Meclizine (Bonine) is a first-generation antihistamine that may cause drowsiness. It depresses the vestibular system and may be used to treat patients with motion sickness and vertigo.
Meclizine Uses:
-
Motion sickness:
- Used in motion sickness to avoid nausea vomiting and lightheadedness.
-
Vertigo:
- Used for management of vestibular system associated vertigo.
Meclizine (Bonine) Dose in Adults:
Meclizine (Bonine) Dose in the treatment of Motion sickness:
- Oral: 25 to 50 mg
- use 1 hour prior to travelling.
- Can be used once a day only.
Meclizine (Bonine) Dose in the treatment of Vertigo:
- Oral: 25 to 100 mg daily in divided doses
Meclizine (Bonine) Dose in Childrens:
Meclizine (Bonine) Dose in the treatment of Motion sickness:
-
Children ≥12 years and Adolescents:
- Oral: 25 to 50 mg
- 1 hour prior to travelling.
- Use once a day only.
Meclizine (Bonine) Dose in the treatment of Vertigo:
-
Children ≥12 years and Adolescents:
- Oral: 25 to 100 mg daily in divided doses.
Pregnancy Risk Category: B
- Studies have not shown an increase in risk for the foetus when taken during pregnancy.
Use during breastfeeding:
- There is no data available to determine if the drug is secreted into breast milk.
- The first-generation antihistamine has been reported to make infants irritable and drowsy in lactating mothers.
- Due to the possibility of infants becoming irritable and drowsy, second-generation antihistamine should be preferred by lactating mothers.
Dose in Kidney Disease:
No data are available regarding dose adjustment in renal dysfunction.
Dose in Liver disease:
No data are available regarding dose adjustment in hepatic dysfunction.
Side effects of Meclizine (Bonine):
-
Central nervous system:
- Drowsiness
- Fatigue
- Headache
-
Gastrointestinal:
- Vomiting
- Xerostomia
-
Hypersensitivity:
- Anaphylactoid reaction
-
Ophthalmic:
- Blurred vision
Contraindications to Meclizine (Bonine):
A history of allergy to the drug, or any component of the formulation.
Warnings and precautions
-
CNS depression:
- It can cause drowsiness or CNS depression. If you must perform tasks that require high mental alertness, avoid use.
-
Asthma
- Asthmatic patients should be cautious.
-
Glaucoma:
- Meclizine's anticholinergic effects may worsen symptoms of narrow-angle vision impairment.
-
Hepatic impairment
- There are no data, but it is important to be cautious as it may cause hepatic impairment and increased drug levels.
-
Prostatic hyperplasia/urinary restriction:
- BPH, bladder neck obstruction and urinary strictures may be exacerbated by anticholinergic drugs.
-
Pyloric/duodenal obstruction
- Avoid using the product if there is a duodenal or pyloric obstruction.
-
Renal impairment
- There are no data, but it is possible that renal dysfunction could lead to increased drug levels. Be careful.
