Meclizine – StatPearls – NCBI Bookshelf

Continuing Education Activity

Meclizine is a medication used to manage and treat nausea, vomiting, and dizziness caused by motion sickness and vertigo. Meclizine belongs to a drug class called antihistamines, which are often used to treat allergies. This activity will review the indications, method of action, contraindications, and other key features for meclizine, as a valuable agent in the therapy for motion sickness and vertigo. This review also highlights pertinent information needed for members of the healthcare team in managing the care of patients with motion sickness and disorders that cause vertigo.

Objectives:

• Describe the FDA and non-FDA indications of meclizine

• Review the adverse effects of meclizine, citing the patient population that is most vulnerable to them.

• Outline the typical presentation of a patient with meclizine toxicity.

• Explain the importance of proper collaboration and coordination among the interprofessional team can enhance patient care when dosing and monitoring meclizine in elderly patients or those with comorbidities can improve patient outcomes for patients receiving the drug.

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Indications

Meclizine, an FDA- approved drug, is a first-generation antihistamine used for the symptomatic management of motion sickness. These symptoms include dizziness, nausea, and vomiting. It also treats vertigo symptoms caused by vestibular diseases that commonly affect the inner ear, such as Meniere’s disease.[1][2] Meclizine off-label can also be an option to treat the same symptoms caused by viral illnesses, gastrointestinal infections, pregnancy, or radiation therapy.[3]

The drug can be taken orally with or without food by tablet. Recommended dosages to control motion sickness are between 25 to 50 mg one hour before embarkation for protection against motion sickness—additional dosages are repeatable once every 24 hours. The recommended dosages for control of vertigo against vestibular diseases are between 25 to 100 mg daily, and subsequent dosages depend upon clinical response.[1]

The drug has not received approval for children under 12 years of age because safety and efficacy have not been established. The drug is in FDA pregnancy category B. It is safe to use to treat nausea and vomiting during pregnancy. It is not thought to harm an unborn baby. It is not known whether meclizine is excreted into breast milk. Extended use and hefty doses of meclizine may cause effects in breastfeeding or decrease the milk supply, especially in combination with sympathomimetic drugs such as pseudoephedrine.[4] The elderly should proceed with caution due to some of the anticholinergic properties of meclizine, which may cause confusion, urinary retention, amnesia, etc.

Mechanism of Action

Meclizine is a first-generation antihistamine (non-selective h2 antagonist). It also has central anticholinergic actions.[5] The blocking actions on these receptors give meclizine its antiemetic and antivertigo properties. This blocking effect occurs in the vomiting center and chemoreceptor trigger zone (CTZ) located in the medulla.[6] These effects result in the inhibition of signals through histamine neurotransmission from the nucleus of the solitary tract and the vestibular nuclei to the chemoreceptor trigger zone and vomiting center located in the medulla. This effect also reduces vestibular incitation and labyrinth excitability. 

Absorption: Meclizine is absorbed post-oral administration. The drug reaches peak plasma levels roughly 3 hours after administration. 

Distribution: Meclizine’s volume of distribution is unknown in humans because it has not had sufficient study.

Metabolism: The data on meclizine metabolism is limited, but according to in vitro metabolic studies, the dominant hepatic enzyme to metabolize meclizine was found to be CYP2D6.[7]

Excretion: The drug is excreted as a metabolite in the urine and is excreted unchanged in the feces.

Administration

Meclizine administration is chewable or non-chewable by oral tablets. Chewable tablets must be crushed or completely chewed before swallowing. The drug can be taken without regard to food.

Meclizine’s half-life is about 6 hours, the onset of action is about 1 hour, and the duration of action is approximately 8 to 24 hours.[7][8]

Adult and Adolescent Dosing

Motion sickness – Orally, 25 to 50 mg one hour before embarkation for protection against motion sickness. Patients can take subsequent dosages once every 24 hours.

Vertigo – Orally, 25 to 100 mg daily, and subsequent dosages depend upon clinical response.

Radiation-induced nausea and vomiting – Orally, 50 mg two to twelve hours before radiotherapy treatment

Pediatric Dosing

The drug is not approved for children less than 12 because safety and efficacy have not been established. For children 12 and older, dosing is similar to that of adults and adolescents.

