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meclizine

Sold as Antivert, Bonine, Dramamine Less Drowsy, Dramamine Nausea Relief, Pepto Nausea and 1 more. Class: Piperazine derivatives. First FDA approval 02/14/1957: 69 years on the US market.

This grade answers one narrow question: how strong is the public evidence and safety record behind this drug, and how clean is its money trail and court record? It is not a verdict on whether the drug is right for you.

B

Score breakdown (80/100)

Safety ×35%
A
Evidence ×25%
F
Regulatory ×15%
A
Money & lawsuits ×15%
A
Options ×10%
A

Safety: 100

Evidence: 24

Regulatory history: 96

Money & lawsuits: 100

Options: 100

What the FDA label says

Approved uses

Meclizine hydrochloride tablets are indicated for the treatment of vertigo associated with diseases affecting the vestibular system in adults. Meclizine hydrochloride tablets are indicated for the treatment of vertigo associated with diseases affecting the vestibular system in adults ( 1 ).

Contraindications

Meclizine hydrochloride tablets are contraindicated in patients with a hypersensitivity to meclizine or any of the inactive ingredients [see Adverse Reactions (6) and Description (11) ]. Meclizine hydrochloride tablets are contraindicated in patients with hypersensitivity to meclizine or any of the inactive ingredients ( 4 ).

Warnings and precautions

May cause drowsiness: Use caution when driving a car or operating dangerous machinery ( 5.1 ). Potential anticholinergic action: this drug should be prescribed with care to patients with a history of asthma, glaucoma, or enlargement of the prostate gland ( 5.2 ). 5.1 Drowsiness Since drowsiness may occur with use of meclizine hydrochloride tablets, patients should be warned of this possibility and cautioned against driving a car or operating dangerous machinery. Patients should avoid alcoholic beverages while taking meclizine hydrochloride tablets [see Drug Interactions (7.1) ] . 5.2 Concurrent Medical Conditions Because of its potential anticholinergic action, meclizine hydrochloride tablets should be used with caution in patients with asthma, glaucoma, or enlargement of the prostate gland.

Adverse reactions (label)

The following adverse reactions associated with the use of meclizine hydrochloride were identified in clinical studies or postmarketing reports. Because some of these reactions were reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Anaphylactic reaction, drowsiness, dry mouth, headache, fatigue, and vomiting. On rare occasions blurred vision has been reported. Common adverse reactions are anaphylactic reaction, drowsiness, dry mouth, headache, fatigue, and vomiting. On rare occasions blurred vision has been reported ( 6 ). To report SUSPECTED ADVERSE REACTIONS, contact Aurobindo Pharma USA, Inc. at 1-866-850-2876 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Source: FDA SPL label for MECLIZINE HYDROCHLORIDE (Bryant Ranch Prepack), effective 20260608. Full label on DailyMed.

Side-effect reports sent to the FDA

These are counts of reports people filed, not rates of harm. Anyone can file one, and nobody checks whether the drug was the cause. Millions of doses are taken for every report sent, so the useful part is how this drug compares with the average across all drugs.

15,046reports that mention this drug
15,038of those blame this drug, not another one the person was taking
60%of reports describe a serious outcome, such as a hospital stay (average for all drugs: 57%)
8.4%of reports include a death, from any cause (average for all drugs: 9.1%)

Problems reported most often

Dizziness · 1,364Fatigue · 1,359Nausea · 1,247Diarrhoea · 1,008Headache · 972Chronic Kidney Disease · 940Fall · 905Pain · 869Dyspnoea · 731Drug Ineffective · 715Asthenia · 673Off Label Use · 671Acute Kidney Injury · 657Vomiting · 638Renal Failure · 621

Reports per year

20192020202120222023202420252026
1,7761,5211,3171,1179821,0381,215588

938 reports blaming this drug for every million Medicare prescriptions filled, which is 0.3× the typical drug on this site. (2,839 reports in 2024–2026, against 3,025,148 Medicare fills in one year. This is the one number here that accounts for how many people take the drug.)

Source: the FDA's Adverse Event Reporting System (FAERS). Reports are voluntary and unverified. Drugs that are prescribed a lot, in the news, or in lawsuits attract more reports, so the percentages are compared with the whole database to correct for that partly, not fully.

Recalls and regulatory record

4recall actions on file
1 / 32brand / generic applications
0label changes since 2021
NoREMS program
DateClassFirmReason
03/2026Class IIAmerisource Health Services LLCFailed tablet specifications.
04/2022Class IIMckesson Medical-Surgical Inc. Corporate OfficecGMP deviations: Temperature abuse
10/2019Class IIISato Pharmaceutical Inc.Subpotent Drug
10/2019Class IIISato Pharmaceutical Inc.Subpotent Drug

Class I = reasonable probability of serious harm. Class II = temporary or reversible harm. Class III = unlikely to harm. Most generic recalls are manufacturing or labeling defects for one lot, not a verdict on the molecule.

Evidence base

10randomized trials (PubMed)
0systematic reviews
11registered trials
43%of completed trials posted results
0%terminated or withdrawn
36%industry-funded

Counts measure how much evidence exists and how transparent it is, not how big the benefit is. For that, ask your prescriber: if 100 people like me took this, how many would get better because of it, and how many would be harmed? (Doctors call these the "number needed to treat" and "number needed to harm.") It differs by condition and is the number drug ads leave out. Sources: PubMed, ClinicalTrials.gov.

Money and lawsuits

In 2024, drug companies reported $0 in payments to US physicians and hospitals tied to this drug across 0 transactions.

No pending federal MDL names this drug or its brands.

Not named in any federal pharmaceutical settlement of $100M or more on record.

Sources: CMS Open Payments (Sunshine Act); Judicial Panel on Multidistrict Litigation pending docket list; DOJ settlements as tabulated on Wikipedia with links to the primary record. State-court and individual suits are not included.

Who takes it and what it costs

1,416,078Medicare Part D patients (2024)
3,025,148prescriptions filled
$8average cost per fill
$25Mtotal Medicare spend

Same-class alternatives

buclizinechlorcyclizinecyclizineoxatomide

Same ATC pharmacological class, graded ones first, best grade at the top. Being in the same class does not make them interchangeable for your condition; it makes them worth asking about.

Questions to ask your prescriber

  1. The most-reported problems in FDA's adverse event data are dizziness, fatigue, nausea, diarrhoea. How would we recognize and handle those?
  2. Why this one over buclizine, cetirizine, chlorcyclizine? What would make you pick one of those instead?
  3. What result are we expecting, by when, and what is the plan if it does not happen?
  4. If 100 people like me took this drug, how many would actually get better because of it, and how many would be harmed by it? (Doctors call these the number needed to treat and the number needed to harm.)