Meclizine: Drug Interaction
|
Acetylcholinesterase Inhibitors |
May diminish the therapeutic effect of Anticholinergic Agents. Anticholinergic Agents may diminish the therapeutic effect of Acetylcholinesterase Inhibitors. |
|
Alcohol (Ethyl) |
CNS Depressants may enhance the CNS depressant effect of Alcohol (Ethyl). |
|
Alizapride |
May enhance the CNS depressant effect of CNS Depressants. |
|
Amantadine |
May enhance the anticholinergic effect of Anticholinergic Agents. |
|
Amezinium |
Antihistamines may enhance the stimulatory effect of Amezinium. |
|
Amphetamines |
May diminish the sedative effect of Antihistamines. |
|
Anticholinergic Agents |
May enhance the adverse/toxic effect of other Anticholinergic Agents. |
|
Betahistine |
Antihistamines may diminish the therapeutic effect of Betahistine. |
|
Botulinum Toxin-Containing Products |
May enhance the anticholinergic effect of Anticholinergic Agents. |
|
Brexanolone |
CNS Depressants may enhance the CNS depressant effect of Brexanolone. |
|
Brimonidine (Topical) |
May enhance the CNS depressant effect of CNS Depressants. |
|
Bromopride |
May enhance the CNS depressant effect of CNS Depressants. |
|
Cannabidiol |
May enhance the CNS depressant effect of CNS Depressants. |
|
Cannabis |
May enhance the CNS depressant effect of CNS Depressants. |
|
Chloral Betaine |
May enhance the adverse/toxic effect of Anticholinergic Agents. |
|
Chlorphenesin Carbamate |
May enhance the adverse/toxic effect of CNS Depressants. |
|
CNS Depressants |
May enhance the adverse/toxic effect of other CNS Depressants. |
|
Dimethindene (Topical) |
May enhance the CNS depressant effect of CNS Depressants. |
|
Doxylamine |
May enhance the CNS depressant effect of CNS Depressants. Management: The manufacturer of Diclegis (doxylamine/pyridoxine), intended for use in pregnancy, specifically states that use with other CNS depressants is not recommended. |
|
Dronabinol |
May enhance the CNS depressant effect of CNS Depressants. |
|
Esketamine |
May enhance the CNS depressant effect of CNS Depressants. |
|
Gastrointestinal Agents (Prokinetic) |
Anticholinergic Agents may diminish the therapeutic effect of Gastrointestinal Agents (Prokinetic). |
|
Glucagon |
Anticholinergic Agents may enhance the adverse/toxic effect of Glucagon. Specifically, the risk of gastrointestinal adverse effects may be increased. |
|
HydrOXYzine |
May enhance the CNS depressant effect of CNS Depressants. |
|
Itopride |
Anticholinergic Agents may diminish the therapeutic effect of Itopride. |
|
Kava Kava |
May enhance the adverse/toxic effect of CNS Depressants. |
|
Lofexidine |
May enhance the CNS depressant effect of CNS Depressants. Management: Drugs listed as exceptions to this monograph are discussed in further detail in separate drug interaction monographs. |
|
Magnesium Sulfate |
May enhance the CNS depressant effect of CNS Depressants. |
|
MetyroSINE |
CNS Depressants may enhance the sedative effect of MetyroSINE. |
|
Mianserin |
May enhance the anticholinergic effect of Anticholinergic Agents. |
|
Minocycline (Systemic) |
May enhance the CNS depressant effect of CNS Depressants. |
|
Mirabegron |
Anticholinergic Agents may enhance the adverse/toxic effect of Mirabegron. |
|
Nabilone |
May enhance the CNS depressant effect of CNS Depressants. |
|
Nitroglycerin |
Anticholinergic Agents may decrease the absorption of Nitroglycerin. Specifically, anticholinergic agents may decrease the dissolution of sublingual nitroglycerin tablets, possibly impairing or slowing nitroglycerin absorption. |
|
Piribedil |
CNS Depressants may enhance the CNS depressant effect of Piribedil. |
|
Pramipexole |
CNS Depressants may enhance the sedative effect of Pramipexole. |
|
Ramosetron |
Anticholinergic Agents may enhance the constipating effect of Ramosetron. |
|
ROPINIRole |
CNS Depressants may enhance the sedative effect of ROPINIRole. |
|
Rotigotine |
CNS Depressants may enhance the sedative effect of Rotigotine. |
|
Rufinamide |
May enhance the adverse/toxic effect of CNS Depressants. Specifically, sleepiness and dizziness may be enhanced. |
|
Selective Serotonin Reuptake Inhibitors |
CNS Depressants may enhance the adverse/toxic effect of Selective Serotonin Reuptake Inhibitors. Specifically, the risk of psychomotor impairment may be enhanced. |
|
Tetrahydrocannabinol |
