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Pronunciation |
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(MEK
li
zeen) |
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U.S. Brand
Names |
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Antivert®; Antrizine®;
Bonine®[OTC]; Dizmiss®[OTC]; Dramamine® II [OTC];
Meni-D®; Ru-Vert-M®; Vergon®[OTC] |
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Generic
Available |
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Yes |
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Synonyms |
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Meclizine Hydrochloride; Meclozine Hydrochloride |
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Pharmacological Index |
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Antihistamine |
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Use |
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Prevention and treatment of symptoms of motion sickness; management of
vertigo with diseases affecting the vestibular system |
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Pregnancy Risk
Factor |
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B |
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Pregnancy/Breast-Feeding
Implications |
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Clinical effects on the fetus: No data available on crossing the placenta.
Probably no effect on the fetus (insufficient data). Available evidence suggests
safe use during pregnancy.
Breast-feeding/lactation: No data available |
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Contraindications |
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Hypersensitivity to meclizine or any component;
pregnancy |
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Warnings/Precautions |
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Use with caution in patients with angle-closure glaucoma, prostatic
hypertrophy, pyloric or duodenal obstruction, or bladder neck obstruction; use
with caution in hot weather, and during exercise; elderly may be at risk for
anticholinergic side effects such as glaucoma, prostatic hypertrophy,
constipation, gastrointestinal obstructive disease; if vertigo does not respond
in 1-2 weeks, it is advised to discontinue use |
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Adverse
Reactions |
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>10%:
Central nervous system: Slight to moderate drowsiness
Respiratory: Thickening of bronchial secretions
1% to 10%:
Central nervous system: Headache, fatigue, nervousness, dizziness
Gastrointestinal: Appetite increase, weight gain, nausea, diarrhea, abdominal
pain, xerostomia
Neuromuscular & skeletal: Arthralgia
Respiratory: Pharyngitis
<1%: Palpitations, hypotension, depression, sedation, photosensitivity,
rash, angioedema, urinary retention, hepatitis, myalgia, tremor, paresthesia,
blurred vision, bronchospasm, epistaxis |
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Overdosage/Toxicology |
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Symptoms of overdose include CNS depression, confusion, nervousness,
hallucinations, dizziness, blurred vision, nausea, vomiting, hyperthermia
There is no specific treatment for an antihistamine overdose, however, most
of its clinical toxicity is due to anticholinergic effects. For anticholinergic
overdose with severe life-threatening symptoms, physostigmine 1-2 mg (0.5 mg or
0.02 mg/kg for children) I.V., slowly may be given to reverse these effects.
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Drug
Interactions |
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Increased toxicity: CNS depressants, neuroleptics,
anticholinergics |
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Mechanism of
Action |
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Has central anticholinergic action by blocking chemoreceptor trigger zone;
decreases excitability of the middle ear labyrinth and blocks conduction in the
middle ear vestibular-cerebellar pathways |
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Pharmacodynamics/Kinetics |
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Onset of action: Oral: Within 1 hour
Duration: 8-24 hours
Metabolism: Reportedly in the liver
Half-life: 6 hours
Elimination: As metabolites in urine and as unchanged drug in feces
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Usual Dosage |
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Children >12 years and Adults: Oral:
Vertigo: 25-100 mg/day in divided doses |
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Dietary
Considerations |
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Alcohol: Additive CNS effect, avoid use |
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Mental Health: Effects
on Mental Status |
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Drowsiness is common; may cause dizziness or nervousness; may rarely cause
sedation or depression |
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Mental Health:
Effects on Psychiatric
Treatment |
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Concurrent use with psychotropic may produce additive sedation and dry
mouth |
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Dental Health: Local
Anesthetic/Vasoconstrictor
Precautions |
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No information available to require special precautions |
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Dental Health:
Effects on Dental Treatment |
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Up to 10% of patients will have significant dry mouth which will disappear
with cessation of drug therapy |
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Patient
Information |
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Take exactly as prescribed; do not increase dose. Avoid alcohol, other CNS
depressants, sleeping aids without consulting prescriber. You may experience
dizziness, drowsiness, or blurred vision (use caution when driving or engaging
in tasks that require alertness until response to drug is known); dry mouth
(frequent mouth care, sucking lozenges, or chewing gum may help); constipation
(increased dietary fluid, fiber, and fruit and exercise may help); heat
intolerance (avoid excessive exercise, hot environments, maintain adequate fluid
intake). Report CNS change (hallucination, confusion, nervousness); sudden or
unusual weight gain; unresolved nausea or diarrhea; chest pain or palpitations;
muscle pain; or changes in urinary pattern. Breast-feeding precautions:
Breast-feeding is not recommended. |
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Nursing
Implications |
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May impair ability to perform hazardous tasks |
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Dosage Forms |
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Capsule, as hydrochloride: 15 mg, 25 mg, 30 mg
Tablet, as hydrochloride: 12.5 mg, 25 mg, 50 mg
Tablet, as hydrochloride:
Chewable: 25 mg
Film coated: 25 mg |
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References |
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Oosterveld WJ, "Vertigo: Current Concepts in Management," Drugs, 1985,
30(3):275-83.
Park J, Logan R, and Pottage A,
"Drug-Induced Extrapyramidal Signs in Chronic Liver Disease - A Case Report,"
Clin Toxicol, 1977, 11(1):117-20.
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