Additive sedation may also occur.Īcetaminophen Chlorpheniramine Dextromethorphan Phenylephrine: (Major) Meclizine is an H1-blocker which exhibits significant anticholinergic effects. 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. The anticholinergic effects of meclizine may be enhanced when combined with other drugs with antimuscarinic activity, including other sedating H1-blockers. Additive sedation may also occur.Īcetaminophen Chlorpheniramine Dextromethorphan: (Major) Meclizine is an H1-blocker which exhibits significant anticholinergic effects. Additive sedation may also occur.Īcetaminophen Chlorpheniramine: (Major) Meclizine is an H1-blocker which exhibits significant anticholinergic effects. 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.Īcetaminophen Caffeine Pyrilamine: (Major) Meclizine is an H1-blocker which exhibits significant anticholinergic effects. Many of these effects may lead to other adverse consequences, such as falls.Īcetaminophen Aspirin Diphenhydramine: (Major) The anticholinergic and sedative effects of meclizine may be enhanced when combined with other drugs with antimuscarinic activity, including other sedating antihistamines (H1-blockers). Anticholinergics may cause excessive sedation, confusion, cognitive impairment, distress, dry mouth, constipation, and urinary retention. If administered, use the smallest possible dose. Antihistamines (e.g., first-generation agents) have strong anticholinergic properties and are not considered medications of choice in older individuals. The federal Omnibus Budget Reconciliation Act (OBRA) regulates medication use in residents of long-term care facilities meclizine should be used only for a limited duration (less than 14 days) unless there is documented evidence of enduring symptoms that cannot otherwise be alleviated. Avoid drugs with strong anticholinergic activity in geriatric patients with the following conditions due to the potential for symptom exacerbation or adverse effects: dementia/cognitive impairment (adverse CNS effects), delirium/high risk of delirium (new-onset or worsening delirium), or lower urinary tract symptoms/benign prostatic hyperplasia in men (urinary retention or hesitancy). According to the Beers Criteria, first-generation antihistamines are considered potentially inappropriate medications (PIMs) in geriatric patients and should be avoided because they are highly anticholinergic, there is reduced clearance in advanced age, tolerance develops when used as hypnotics, and there is a greater risk of anticholinergic effects (e.g., confusion, dry mouth, constipation) and toxicity compared to younger adults. In addition, the anticholinergic effects of meclizine may be significant and are additive with other anticholinergic medications in any patient, and especially in the elderly. Use meclizine with caution in geriatric adults because they may be more sensitive to the anticholinergic effects of meclizine than younger adults.
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