From the FDA Drug Label
2.1 Recommended Dosage The recommended dosage is 25 mg to 100 mg daily administered orally, in divided doses, depending upon clinical response. The recommended dose of meclizine for treating dizziness is 25 mg to 100 mg daily, administered orally in divided doses, depending on the clinical response 1.
- The dose may be adjusted based on the patient's response to the medication.
- It is essential to follow the prescribed dosage and administration instructions to ensure safe and effective treatment.
From the Research
The recommended dose of meclizine for treating dizziness is typically 25 to 50 mg taken by mouth up to three times daily as needed. This dosage is based on the most recent and highest quality study available, which suggests that single-dose antihistamines, such as meclizine, provide greater vertigo relief at 2 hours than single-dose benzodiazepines 2.
Key Points to Consider
- Meclizine works by blocking histamine H1 receptors in the brain, which helps reduce the sensitivity of the inner ear's balance system and decreases stimulation of the brain's vomiting center.
- The medication typically starts working within an hour and its effects can last for 8-24 hours depending on the dose.
- Common side effects include drowsiness, dry mouth, and blurred vision, so patients should avoid driving or operating machinery until they know how the medication affects them.
- Elderly patients may need lower doses due to increased sensitivity to side effects.
- Meclizine should not be taken with alcohol or other central nervous system depressants as this can increase drowsiness and impairment.
Evidence-Based Recommendation
The study published in JAMA Neurology in 2022 2 provides the most recent and highest quality evidence for the use of meclizine in treating dizziness. This systematic review and meta-analysis found that single-dose antihistamines resulted in significantly more improvement on 100-point VAS scores compared with benzodiazepines. However, it's essential to note that the evidence for long-term use of meclizine is limited, and patients should be monitored for potential side effects and interactions with other medications.
Patient-Specific Considerations
- Patients with a history of vertigo or motion sickness may benefit from taking meclizine 1 hour before travel and then repeating every 24 hours for the duration of the journey.
- Patients who experience severe nausea or vomiting may require alternative treatments or adjustments to their meclizine dosage.
- Patients taking other medications, such as sedatives or antidepressants, should be cautious when taking meclizine due to potential interactions and increased risk of side effects.