Are hydroxyzine and meclizine the same?

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From the Guidelines

No, hydroxyzine and meclizine are not the same medication, as they have different therapeutic applications and properties, despite both being antihistamines. Hydroxyzine is primarily used to treat anxiety, tension, and allergic reactions, working as both a sedating antihistamine and anxiolytic, whereas meclizine is specifically used to treat motion sickness, vertigo, and dizziness associated with inner ear problems 1. While both medications block histamine H1 receptors and can cause drowsiness, they have different chemical structures and uses. Hydroxyzine tends to be more sedating than meclizine and has more pronounced anti-anxiety effects.

Some key differences between the two medications include their sedative effects, with hydroxyzine being more sedating, and their anti-anxiety properties, which are more pronounced in hydroxyzine 1. Meclizine, on the other hand, is often used to treat vertigo and motion sickness, and is commonly prescribed for patients with inner ear problems.

It's also worth noting that both medications can have significant side effects, including sedation, performance impairment, and anticholinergic effects, particularly in older adults or those with certain comorbid conditions 1. Therefore, patients should never substitute one medication for the other without medical guidance, as their dosing regimens and side effect profiles differ significantly.

In terms of their use in clinical practice, hydroxyzine and meclizine should be prescribed based on their specific indications and the patient's individual needs, taking into account their potential side effects and interactions with other medications. As with any medication, it's essential to carefully evaluate the benefits and risks of each medication and to monitor patients closely for any adverse effects.

Overall, while hydroxyzine and meclizine share some similarities as antihistamines, they have distinct differences in their therapeutic applications, properties, and side effect profiles, and should be used accordingly.

From the Research

Comparison of Hydroxyzine and Meclizine

  • Hydroxyzine and meclizine are two different medications with distinct uses and mechanisms of action 2, 3.
  • Hydroxyzine is an antihistamine used to treat anxiety, while meclizine is an antihistamine used to treat vertigo and motion sickness 2, 3.
  • There is no evidence to suggest that hydroxyzine and meclizine are the same medication or have the same effects on the body 2, 3, 4, 5, 6.

Mechanism of Action

  • Hydroxyzine works by blocking histamine receptors in the brain, which helps to reduce anxiety and promote relaxation 2.
  • Meclizine works by blocking histamine receptors in the inner ear, which helps to reduce the symptoms of vertigo and motion sickness 3, 5.

Uses and Indications

  • Hydroxyzine is used to treat generalized anxiety disorder, while meclizine is used to treat vertigo and motion sickness 2, 3, 5.
  • Hydroxyzine may also be used to treat itching and hives, while meclizine may also be used to treat nausea and vomiting 2, 3, 5.

Safety and Efficacy

  • Both hydroxyzine and meclizine have been shown to be effective in treating their respective conditions, but they may have different side effect profiles 2, 3, 5, 6.
  • Hydroxyzine may cause drowsiness and dry mouth, while meclizine may cause dizziness and headache 2, 3, 5, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Hydroxyzine for generalised anxiety disorder.

The Cochrane database of systematic reviews, 2010

Research

The effects of meclizine on motion sickness revisited.

British journal of clinical pharmacology, 2020

Research

Prospective controlled study of hydroxyzine and cetirizine in pregnancy.

Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 1997

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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