Is meclizine (Antivert) indicated for Meniere's disease?

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From the Guidelines

Meclizine is indicated for Ménière's disease to manage vertigo symptoms, as stated in the clinical practice guideline: Ménière's disease 1. Meclizine is an antihistamine that helps reduce symptoms of vertigo, dizziness, and nausea associated with this inner ear disorder. The typical dosage is 25-50 mg taken orally 1-3 times daily as needed for symptoms. For acute attacks, patients can take 25-50 mg at the onset of symptoms and repeat every 4-6 hours if needed, not exceeding 150 mg per day. Meclizine works by suppressing vestibular input to the brain and reducing the sensitivity of the nerve endings in the inner ear. This helps decrease the sensation of motion and the associated nausea. Some key points to consider when using meclizine for Ménière's disease include:

  • The goals of treatment are to prevent or reduce the severity and frequency of vertigo attacks, relieve or prevent hearing loss, tinnitus, and aural fullness, and improve overall quality of life (QOL) 1.
  • Treatment approaches may include modifications of lifestyle factors, mental health treatment, or medical and/or surgical treatment 1.
  • Clinicians should educate patients with Ménière’s disease about the natural history, measures for symptom control, treatment options, and outcomes 1. Patients should be aware that meclizine may cause drowsiness, dry mouth, and blurred vision, so they should avoid driving or operating machinery until they know how the medication affects them. While meclizine helps manage symptoms, it does not treat the underlying cause of Ménière's disease, so it's typically used as part of a comprehensive treatment plan that may include dietary changes (reducing salt intake), avoiding caffeine and alcohol, and other medications. The use of meclizine for Ménière's disease is supported by the clinical practice guideline, which recommends offering a limited course of vestibular suppressants to patients with Ménière’s disease for management of vertigo only during Ménière’s disease attacks 1.

From the FDA Drug Label

Meclizine hydrochloride tablets are indicated for the treatment of vertigo associated with diseases affecting the vestibular system in adults.

The answer to whether meclizine is indicated for Mènieres disease is: yes, as Mènieres disease is a condition that affects the vestibular system and can cause vertigo. [@\1@]

From the Research

Meclizine and Meniere's Disease

  • Meclizine is used to treat vertigo, which is a symptom of Meniere's disease 2
  • A study found that meclizine and diazepam are equally effective in treating vertigo in patients with peripheral vertigo, which may be relevant to Meniere's disease 2
  • However, there is limited evidence to support the use of meclizine specifically for Meniere's disease, and more research is needed to determine its effectiveness 3, 4, 5

Treatment of Meniere's Disease

  • Meniere's disease is typically treated with a combination of medications, lifestyle changes, and other interventions 4, 5
  • Betahistine is often used to treat Meniere's disease, but its effectiveness is not well established 3, 4
  • Other treatments for Meniere's disease may include diuretics, intratympanic administration of corticosteroids or gentamicin, and vestibular rehabilitation 4, 5

Vertigo and Meniere's Disease

  • Vertigo is a common symptom of Meniere's disease, and can be debilitating for patients 3, 4, 2
  • Meclizine and other medications may be used to treat vertigo in patients with Meniere's disease, but more research is needed to determine the most effective treatments 2
  • Meniere's disease can also cause other symptoms, including hearing loss, tinnitus, and aural fullness, which can impact patients' quality of life 3, 4, 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

The pharmacological management of vertigo in Meniere disease.

Expert opinion on pharmacotherapy, 2020

Research

Menière's disease.

BMJ clinical evidence, 2007

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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