Meclizine (Antivert) Interactions
- Amantadine
Aminoglycosides
- Amoxapine
Antimuscarinics
Anxiolytics, Sedatives, and Hypnotics
Barbiturates
- Buprenorphine
- Butorphanol
- Clozapine
- Cyclobenzaprine
- Dextroamphetamine
- Digoxin
- Disopyramide
- Dronabinol, THC
- Entacapone
- Ethanol
General Anesthetics
- Haloperidol
- Maprotiline
Monoamine oxidase inhibitors (MAOIs)
- Nalbuphine
- Olanzapine
Opiate agonists
- Orphenadrine
- Pentazocine
Phenothiazines
- Pramipexole
- Pregabalin
- Risperidone
- Ropinirole
Sedating H1-blockers
- Tolcapone
- Tramadol
- Trazodone
Tricyclic antidepressants
Meclizine (Antivert) Interactions
MAOIs may prolong and intensify the anticholinergic effects of antihistamines. Although the anticholinergic activity of MAOIs is minimal; anticholinergic effects sometimes occur. It is recommended that the concurrent use of MAOIs with drugs possessing anticholinergic activity be avoided, since the effects of other anticholinergic drugs are potentiated and may become severe. Most manufacturers recommend that sedating H1-antagonists should not be used within 2 weeks of therapy with a MAOI.
Meclizine may produce significant sedative effects. Enhanced CNS depressant effects may occur when meclizine is combined with other CNS depressants including anxiolytics, sedatives, and hypnotics, barbiturates, buprenorphine, butorphanol, dronabinol, THC, entacapone, ethanol, general anesthetics, nalbuphine, opiate agonists, pentazocine, pramipexole, pregabalin, ropinirole, tolcapone, tramadol, and psychotropic medications like haloperidol, risperidone or trazodone.
Meclizine is an H1-blocker which exhibits significant anticholinergic effects. The anticholinergic effects of meclizine may be enhanced when combined with other drugs with antimuscarinic activity, including other sedating H1-blockers. Other commonly used drugs with significant anticholinergic effects include amantadine, amoxapine, antimuscarinics, clozapine, cyclobenzaprine, disopyramide, maprotiline, olanzapine, orphenadrine, most phenothiazines, and most tricyclic antidepressants. Clinicians should note that antimuscarinic effects might be seen not only on GI smooth muscle, but also on bladder function, the eye, and temperature regulation. With many of the listed agents, additive sedation may also occur when combined with meclizine.
Meclizine and other antiemetics should be used carefully with aminoglycosides because they can mask symptoms of ototoxicity (e.g., nausea secondary to vertigo).
Patients receiving oral digoxin therapy should be monitored for increased digoxin effects when receiving drugs with substantial anticholinergic activity. Meclizine can theoretically increase the absorption of digoxin by decreasing gastrointestinal motility. Anticholinergics, because of their ability to cause tachycardia, can also antagonize the beneficial actions of digoxin in atrial fibrillation/flutter.
Dextroamphetamine and other amphetamines may pharmacodynamically counteract the sedative properties of some antihistamines, such as the sedating H1-blockers. If a patient is receiving an amphetamine for treatment of narcolepsy, the combination with a sedating antihistamine may reverse the action of the amphetamine.
[ Last revised: 3/15/2005 9:13:00 AM ]
References
. Lanoxin® (digoxin) package insert. Research Triangle Park, NC: Glaxo Smith Kline; 2001 Aug.
. Dexedrine® (dextroamphetamine) package insert. Research Triangle Park, NC; GlaxoSmithKline; 2002 Jan.
. Hoffman BB, Lefkowitz RJ. Atropine, scopolamine, and related antimuscarinic drugs. Gilman AG, Rall TW, Nies AS, Taylor P, (eds.) In: Goodman and Gilman’s Pharmacological Basis of Therapeutics. 8th ed., New York, Pergamon Press. 1990. 150 - 61.
. Seixas FA. Alcohol and its drug interactions. Ann Intern Med 1975;83:86 - 92.
. Hoffman BB, Lefkowitz RJ. Monoamine oxidase (MAO) inhibitors. Gilman AG, Rall TW, Nies AS, Taylor P, (eds.) In: Goodman and Gilman’s Pharmacological Basis of Therapeutics. 8th ed., New York, Pergamon Press. 1990. 416 - 17.
. Antivert® (meclizine) package insert. New York, NY: Pfizer; 1996 Jun.
. Welch MJ, Meltzer EO, Simons FE. H1-antihistamines and the central nervous system. Clin Allergy Immunol 2002;17:337 - 88.
. Brown JH, Taylor P. Muscarinic receptor agonists and antagonists. In: Hardman JG, Limbird LE, Molinoff PB, Ruddon RW, Gilman AG, eds. Goodman and Gilman’s the pharmacological basis of therapeutics, 9th edn. New York: McGraw Hill, 1996;141 - 160.
. Frampton JE, Foster RH. Pregabalin: in the treatment of postherpetic neuralgia. Drugs. 2005;65:111 - 8.
. Brown NJ, Roberts LJ. Histamine, Bradykinin, and their Antagonists. In: Gilman AG, Hardman JG, Limbird LE, eds. Goodman and Gilman’s The Pharmacological Basis of Therapeutics. 10th ed., New York, McGraw-Hill Companies. 2001:645 - 67.
. Chambers HF. Antimicrobial Agents: the aminoglycosides. In: Gilman AG, Hardman JG, Limbird LE, eds. Goodman and Gilman’s The Pharmacological Basis of Therapeutics. 10th ed., New York, McGraw-Hill Companies. 2001:1219 - 38.
. Pasricha PJ. Prokinetic agents, antiemetics, and agents used in irritable bowel syndrome.. In: Gilman AG, Hardman JG, Limbird LE, eds. Goodman and Gilman’s The Pharmacological Basis of Therapeutics. 10th ed., New York, McGraw-Hill Companies. 2001:1021 - 36.
. Lanoxicaps® (digoxin solution in capsules) package insert. Research Triangle Park, NC: GlaxoSmithKline; 2003 Oct.
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