From the Guidelines
Meclizine is not recommended for treating itching, as there is no evidence to support its effectiveness for this purpose. Meclizine is primarily an antihistamine used to treat motion sickness, vertigo, and dizziness, not itching 1. While some antihistamines can help with itching caused by allergic reactions, the British Association of Dermatologists' guidelines suggest that oral antihistamines may be effective in uraemic pruritus, but there are no RCTs to support this, and meclizine is not mentioned as a treatment option 1.
For itching, medications like diphenhydramine (Benadryl), cetirizine (Zyrtec), or loratadine (Claritin) are more commonly recommended, but even these have limited evidence to support their use in certain types of pruritus, such as uraemic pruritus, where cetirizine 10 mg daily did not help in patients on haemodialysis 1.
Some key points to consider when treating itching include:
- Identifying the underlying cause of the itching, as treatment approaches differ depending on whether the itching is due to allergies, dry skin, insect bites, or other conditions
- Using emollients to treat dry skin (xerosis), which is a common cutaneous sign in patients on dialysis, and may have a permissive effect on pruritus 1
- Considering topical treatments like hydrocortisone cream or calamine lotion for severe or persistent itching
- Consulting with a healthcare provider for proper diagnosis and treatment recommendations tailored to the specific situation.
From the Research
Meclizine and Itching
- Meclizine is a piperazine-derivative antihistamine that has been studied for its potential to attenuate allergic reactions 2.
- There is evidence to suggest that meclizine can bind to dimerized translationally controlled tumor protein (dTCTP) and reduce IL-8 release, suppressing the NF-κB pathway 2.
- Meclizine has been shown to attenuate ovalbumin (OVA)-induced airway inflammation in mice, indicating its potential as an anti-allergic drug 2.
- However, the effectiveness of meclizine in relieving itching is not directly addressed in the available studies, except for its potential anti-allergic properties.
- Topical antihistamines, in general, have mixed evidence supporting their use in relieving pruritus, with only topical doxepin demonstrating significant efficacy in large, randomized, double-blind, placebo-controlled clinical trials 3.
- It is essential to note that meclizine is not typically used as a topical antihistamine, and its effectiveness in relieving itching would require further investigation.
- Other antihistamines, such as hydroxyzine and cetirizine, have been reported to cause cutaneous drug eruptions and hypersensitivity reactions in some cases 4, 5.