May enhance the CNS depressant effect of CNS Depressants. |
|
Tetrahydrocannabinol and Cannabidiol |
May enhance the CNS depressant effect of CNS Depressants. |
|
Thiazide and Thiazide-Like Diuretics |
Anticholinergic Agents may increase the serum concentration of Thiazide and Thiazide-Like Diuretics. |
|
Topiramate |
Anticholinergic Agents may enhance the adverse/toxic effect of Topiramate. |
|
Trimeprazine |
May enhance the CNS depressant effect of CNS Depressants. |
|
Risk Factor D (Consider therapy modification) |
|
|
Benzylpenicilloyl Polylysine |
Antihistamines may diminish the diagnostic effect of Benzylpenicilloyl Polylysine. Management: Suspend systemic H1 antagonists for benzylpenicilloyl-polylysine skin testing and delay testing until systemic antihistaminic effects have dissipated. A histamine skin test may be used to assess persistent antihistaminic effects. |
|
Blonanserin |
CNS Depressants may enhance the CNS depressant effect of Blonanserin. |
|
Buprenorphine |
CNS Depressants may enhance the CNS depressant effect of Buprenorphine. Management: Consider reduced doses of other CNS depressants, and avoiding such drugs in patients at high risk of buprenorphine overuse/self-injection. Initiate buprenorphine at lower doses in patients already receiving CNS depressants. |
|
Chlormethiazole |
May enhance the CNS depressant effect of CNS Depressants. Management: Monitor closely for evidence of excessive CNS depression. The chlormethiazole labeling states that an appropriately reduced dose should be used if such a combination must be used. |
|
Droperidol |
May enhance the CNS depressant effect of CNS Depressants. Management: Consider dose reductions of droperidol or of other CNS agents (eg, opioids, barbiturates) with concomitant use. Exceptions to this monograph are discussed in further detail in separate drug interaction monographs. |
|
Flunitrazepam |
CNS Depressants may enhance the CNS depressant effect of Flunitrazepam. |
|
Hyaluronidase |
Antihistamines may diminish the therapeutic effect of Hyaluronidase. Management: Patients receiving antihistamines (particularly at larger doses) may not experience the desired clinical response to standard doses of hyaluronidase. Larger doses of hyaluronidase may be required. |
|
HYDROcodone |
CNS Depressants may enhance the CNS depressant effect of HYDROcodone. Management: Avoid concomitant use of hydrocodone and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. |
|
Lemborexant |
May enhance the CNS depressant effect of CNS Depressants. Management: Dosage adjustments of lemborexant and of concomitant CNS depressants may be necessary when administered together because of potentially additive CNS depressant effects. Close monitoring for CNS depressant effects is necessary. |
|
Methotrimeprazine |
CNS Depressants may enhance the CNS depressant effect of Methotrimeprazine. Methotrimeprazine may enhance the CNS depressant effect of CNS Depressants. Management: Reduce adult dose of CNS depressant agents by 50% with initiation of concomitant methotrimeprazine therapy. Further CNS depressant dosage adjustments should be initiated only after clinically effective methotrimeprazine dose is established. |
|
Opioid Agonists |
CNS Depressants may enhance the CNS depressant effect of Opioid Agonists. Management: Avoid concomitant use of opioid agonists and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. |
|
OxyCODONE |
CNS Depressants may enhance the CNS depressant effect of OxyCODONE. Management: Avoid concomitant use of oxycodone and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. |
|
Perampanel |
May enhance the CNS depressant effect of CNS Depressants. Management: Patients taking perampanel with any other drug that has CNS depressant activities should avoid complex and high-risk activities, particularly those such as driving that require alertness and coordination, until they have experience using the combination. |
|
Pramlintide |
May enhance the anticholinergic effect of Anticholinergic Agents. These effects are specific to the GI tract. |
|
Secretin |
Anticholinergic Agents may diminish the therapeutic effect of Secretin. Management: Avoid concomitant use of anticholinergic agents and secretin. Discontinue anticholinergic agents at least 5 half-lives prior to administration of secretin. |
|
Sodium Oxybate |
