Meclizine is Not a Scheduled Medication
Meclizine is not a scheduled medication under the Controlled Substances Act. It is an over-the-counter antihistamine commonly used for motion sickness and vertigo without controlled substance restrictions 1.
Classification and Availability
- Meclizine is an H1 antihistamine used primarily for treating vertigo, dizziness, and motion sickness 1
- It is available over-the-counter without prescription requirements, indicating its non-scheduled status 2
- Meclizine belongs to the antivertigo class of medications and is not subject to the special prescribing, dispensing, or record-keeping requirements that apply to controlled substances 1
Clinical Uses
- Primarily used for management of motion sickness and vertigo symptoms 1
- Can be used in the treatment of nausea and vomiting in palliative care settings 1
- Sometimes used to manage withdrawal symptoms from other medications, such as scopolamine 3
Pharmacology and Administration
- Meclizine is metabolized primarily through the CYP2D6 enzyme pathway 2
- Available in both tablet and suspension formulations, with the suspension form showing more rapid absorption 2
- Typical dosing is 25 mg every 12-24 hours for motion sickness and vertigo 3
Side Effects and Precautions
- Common side effects include sedation, drowsiness, and anticholinergic effects 4
- May cause cognitive impairment, particularly concerning in elderly patients 1
- Can impair performance on psychometric tests and cause subjective sleepiness 4
- Evidence suggests possible development of acute tolerance to CNS effects with repeated dosing 4
Special Populations Considerations
- Should be used with caution in patients with renal or hepatic impairment 1
- Not recommended for routine treatment of benign paroxysmal positional vertigo (BPPV), as repositioning maneuvers are more effective 1
- Should be avoided during pregnancy, especially in the first trimester, unless benefits clearly outweigh risks 1
Clinical Pearls
- When used for motion sickness, meclizine should be taken approximately 1 hour before travel for optimal effect 2
- May be more effective for low-acceleration motion environments than high-acceleration settings 5
- Antihistamines like meclizine are not recommended as first-line treatments for BPPV but may help manage associated vegetative symptoms like nausea 1
While meclizine has sedative properties and can cause drowsiness, it does not have abuse potential and is not classified as a controlled substance under any schedule of the Controlled Substances Act 1, 2.