Geriatric Dosing

Patients 65 years or older may be more sensitive to the effects of the usual adult dose due to the anticholinergic properties of meclizine. Caution is advisable when dosing for this population.

Pregnancy/Nursing Mothers

Meclizine is an FDA Pregnancy Category B drug. Studies conducted in child-bearing women have not shown an elevated risk of developing fetal abnormalities when taking meclizine.[9] Rat studies showed meclizine increases the risk of developing cleft palate when given increased doses 25 to 50 times more than the recommended human dose.  It is unknown if meclizine passes through breast milk. There have not been any documented problems in nursing mothers. Extended use and hefty doses of meclizine may cause effects in breastfeeding or decrease the milk supply, especially in combination with sympathomimetic drugs such as pseudoephedrine.[4] The anticholinergic actions of meclizine may also inhibit lactation.

Renal impairment – There is limited data on how renal impairment affects the pharmacokinetics of meclizine. Because the drug is renally excreted, there is a potential for the drug/metabolite to accumulate. In such cases, meclizine administration requires caution in patients with reduced renal function.

Hepatic impairment – There is limited data on how hepatic impairment affects the pharmacokinetics of meclizine. Hepatic impairment could result in increased systemic exposure to the drug because the liver metabolizes meclizine. Caution is necessary when administering meclizine in patients with hepatic impairment.

Due to meclizine’s anticholinergic and CNS depressant properties, this drug has the potential to interact with a variety of medications. Especially those that have anticholinergic and sedative properties.[10] As well as drugs that are metabolized by the hepatic enzyme CYP2D6. Using meclizine with alcohol or CNS depression–producing medication may heighten the CNS depressant effects of either of these substances. Anticholinergic drugs or drugs with anticholinergic properties taken with meclizine may also increase anticholinergic effects.[3]

Adverse Effects

Common adverse effects of patients taking meclizine include drowsiness, urinary retention, dry mouth, headache, fatigue, and vomiting.[11] On rare occasions, there have been reports of blurred vision and anaphylactic reactions.[12]

Due to the potential to cause drowsiness, the prescriber should caution the patients against driving and using heavy machinery.

Patients should avoid alcoholic beverages, tranquilizers, and sedatives while taking meclizine due to an increased risk of central nervous system depression.

The potential anticholinergic actions of meclizine pose a risk to patients with asthma, glaucoma, or an enlarged prostate gland. Caution is necessary with the use of the drug in such patients.

Contraindications

Meclizine is contraindicated in individuals with a history of hypersensitivity to the drug or any of the inactive ingredients.

Monitoring

Meclizine has not been shown to require serum testing for monitoring. There is no established therapeutic level for meclizine. Just like any drug, patients require clinical monitoring for any adverse reactions.

Due to meclizine’s anticholinergic effects, its ability to cause CNS depression, and its metabolism by CYP enzymes, it has the potential to interact with a large variety of different drugs. Before prescribing, the healthcare provider should carefully review a patient’s current medication list and past medical history to avoid interactions, systemic drug accumulation, and/or exacerbating an already establish ailment.

Toxicity

There are no specific antidotes available for meclizine overdose. Treatment is primarily supportive and focused on symptoms.

Symptoms of an overdose may include signs of CNS depression such as drowsiness, seizures, and/or coma.  Hypotension can occur, but it is more likely to be seen in the elderly.  The anticholinergic effects and CNS stimulation of an overdose in children can present with hallucinations, seizures, and/or issues sleeping.[10]

With recent ingestion, induce emesis or perform gastric lavage to prevent further drug absorption. Activated charcoal is also an option. There is no known antidote for meclizine, but physostigmine can help to counter the systemic anticholinergic effects of meclizine.[13]

Enhancing Healthcare Team Outcomes

Meclizine is a commonly prescribed drug by many healthcare professionals, including primary care providers, emergency medicine physicians, oncologists, internists, and PAs and nurse practitioners. When prescribing this medication, all healthcare providers should be aware of the most common adverse effects of the drug and the most susceptible population. The successful use of the drug also depends on the patient’s adherence to and knowledge of the potential effects of the drug.