May enhance the CNS depressant effect of CNS Depressants. Management: Consider alternatives to combined use. When combined use is needed, consider minimizing doses of one or more drugs. Use of sodium oxybate with alcohol or sedative hypnotics is contraindicated. |
|
Suvorexant |
CNS Depressants may enhance the CNS depressant effect of Suvorexant. Management: Dose reduction of suvorexant and/or any other CNS depressant may be necessary. Use of suvorexant with alcohol is not recommended, and the use of suvorexant with any other drug to treat insomnia is not recommended. |
|
Tapentadol |
May enhance the CNS depressant effect of CNS Depressants. Management: Avoid concomitant use of tapentadol and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. |
|
Zolpidem |
CNS Depressants may enhance the CNS depressant effect of Zolpidem. Management: Reduce the Intermezzo brand sublingual zolpidem adult dose to 1.75 mg for men who are also receiving other CNS depressants. No such dose change is recommended for women. Avoid use with other CNS depressants at bedtime; avoid use with alcohol. |
|
Risk Factor X (Avoid combination) |
|
|
Aclidinium |
May enhance the anticholinergic effect of Anticholinergic Agents. |
|
Azelastine (Nasal) |
CNS Depressants may enhance the CNS depressant effect of Azelastine (Nasal). |
|
Bromperidol |
May enhance the CNS depressant effect of CNS Depressants. |
|
Cimetropium |
Anticholinergic Agents may enhance the anticholinergic effect of Cimetropium. |
|
Eluxadoline |
Anticholinergic Agents may enhance the constipating effect of Eluxadoline. |
|
Glycopyrrolate (Oral Inhalation) |
Anticholinergic Agents may enhance the anticholinergic effect of Glycopyrrolate (Oral Inhalation). |
|
Glycopyrronium (Topical) |
May enhance the anticholinergic effect of Anticholinergic Agents. |
|
Ipratropium (Oral Inhalation) |
May enhance the anticholinergic effect of Anticholinergic Agents. |
|
Levosulpiride |
Anticholinergic Agents may diminish the therapeutic effect of Levosulpiride. |
|
Orphenadrine |
CNS Depressants may enhance the CNS depressant effect of Orphenadrine. |
|
Oxatomide |
May enhance the anticholinergic effect of Anticholinergic Agents. |
|
Oxomemazine |
May enhance the CNS depressant effect of CNS Depressants. |
|
Paraldehyde |
CNS Depressants may enhance the CNS depressant effect of Paraldehyde. |
|
Pitolisant |
Antihistamines may diminish the therapeutic effect of Pitolisant. |
|
Potassium Chloride |
Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Chloride. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium chloride. |
|
Potassium Citrate |
Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Citrate. |
|
Revefenacin |
Anticholinergic Agents may enhance the anticholinergic effect of Revefenacin. |
|
Thalidomide |
CNS Depressants may enhance the CNS depressant effect of Thalidomide. |
|
Tiotropium |
Anticholinergic Agents may enhance the anticholinergic effect of Tiotropium. |
|
Umeclidinium |
May enhance the anticholinergic effect of Anticholinergic Agents. |
Monitoring Parameters:
None mentioned.
How to administer Meclizine (Bonine)?
Chewable tablets:
- Chew or crush completely before swallowing.
Tablets:
- Swallow whole.
Mechanism of action of Meclizine (Bonine):
- It is an antihistamine of the first generation that also has anticholinergic and central nervous system depressant properties.
- It is also used to treat vertigo, motion sickness, and vestibular end-organs.
The beginning of action:
- It takes approximately 1 hour.
Time:
- Within 24 hours.
Metabolism:
- Hepatic to norchlorcyclizine.
Half-life elimination:
- 5.2 ± 0.8 hours.
Time to peak, plasma:
- 3.1 ± 1.4 hours.
Excretion:
- Urine and feces as unchanged drug and metabolites.
International Brand Names of Meclizine:
- Bonine
- Dramamine Less Drowsy
- Medi-Meclizine
- Motion-Time
- Travel Sickness
- Travel-Ease
- Agyrax
- Bonadoxina
- Bonamina
- Bonamine
- Chiclida
- Clizine
- Emestop
- Emetostop
- Meclin
- Meclitab
- Navicalm
- Navidoxine
- Navoproxin
- Postafen
- Postafene
- SeaLegs
- Suprimal
- Vertigol
- Vomidoxine
- Vomiseda
Meclizine Brand Names in Pakistan:
Dry Susp 80 mg/0.8ml in Pakistan |
|
| Qwer | 21st Century Pharmaceuticals Co. |
Meclizine Tablets (plus VIta 6) in Pakistan |
|
| Navidoxine | AGP Private Limited |
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