Meclizine (Bonine) - Uses, Dose, MOA, Brands, Side effects

Meclizine is an antihistamine that is commonly used to prevent and treat nausea, vomiting, and dizziness caused by motion sickness. It can also be used to treat symptoms of vertigo (dizziness or spinning sensation) caused by disease that affects your inner ear.

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:

  • Take 25 to 50 mg by mouth.
  • Do this 1 hour before you travel.
  • If you still feel sick the next day, you can take another dose after 24 hours.

Meclizine (Bonine) Dose in the treatment of Vertigo:

  • Take between 25 to 100 mg in total each day.
  • Split this amount into smaller doses throughout the day.

Meclizine (Bonine) Dose in Childrens:

Meclizine (Bonine) Dose in the treatment of Motion sickness:

For motion sickness in kids 12 years and older:

  • Give them 25 to 50 mg by mouth.
  • Do this 1 hour before traveling.
  • If they still feel sick the next day, you can give another dose after 24 hours.

Meclizine (Bonine) Dose in the treatment of Vertigo:

For vertigo in kids 12 years and up:

  • Give them between 25 to 100 mg each day.
  • Spread this amount into 3 or 4 smaller doses during the day.

Pregnancy Risk Category: B

  • Most studies show that when mothers take meclizine, it doesn't usually increase the chances of their baby having birth defects.

Use during breastfeeding:

  • We don't know for sure if meclizine can get into breast milk.
  • Other antihistamines have made breastfed babies feel drowsy or irritable.
  • If a nursing mother needs meclizine, she should think about the risk to her baby, the benefits of breastfeeding, and her own treatment.
  • If a baby does get a first-generation antihistamine through breast milk, watch for any fussiness or drowsiness.
  • If possible, it's better for breastfeeding moms to use second-generation antihistamines.
  • Antihistamines might reduce a mother's prolactin levels, which can affect milk production if given before breastfeeding is well established.

Meclizine Dose in Kidney Disease:

  • The maker of the medicine hasn't given special dosing instructions for people with kidney problems (because they haven't studied it in that group).
  • So, be careful when using it if you have kidney issues.

Meclizine Dose in Liver disease:

  • The company that makes the medicine hasn't given special instructions for people with liver problems (because they haven't tested it on them).
  • So, if you have liver issues, use the medicine carefully.

Side effects of Meclizine (Bonine):

  • Central nervous system:
    • Drowsiness
    • Fatigue
    • Headache
  • Gastrointestinal:
    • Vomiting
    • Xerostomia
  • Hypersensitivity:
    • Anaphylactoid reaction
  • Ophthalmic:
    • Blurred vision

Contraindications to Meclizine (Bonine):

If you're allergic to meclizine or any part of the medicine, you shouldn't take it.

Warnings and precautions

CNS depression:

  • Meclizine can make you feel drowsy or less alert.
  • So, be careful doing things where you need to be alert, like driving or using machines.

Asthma

  • If you have asthma, be extra careful when using this medicine.

Glaucoma:

  • If you have a specific type of eye problem called narrow-angle glaucoma, be careful when using this medicine.
  • It might make the condition worse.

Hepatic impairment

  • If you have liver problems, this medicine might build up in your body because your liver isn't working at its best (this hasn't been fully studied).
  • Be careful when using it.

Prostatic hyperplasia/urinary restriction:

  • If you have an enlarged prostate or problems with urine flow, be careful when using this medicine.

Pyloric/duodenal obstruction

  • If you have a blockage in your stomach or the beginning of your small intestine, be careful when using this medicine.

Renal impairment

  • If you have kidney problems, the medicine might build up in your body because your kidneys aren't working their best (this hasn't been fully studied).
  • Be careful when using it.

Meclizine: Drug Interaction

Risk Factor C (Monitor therapy)

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)?

For the chewable version:

  • Chew them well or crush them before you swallow.

For the regular tablets:

  • Swallow them as they are, without breaking or chewing.

Mechanism of action of Meclizine (Bonine):

  • This medicine works by calming down the inner ear and blocking certain pathways in the brain, helping reduce dizziness and other symptoms.

Starts working:

  • About 1 hour after taking it.

Lasts:

  • Roughly 24 hours.

Spread in the body:

  • For every kilogram of body weight, 7 liters of the drug spreads around.

How it's broken down:

  • In the liver, turning into a substance called norchlorcyclizine.

How long it stays in the body:

  • About 5.2 hours (plus or minus 0.8 hours) for half of it to be gone.

Time to maximum effect:

  • About 3.1 hours (give or take 1.4 hours) after taking, it reaches its highest level in the blood.

How it leaves the body:

  • Goes out in urine and poop, both as the original drug and its breakdown products.

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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