Patients should be aware of the drowsiness and fatigue that the drug can cause so they can avoid driving or operating dangerous machinery when taken. Due to the CNS depression effects of meclizine, health care providers should stress not to drink alcohol or take other drugs that can potentiate this effect. The elderly and patients with comorbidities such as asthma, glaucoma, and BPH should be aware of the anticholinergic properties of the drug to avoid further complications or be educated on what to do should they arrive.[10]

Other providers, such as pharmacists, should work in concert with prescribers to guarantee that the patient knows proper administration, dosing, and knowledge of potential drug interactions. Clinical nurses should be aware of the adverse effects of the medication. All healthcare professionals must be cognizant of possible adverse outcomes and work together to prevent, manage, and/or treat accordingly if such an event should occur. This form of interprofessional collaboration will lead to successful outcomes when prescribing meclizine. [Level 5]

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References

1.

LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases; Bethesda (MD): Jan 16, 2017. Meclizine. [PubMed: 31643231]

2.

Nakashima T, Pyykkö I, Arroll MA, Casselbrant ML, Foster CA, Manzoor NF, Megerian CA, Naganawa S, Young YH. Meniere’s disease. Nat Rev Dis Primers. 2016 May 12;2:16028. [PubMed: 27170253]

3.

LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases; Bethesda (MD): Jan 15, 2018. Antiemetic Agents. [PubMed: 31643401]

4.

Drugs and Lactation Database (LactMed®) [Internet]. National Institute of Child Health and Human Development; Bethesda (MD): Sep 20, 2021. Meclizine. [PubMed: 30000495]

5.

Wibble T, Engström J, Verrecchia L, Pansell T. The effects of meclizine on motion sickness revisited. Br J Clin Pharmacol. 2020 Aug;86(8):1510-1518. [PMC free article: PMC7373708] [PubMed: 32077140]

6.

Lauter JL, Lynch O, Wood SB, Schoeffler L. Physiological and behavioral effects of an antivertigo antihistamine in adults. Percept Mot Skills. 1999 Jun;88(3 Pt 1):707-32. [PubMed: 10407877]

7.

Wang Z, Lee B, Pearce D, Qian S, Wang Y, Zhang Q, Chow MS. Meclizine metabolism and pharmacokinetics: formulation on its absorption. J Clin Pharmacol. 2012 Sep;52(9):1343-9. [PubMed: 21903894]

8.

Qazi F, Shoaib MH, Yousuf RI, Nasiri MI, Ahmed K, Ahmad M. Lipids bearing extruded-spheronized pellets for extended release of poorly soluble antiemetic agent-Meclizine HCl. Lipids Health Dis. 2017 Apr 12;16(1):75. [PMC free article: PMC5389104] [PubMed: 28403892]

9.

Vlastarakos PV, Nikolopoulos TP, Manolopoulos L, Ferekidis E, Kreatsas G. Treating common ear problems in pregnancy: what is safe? Eur Arch Otorhinolaryngol. 2008 Feb;265(2):139-45. [PubMed: 18034353]

10.

Yayla EM, Yavuz E, Bilge U, Keskin A, Binen E. Drugs with anticholinergic side-effects in primary care. Niger J Clin Pract. 2015 Jan-Feb;18(1):18-21. [PubMed: 25511338]

11.

Weerts AP, Pattyn N, Van de Heyning PH, Wuyts FL. Evaluation of the effects of anti-motion sickness drugs on subjective sleepiness and cognitive performance of healthy males. J Psychopharmacol. 2014 Jul;28(7):655-64. [PubMed: 24346808]

12.

Verhamme KM, Sturkenboom MC, Stricker BH, Bosch R. Drug-induced urinary retention: incidence, management and prevention. Drug Saf. 2008;31(5):373-88. [PubMed: 18422378]

13.

Boley SP, Stellpflug SJ. A Comparison of Resource Utilization in the Management of Anticholinergic Delirium Between Physostigmine and Nonantidote Therapy. Ann Pharmacother. 2019 Oct;53(10):1026-1032. [PubMed: 31023063]

Disclosure: Bobby Houston declares no relevant financial relationships with ineligible companies.

Disclosure: Yuvraj Chowdhury declares no relevant financial relationships with ineligible companies.

