From the Research
Meclizine is recommended for children with a dose of 12.5 mg/day for patients < 20 kg and 25 mg/day for patients ≥ 20 kg, as this dosing regimen has been shown to be safe and effective in promoting bone growth in children with achondroplasia 1. The study published in 2023 in PloS one, which is the most recent and highest quality study, provides evidence for the safety and pharmacokinetics of meclizine in children with achondroplasia after a 14-day-repeated dose of meclizine 1. Some key points to consider when administering meclizine to children include:
- Meclizine should be administered after meals to minimize gastrointestinal side effects
- The average maximum drug concentration (Cmax), peak drug concentration (Tmax), area under the curve (AUC) from 0 to 24 h, and terminal elimination half-life (t1/2) after a 14-day-repeated administration of meclizine (12.5 mg) were 167 (83-250) ng/mL, 3.7 (3.1-4.2) h, 1170 (765-1570) ng·h/mL, and 7.4 (6.7-8.0) h, respectively 1
- Cmax and AUC were higher in cohort 2 than in cohort 1 in a dose-dependent manner, indicating that the 25 mg dose may be more effective for larger children 1
- The AUC0-24h after the final administration was 1.5 times that after the initial dose, suggesting that meclizine accumulates in the body over time 1
- Compartment models demonstrated that the plasma concentration of meclizine achieved at a steady state after the 14th administration, indicating that the drug reaches a stable level in the body after repeated dosing 1
- Long-term administration of meclizine 12.5 or 25 mg/day is recommended for phase 2 clinical trials in children with achondroplasia, based on the safety and efficacy data from this study 1. It is essential to consult a healthcare provider before giving meclizine to children, as individual dosing may vary based on the child's specific condition, weight, and medical history. Alternative motion sickness remedies might be more appropriate for younger children, such as positioning, fresh air, or focusing on the horizon during travel.