Drug Guide
Meclizine Hydrochloride
Classification
Therapeutic: Antiemetic, Motion Sickness Agent
Pharmacological: Antihistamine (H1 antagonist)
FDA Approved Indications
- Motion sickness
- Vertigo
Mechanism of Action
Meclizine is an H1 histamine receptor antagonist that blunts the vestibular apparatus responses and reduces nausea and vomiting associated with motion sickness and vertigo.
Dosage and Administration
Adult: 25-50 mg, 1 hour before travel, then 25 mg 24 hours later if needed
Pediatric: 6-12 years: 12.5-25 mg 1 hour before travel, then 12.5 mg 24 hours later if needed (consult specific dosing for age and weight)
Geriatric: Typically start at lower end of dosing range due to increased sensitivity
Renal Impairment: Adjust dose based on severity, use with caution
Hepatic Impairment: Use with caution; no specific dose adjustment established
Pharmacokinetics
Absorption: Well absorbed from gastrointestinal tract
Distribution: Widely distributed, crosses the blood-brain barrier
Metabolism: Hepatically metabolized
Excretion: Renal excretion of unchanged drug and metabolites
Half Life: Approximately 6 hours
Contraindications
- Hypersensitivity to meclizine or other antihistamines
- Pregnancy (category B, use only if clearly needed)
Precautions
- Use with caution in patients with glaucoma, urinary retention, or GI obstruction; caution in elderly due to increased sedation and anticholinergic effects
Adverse Reactions - Common
- Drowsiness (Very common)
- Dry mouth (Common)
- Dizziness (Common)
Adverse Reactions - Serious
- Severe allergic reactions (rare) (Rare)
- Respiratory depression (rare, especially in overdose) (Rare)
Drug-Drug Interactions
- Addictive CNS depressants (e.g., alcohol, sedatives)
- Other anticholinergic drugs
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor for signs of drowsiness, anticholinergic effects, and effectiveness in controlling vertigo or motion sickness.
Diagnoses:
- Risk for injury related to dizziness or drowsiness
- Ineffective airway clearance if anticholinergic effects cause dry secretions
Implementation: Administer as directed, usually 1 hour before travel or vertigo episodes. Advise patients to avoid operating heavy machinery.
Evaluation: Assess reduction in vertigo symptoms and tolerance; monitor for adverse effects.
Patient/Family Teaching
- Take medication as directed, preferably 1 hour before travel or vertigo episodes.
- Caution against driving or operating machinery until response is known.
- Report excessive drowsiness, dry mouth, or allergic reactions.
- Avoid alcohol and other CNS depressants.
Special Considerations
Black Box Warnings: N/A
Genetic Factors: None specified
Lab Test Interference: None noted
Overdose Management
Signs/Symptoms: Extreme drowsiness, hallucinations, seizures, agitation, hallucinations, dry mouth, urinary retention, hallucinations
Treatment: Supportive care, gastric lavage if recent ingestion, activated charcoal, symptomatic treatment for anticholinergic toxicity.
Storage and Handling
Storage: Store at room temperature, away from moisture and light
Stability: Stable under recommended storage conditions