Side Effects, Dosage, Uses, and More

Highlights for meclizine

1. Meclizine oral tablet is a prescription drug that’s available as the brand-named drug Antivert. It’s also available as a generic drug.
2. Meclizine comes as a tablet you take by mouth.
3. Meclizine oral tablet is used to treat vertigo (a condition that causes you to feel like you or the room is spinning).

• Drowsiness warning: This drug may cause drowsiness. You shouldn’t drive, use machinery, or do other tasks that require alertness until you know how this drug affects you.
• Alcohol use warning: The use of drinks that contain alcohol can make drowsiness caused by meclizine worse. You should limit or avoid drinking alcohol while you take this drug.

Meclizine is a prescription drug that comes as an oral tablet. It also comes as a chewable tablet.

Meclizine oral tablet is a prescription drug that’s available as the brand-named drug Antivert. It’s also available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version.

Why it’s used

Meclizine oral tablet is used to treat vertigo (feeling like you or the room is spinning).

Meclizine may be used as part of a combination therapy. This means you may need to take it with other drugs.

How it works

Meclizine belongs to a class of drugs called antihistamines. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions. Meclizine works in your brain. It works by blocking chemicals that control nausea, vomiting, and balance.

Meclizine oral tablet may cause drowsiness. You shouldn’t drive, use machinery, or do other tasks that require alertness until you know how this drug affects you. It may also cause other side effects.

More common side effects

The more common side effects of meclizine can include:

• drowsiness
• tiredness
• headache
• blurry vision
• dry mouth

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• serious allergic reactions, with symptoms such as:
  • trouble breathing
  • swelling of your throat or tongue

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare professional who knows your medical history.

Meclizine oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk with your doctor or pharmacist.

Taking meclizine with certain medications raises your risk of side effects from these drugs. Examples of these drugs include:

• Drugs that treat insomnia, such as zolpidem, zaleplon, eszopiclone, temazepam, triazolam, estazolam, flurazepam, suvorexant, and doxepin. Taking these drugs with meclizine can increase your risk of sedative effects. These include drowsiness, slowed breathing, and trouble thinking.
• Drugs that treat psychotic disorders, such as haloperidol, fluphenazine, chlorpromazine, olanzapine, clozapine, quetiapine, and risperidone. Taking these drugs with meclizine can increase your risk of sedative effects. These include drowsiness, slowed breathing, and trouble thinking.
• Drugs that treat anxiety, such as lorazepam, clonazepam, alprazolam, diazepam, chlordiazepoxide, paroxetine, and hydroxyzine. Taking these drugs with meclizine can increase your risk of sedative effects. These include drowsiness, slowed breathing, and trouble thinking.
• Drugs that treat allergies, such as clemastine, carbinoxamine, diphenhydramine, and hydroxyzine. Taking these drugs with meclizine can increase your risk of sedative effects. These include drowsiness, slowed breathing, and trouble thinking.
• Drugs that treat muscle spasms, such as cyclobenzaprine, orphenadrine, baclofen, and methocarbamol. Taking these drugs with meclizine can increase your risk of sedative effects. These include drowsiness, slowed breathing, and trouble thinking.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare professional about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you’re taking.

Meclizine oral tablet comes with several warnings

Allergy warning

Meclizine can cause a severe allergic reaction. Symptoms can include:

• trouble breathing
• swelling of your throat or tongue
• rash
• hives

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Alcohol interaction warning

The use of drinks that contain alcohol can increase your risk of drowsiness from meclizine. If you drink alcohol, talk with your doctor.

Warnings for people with certain health conditions

For people with breathing problems: This drug can thicken the mucus in your lungs. This may make it harder for you to breathe. Talk with your doctor if you have breathing problems, such as asthma or chronic obstructive pulmonary disease (COPD), before starting this drug.

For people with glaucoma: This drug may make your glaucoma symptoms worse. Speak with your doctor if you have glaucoma before starting this drug.

For people with an enlarged prostate: This drug can make it more difficult for you to urinate. If you have trouble urinating due to an enlarged prostate, ask your doctor about whether this drug is safe for you.

For people with liver problems: It isn’t known if this drug is safe or effective for people with liver problems. Having liver problems may keep your body from processing this drug properly. This puts you at risk of more side effects. If you have liver problems, talk with your doctor before taking this drug.

