MeclizineMeclizine Hydrochloride

About Meclizine

Meclizine is thought to work by blocking histamine H1 receptors, though its exact mechanism is unknown. The prescription label covers vertigo associated with diseases affecting the vestibular system, the balance organs of the inner ear, in adults: 25 to 100 mg a day by mouth in divided doses, depending on the response. Safety and effectiveness in children are not established. Over-the-counter meclizine is sold under the federal monograph for antiemetics, to prevent and treat the nausea, vomiting or dizziness of motion sickness in adults and children 12 and older, at 25 to 50 mg once a day; MedlinePlus says to take it an hour before travel. Regular tablets are swallowed whole, and the Antivert chewable tablet is chewed or crushed completely, never swallowed whole.

There is no boxed warning. Meclizine can cause drowsiness, so the label warns against driving a car or operating dangerous machinery and advises avoiding alcohol. Because of its anticholinergic action it is used with caution in asthma, glaucoma and an enlarged prostate, and the over-the-counter label says not to take it, unless a doctor directs, with a breathing problem such as emphysema or chronic bronchitis, glaucoma, or trouble urinating from an enlarged prostate, nor to give it to children under 12 without a doctor’s direction. Anaphylaxis, drowsiness, dry mouth, headache, tiredness and vomiting have been reported, and blurred vision rarely. The only contraindication is allergy to meclizine or an inactive ingredient.

MedlinePlus says older adults should not usually take meclizine, because other medicines for the same condition are considered safer and more effective, and the label says older patients start at the low end of the dose range. The liver enzyme CYP2D6 clears it, genetic differences in that enzyme make exposure vary widely, and medicines that block CYP2D6 may interact with it; liver or kidney impairment calls for caution. Epidemiological studies in pregnancy have not shown a link with major birth defects, and there are no data on breastfeeding. The FDA still lists the Antivert brand in 12.5, 25 and 50 mg tablets and a 25 mg chewable tablet.

Taking Meclizine

How to take it

For vertigo, take it as the prescriber directs, usually in divided doses; swallow regular tablets whole, and chew or crush chewable tablets completely before swallowing. For motion sickness, take it about an hour before travel; a dose can be repeated every 24 hours if needed.

If you miss a dose

It is often taken only as needed. On a schedule, take a missed dose as soon as you remember unless the next one is nearly due; then skip it. Do not take a double dose.

Storage

At room temperature in a tightly closed, light-resistant container, away from heat and moisture and out of reach of children.

Interactions to know about

Alcohol, sleep medicines, sedatives, opioid pain medicines, muscle relaxers, and medicines for anxiety, depression or seizures add to its drowsiness. Medicines that block the liver enzyme CYP2D6 may interact with it, so watch for more side effects.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Meclizine differs from pharmacy to pharmacy

Generic meclizine tablets are old generics from many makers that cost pharmacies little, so a quote is mostly the dispensing fee and markup, and whether meclizine is on a pharmacy’s flat-price generic list varies. The 50 mg tablet has fewer makers, and the chewable tablet has no separately approved generic, so prescriptions for either may be quoted higher.

Over-the-counter meclizine for motion sickness is a shelf item rather than a prescription fill, but its labeled use and directions differ from a prescription for vertigo, so ask before using one in place of the other.

Ways to pay less for Meclizine without insurance

• Ask for generic meclizine tablets, and make sure the prescription does not require the Antivert brand.
• Ask whether meclizine is on the pharmacy’s flat-price generic list, and compare more than one pharmacy.
• If a chewable tablet is prescribed and you can swallow tablets, ask the prescriber whether regular generic tablets would suit you.
• For motion sickness, ask the pharmacist whether an over-the-counter meclizine product would suit you instead of a prescription.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Meclizine

1. 1.Is it safe for me to drive after taking it?
2. 2.Is it safe with my glaucoma, asthma or prostate problems?
3. 3.Do any of my medicines add to the drowsiness or raise meclizine levels?
4. 4.Is the over-the-counter product the same as my prescription?

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