meclizine hydrochloride

(mek' li zeen)
Bonamine (CAN), Bonine
Oral prescription tablets:
Antivert, Antrizine, Dramamine Less Drowsy Formula, Meni-D

Pregnancy Category B

Drug classes
Antiemetic
Anti-motion sickness drug
Antihistamine
Anticholinergic

Therapeutic actions
Reduces sensitivity of the labyrinthine apparatus; probably acts at least partly by blocking
cholinergic synapses in the vomiting center, which receives input from the chemoreceptor
trigger zone and from peripheral nerve pathways; peripheral anticholinergic effects may
contribute to efficacy.

Indications
• Prevention and treatment of nausea, vomiting, motion sickness
• Possibly effective for the management of vertigo associated with diseases
affecting the vestibular system

Contraindications and cautions

• Contraindicated with allergy to meclizine or cyclizine, pregnancy.
• Use cautiously with lactation, narrow-angle glaucoma, stenosing peptic ulcer,
symptomatic prostatic hypertrophy, bronchial asthma, bladder neck obstruction,
pyloroduodenal obstruction, cardiac arrhythmias, postoperative state (hypotensive
effects may be confusing and dangerous).

Available forms
Tablets—12.5, 25, 50 mg; chewable tablets—25 mg; capsules—25, 30 mg

Dosages
ADULTS
• Motion sickness: 25–50 mg PO 1 hr prior to travel. May repeat dose every 24 hr
for the duration of the journey.
• Vertigo: 25–100 mg PO daily in divided doses.
PEDIATRIC PATIENTS
Not recommended for use in children < 12 yr.
GERIATRIC PATIENTS
More likely to cause dizziness, sedation, syncope, toxic confusional states, and
hypotension in elderly patients; use with caution.

Pharmacokinetics
Route Onset Peak Duration
Oral 1 hr 1–2 hr 12–24 hr

Metabolism: T1/2: 6 hr
Distribution: Crosses placenta; may enter breast milk
Excretion: Feces

Adverse effects
• CNS: Drowsiness, confusion, euphoria, nervousness, restlessness, insomnia and
excitement, seizures, vertigo, tinnitus, blurred vision, diplopia, auditory and visual
hallucinations
• CV: Hypotension, palpitations, tachycardia
• Dermatologic: Urticaria, rash
• GI: Dry mouth, anorexia, nausea, vomiting, diarrhea or constipation
• GU: Urinary frequency, difficult urination, urinary retention
• Respiratory: Respiratory depression, death (due to overdose, especially in
young children), dry nose and throat

Interactions
Drug-drug
• Increased sedation with alcohol or other CNS depressants

Nursing considerations
Assessment
• History: Allergy to meclizine or cyclizine, pregnancy, narrow-angle glaucoma,
stenosing peptic ulcer, symptomatic prostatic hypertrophy, bronchial asthma,
bladder neck obstruction, pyloroduodenal obstruction, cardiac arrhythmias,
postoperative patients, lactation, pregnancy
• Physical: Skin color, lesions, texture; orientation, reflexes, affect; ophthalmic
exam; P, BP; R, adventitious sounds; bowel sounds, normal output, status of
mucous membranes; prostate palpation, urinary output

Interventions
• Monitor I & O, and take appropriate measures with urinary retention.

Teaching points
• Take as prescribed. Avoid excessive dosage. Chew the chewable tablets carefully
before swallowing.
• Anti-motion sickness drugs work best if used ahead of time for prevention.
• Avoid alcohol; serious sedation could occur.
• These side effects may occur: Dizziness, sedation, drowsiness (use caution
driving or performing tasks that require alertness); epigastric distress, diarrhea, or
constipation (take with food); dry mouth (practice frequent mouth care, suck
sugarless lozenges); dryness of nasal mucosa (try another motion sickness,
antivertigo remedy).
 • Report difficulty breathing, hallucinations, tremors, loss of coordination, visual
disturbances, irregular heartbeat.

Adverse effects in Italic are most common; those in Bold are life-threatening.