From the Guidelines
Meclizine is generally considered low-risk during pregnancy, but it's best to consult with a healthcare provider before taking it during the first trimester. The FDA classifies it as Category B, meaning animal studies haven't shown risks to the fetus, but there aren't adequate studies in pregnant women 1. For managing dizziness during early pregnancy, several safer alternatives exist. Non-medication approaches include:
- Changing positions slowly
- Staying hydrated
- Eating small frequent meals
- Avoiding triggers like strong odors
- Getting adequate rest Ginger in the form of tea, candies, or capsules has shown effectiveness for pregnancy-related dizziness. Vitamin B6 supplements may also help, particularly when combined with doxylamine for morning sickness. Acupressure wristbands designed for motion sickness can provide relief without medication. According to the study published in the European Respiratory Journal in 2020 1, the use of any drugs during pregnancy and lactation needs to balance the maternal risk of therapy versus no therapy and the fetal risk of uncontrolled maternal disease with the risk of therapy on the newborn. It is crucial to weigh the benefits and risks of meclizine use during pregnancy, considering the limited data available. If dizziness is severe, persistent, or accompanied by other concerning symptoms like fainting or severe headaches, immediate medical attention is necessary to rule out more serious conditions.
From the FDA Drug Label
- 1 Pregnancy Risk Summary: Data from epidemiological studies have not generally indicated a drug-associated risk of major birth defects with meclizine during pregnancy. However, in a published study, an increased incidence of fetal malformations was observed following oral administration of meclizine to pregnant rats during the period of organogenesis, at doses similar to those used clinically.
The use of meclizine during pregnancy is not entirely risk-free. Caution is advised when administering meclizine to pregnant women, especially during the first weeks of pregnancy.
- The FDA drug label does not provide clear guidance on alternative treatments for dizziness in pregnant women.
- However, it is recommended that pregnant women consult their healthcare provider before taking any medication, including meclizine.
- The healthcare provider can help determine the best course of treatment for dizziness and ensure the safety of both the mother and the fetus 2.
From the Research
Safety of Meclizine for Dizziness in Early Pregnancy
- There is no direct evidence in the provided studies regarding the safety of meclizine for dizziness in early pregnancy.
- However, the studies focus on the treatment of nausea and vomiting during pregnancy, which can be related to dizziness.
Alternative Treatments for Dizziness and Nausea
- Vitamin B6 is officially recommended in the USA, Canada, and Australia for the treatment of mild to moderate pregnancy sickness and vomiting 3.
- The harmlessness of oral vitamin B6 during pregnancy has been established for doses up to 40-60mg/day, mainly in combination with doxylamine 3.
- Ginger and vitamin B6 have been shown to reduce the severity of nausea and vomiting during pregnancy, with ginger being more effective for nausea and distress of vomiting 4.
- Pyridoxine (vitamin B6) supplementation has been widely used for the treatment of nausea and vomiting during pregnancy, with beneficial effects on symptoms of nausea and vomiting 5.
Precautions with Vitamin B6
- High doses of vitamin B6 can have implications on neurological function and may result in adverse outcomes such as miscarriage, intrauterine fetal demise, and congenital abnormalities 6.
- Excessive intake of vitamin B6 can cause neurological symptoms such as burning, tingling, paresthesia, ataxia, or perioral numbness 6.