PO every 6 hours PRN 2) motion sickness: 25-50 mg 1 hour prior to exposure 3) 25-50 mg every 8-12 hours PRN 4) maximum 100 mg/day 5) take after meals Tabs: 12,5, 25, 50 mg. Pharmacokinetics: 1) onset of action is about 1 hour 2) duration of action is 8-24 hours 3) 1/2life is approximately 6 hours 4) metabolized by the liver 5) eliminated in the urine & feces Adverse effects: 1) common (> 10%) - slight to moderate drowsiness - thickening of bronchial secretions 2) less common (1-10%) - headache, fatigue, appetite increase, weight increase, nervousness, dizziness, nausea, diarrhea, abdominal pain, dry mouth, pharyngitis, arthralgia 3) uncommon (< 1%) - angioedema, bronchospasm, depression, edema, epistaxis, hepatitis, myalgia, palpitations, paresthesias, photosensitivity, rash, hypotension, sedation, paradoxical excitement, insomnia, tremor, blurred vision, urinary retention 4) other - constipation - increased risk of falls in the elderly [5] Drug interactions: 1) other CNS depressants & MAO inhibitors intensify anti-cholinergic effects 2) neuroleptics 3) anticholinergic agents Mechanism of action: 1) histamine H1 receptor antagonist 2) anticholinergic, antiemetic, anesthetic & anti-motion sickness properties 3) depresses excitability & conduction in vestibular-cerebellar pathways

General

anti-emetic neurologic agent

Properties

MISC-INFO: elimination route LIVER pregnancy-category B safety in lactation ?

Database Correlations

PUBCHEM correlations

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  3. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  4. Deprecated Reference
  5. Adams ME et al. Meclizine use and subsequent falls among patients with dizziness. JAMA Otolaryngol Head Neck Surg 2025 Jul 24 PMID: 40705353 https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2836843