For people with kidney problems: It isn’t known if this drug is safe or effective for people with kidney problems. Having kidney problems may keep your body from clearing this drug properly. This puts you at risk of more side effects. If you have kidney problems, talk with your doctor before taking this drug.

Warnings for other groups

For pregnant women: Meclizine is a category B pregnancy drug. That means two things:

1. Research in animals hasn’t shown a risk to the fetus when the mother takes the drug.
2. There aren’t enough studies done in humans to show if the drug poses a risk to the fetus.

Talk with your doctor if you’re pregnant or planning to become pregnant. Animal studies don’t always predict the way humans would respond. Therefore, this drug should only be used in pregnancy if clearly needed.

For women who are breastfeeding: It isn’t known if meclizine passes into breast milk. If it does, it may cause side effects in a child who is breastfed. Talk with your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

For seniors: The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

For children: This medication hasn’t been studied in children. It shouldn’t be used in people younger than 12 years.

When to call your doctor

If you’ve been taking this drug and it isn’t helping to control your symptoms of vertigo, call your doctor. Taking this drug for a long period of time can cause problems with the system in your body that controls balance. Call your doctor if you still have nausea, vomiting, or dizziness after you stop taking the drug.

This dosage information is for meclizine oral tablet. All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

• your age
• the condition being treated
• the severity of your condition
• other medical conditions you have
• how you react to the first dose

Forms and strengths

Generic: Meclizine

• Form: oral tablet
• Strengths: 12. 5 mg, 25 mg, 50 mg

Brand: Antivert

• Form: Oral tablet
• Strengths: 12.5 mg, 25 mg, 50 mg

Dosage for vertigo

Adult dosage (ages 18–64 years):

• Typical dosage: 25–100 mg per day, taken in divided doses.
• Dosage increases: Your doctor will decide the dose that’s right for you. They’ll increase your dose if needed depending on how you respond to and tolerate this drug.

Child dosage (ages 12–17 years):

• Typical dosage: 25–100 mg per day, taken in divided doses.
• Dosage increases: Your doctor will decide the dose that’s right for you. They’ll increase your dose if needed depending on how you respond to and tolerate this drug.

Child dosage (ages 0–11 years):

It hasn’t been confirmed that meclizine is safe and effective for use in people younger than 12 years.

Senior dosage (ages 65 years and older):

The liver and kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects. Your doctor may start you on a lowered dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Meclizine oral tablet is used for short-term or long-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug or don’t take it at all: Your dizziness or vertigo may not go away.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

• extreme drowsiness
• sedation
• seizures
• hallucinations (seeing or hearing things that aren’t there)
• irregular heart rhythm
• decreased breathing

If you think you’ve taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 1-800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: Your symptoms of dizziness or vertigo should improve.

Keep these considerations in mind if your doctor prescribes meclizine oral tablet for you.

General

• You can take meclizine with or without food.
• You cannot cut or crush the tablet.

Storage

• Store meclizine at room temperature. Keep it between 68°F and 77°F (20°C and 25°C).
• Keep it away from light.
• Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You shouldn’t need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

• Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
• Don’t worry about airport X-ray machines. They can’t hurt your medication. You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
• Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk with your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Memorial Sloan Kettering Cancer Center

Adult Medication

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Provided by Lexicomp ^® , this document contains all the information you need to know about this medicine, including indications, directions for use, side effects, and when your healthcare provider should be contacted.

Trade names: USA

Antivert; Bonine [OTC]; Dramamine Less Drowsy [OTC] [DSC]; Motion Time [OTC]; Travel Sickness [OTC] [DSC]; Travel Easy [OTC]

What is this drug used for?

• It is used for motion sickness.
• Used to treat dizziness.
• This drug may also be used for other indications. Consult your doctor.

What should I tell my doctor BEFORE taking this drug?

• If you have an allergy to this drug, any of its ingredients, other drugs, foods or substances. Tell your doctor about your allergies and how they have manifested.

Combining this drug with certain drugs and conditions may be unfavorable.

Tell your doctor and pharmacist about all medicines you take (prescription and over-the-counter, natural products and vitamins) and any health problems you have. You need to make sure that this drug is safe for your conditions and in combination with other drugs you are already taking. Do not start or stop taking any drug or change the dosage without your doctor’s advice.

What do I need to know or do while taking this drug?

• Tell all your health care workers that you are taking this drug. These are doctors, nurses, pharmacists and dentists.
• Avoid driving and other activities that require increased attention until you see how this drug affects you.
• If you are allergic to tartrazine (dye yellow #5), talk to your doctor. Some products contain tartrazine.
• Avoid drinking alcohol while taking this drug.
• Check with your doctor before using marijuana, other forms of cannabis, or prescription or over-the-counter drugs that can slow you down.
• If you have phenylketonuria, talk to your doctor. Some foods contain phenylalanine.
• If you are 65 years of age or older, use this drug with caution. You may experience more side effects.
• Do not give this drug to a child without first talking to the child’s doctor.
• Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding. The benefits and risks for you and your child will need to be discussed.

What side effects should I report to my doctor immediately?

WARNING. In rare cases, this drug can cause serious and sometimes deadly side effects in some patients. Call your doctor right away or get medical help if you have any of the following signs or symptoms that could be associated with serious side effects:

• Signs of an allergic reaction, such as rash, hives, itching, red and swollen skin with blisters or peeling, possibly accompanied by fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue or throat.

What are some other side effects of this drug?

Any medicine can have side effects. However, for many people, side effects are either minor or non-existent. Talk to your doctor or get medical help if these or any other side effects bother you or don’t go away:

• Drowsiness.
• Dry mouth.
• Headache.
• Feeling tired or weak.
• Vomit.

This list of possible side effects is not exhaustive. If you have any questions about side effects, please contact your doctor. Talk to your doctor about side effects.

You can report side effects to the National Health Board.

You can report side effects to the FDA at 1-800-332-1088. You can also report side effects at https://www.fda.gov/medwatch.

What is the best way to take this drug?

Use this drug as directed by your doctor. Read all the information provided to you. Strictly follow all instructions.

Tablets:

• Swallow whole. Do not chew, break or crush.
• If you are taking this drug to prevent motion sickness, take it 1 hour before you travel.

Chewable:

• Chew thoroughly before swallowing.
• Some brand name drugs can be swallowed whole. Ask your pharmacist if you can swallow your brand name medicine whole.
• If you are taking this drug to prevent motion sickness, take it 1 hour before you travel.

What if I miss a dose of a drug?

• If you take the drug regularly, take the missed dose as soon as you can.
• If it’s time for your next dose, don’t take the missed dose and then go back to your regular dosing schedule.
• Do not take 2 doses or an additional dose at the same time.
• In most cases, this drug is used as needed. Do not take the drug more often than prescribed by your doctor.

How do I store and/or discard this drug?

• Store at room temperature, protected from light. Store in a dry place. Do not store in the bathroom.
• Keep all medicines in a safe place. Keep all medicines out of the reach of children and pets.
• Dispose of unused or expired drugs. Do not empty into a toilet or sewer unless instructed to do so. If you have any questions about disposing of medicines, ask your pharmacist. Drug disposal programs may be in place in your area.

General information about medicines

• If your health does not improve or even worsens, see your doctor.
• Do not give your medicine to anyone and do not take other people’s medicines.
• Some medicines may come with other patient information leaflets. If you have any questions about this drug, talk with your doctor, nurse, pharmacist, or other health care professional.
• Some medicines may come with other patient information leaflets. Check with your pharmacist. If you have any questions about this drug, talk with your doctor, nurse, pharmacist, or other health care professional.
• If you think you have overdosed, call a poison control center or get medical help right away. Be prepared to tell or show what drug you took, how much, and when it happened.

Consumer Use of Information and Limitation of Liability

This summary information includes a summary of the diagnosis, treatment, and/or drug product. It is not intended to be a comprehensive source of data and should be used as a tool to help the user understand and/or evaluate potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a particular patient. It should not be considered medical advice or a substitute for medical advice, diagnosis or treatment provided by a physician based on a medical examination and assessment of the patient’s specific and unique circumstances. Patients should consult with their physician for full information about their health, medical issues, and treatment options, including any risks or benefits regarding the use of medications.