Meclizine is commonly prescribed for people with dizziness and vertigo, including older adults. In some cases, it may be needed but in other cases it is dangerous.
Older adults are often frequently told that there’s nothing they can do about the vertigo because they are older. They are advised to take the meclizine as prescribed to reduce their discomfort. Frequently, no further care is recommended.
Meclizine is on the BEERS criteria is “not recommended” for older adults, with moderate evidence to support that recommendation.
In this article we will talk about what makes Meclizine dangerous for treating vertigo, especially in older adults.
Medication Side Effects Increase Risk of Falling
There are three reasons why Meclizine is dangerous for older adults related to medication side effects and falls:
- Meclizine increases the risk of falling due to Medication Side Effects.
- Side effects of Meclizine include dizziness, drowsiness and blurry vision.
- Those side effects can increase the risk of falling for people of any age, but especially for older adults who may have other problems like muscle weakness and vision problems.
More than That…
More than just the side effects of the medication and falls, there are a few other reasons why meclizine is dangerous for long term use in older adults with dizziness and vertigo.
Meclizine Is Dangerous Because It Masks the Problem
Meclizine is dangerous because it masks the symptoms of dizziness and vertigo to reduce discomfort, but does not correct the underlying problem.
The lack of root cause leaves the person with a balance impairment that has not been addressed, even if they no longer feel dizzy or spinny on the medication.
An unidentified and unaddressed balance impairment increases the risk of falls.
Many older patients I have met who sustained a serious fall-related injury are on meclizine and have been taking it for many years to mask their dizziness.
Anti-Cholinergic Effect on the Brain
Meclizine is dangerous because it works to reduce dizziness and vertigo by reducing the activity of a chemical called acetylcholine in the brain. Medications that are currently marketed to stop the progression of dementia increase the activity of acetylcholine in the brain.
Hmmm… think about that for a minute.
Anticholinergic medications have been shown in research to cause irreversible cognitive impairment with long term use. Meclizine is dangerous for treating vertigo because the long-term use of Meclizine can cause irreversible cognitive impairment.
Yes that’s right! Even so, older adults are still commonly prescribed Meclizine when they complain of dizziness or vertigo.
A Better Plan
Since Meclizine is dangerous for treating vertigo especially in older adults, I would like to propose an alternative approach.
Instead of recommending Meclizine as a long-term solution of vertigo, people with dizziness, vertigo, and balance problems should be referred to Vestibular rehabilitation physical therapy to identify and eliminate the root cause of the dizziness and vertigo if possible.
Take Caution and Next Steps
Please note: All medications should be taken as prescribed by your doctor. If you have been prescribed meclizine, you must follow up with your doctor to discuss your concerns and request for the medication to be reduced if possible.
For people with a poor prognosis of vestibular recovery, meclizine may be appropriate for long term use. However, the accurate prognosis can not be determined until an exam by a vestibular expert provider has been conducted.
Meclizine may also be helpful to take short term until proper vestibular care can be found. Sometimes, it takes awhile to find the right provider.
Disclaimer
This blog is provided for informational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.
Wonderful information. I will certainly keep this article and share with any of my patients who are on this drug.
I am currently on the prescription drug meclizine and was looking for any input i can get and help in making it less inhibiting to what i am experiencing
Hi Sharon,
You should talk to the doctor who prescribed the medication to you or a pharmacist about your questions and concerns regarding this drug. It’s important to take medications as prescribed by your doctor.
Also you may want to consult a Vestibular Physical therapist.
You can use this article to search for one in your area.
Best wishes,
Kim Bell, DPT
Dr. Kimberley can meclizen cause a mild stroke if taken long period of time like 10 years plus twice a day????? cause of yesterday my father had a mild stroke thank god hes ok but this VA doctor took him off of the meds on friday the 25th of march im just wondering if it can cause a stroke!!!
Hi Kelly,
I am sorry to hear your father had a mild stroke! Thank God he is ok.
I have never heard of meclizine causing a stroke. I don’t think that could cause a stroke, but I would defer to your dad’s doctor on his opinion.
I hope he feels better soon!
Sincerely,
Kim Bell, DPT
I was taking this medication and it did nothing for me.
I am terribly off balance, dizzy and lightheaded ALL the time!
I will now try to find a Vestibular Physical Therapist.
Thanks 🙏🏾
Hi Bessie,
You should take your medications as prescribed by your doctor and talk to your doctor before making any changes.
If you are supposed to take meclizine regularly, your doctor may be able to switch your meclizine to “as needed” if it is not helping you.
You can use this article to search for a vestibular physical therapist in your area.
I hope you feel better soon!
Good idea. I just started treatment a couple of weeks ago and in fact going today for more. It is helping!!
Try to do a therapy for dizziness. It will help you and get you better if the ears cause that.
Would this medication if taken every morning cause you to pass out when standing up and taking a few steps then everything turns black and legs just buckle
Hi Johnnie,
Low blood pressure is a possible side effect of meclizine. If your blood pressure gets low enough, it could cause a syncopal episode similar to what you describe.
Since this is a very serious symptom you are discussing with a high risk of falling or potential injury from a fall, I suggest you notify your primary doctor immediately.
You can schedule an appointment for medical care as soon as possible because this may be caused by a medical condition that needs immediate attention.
If needed, you may want to go to the emergency room.
Yes, meclizine masks the symptoms of vertigo and doesn’t cure it.
Often, the process of obtaining a definitive diagnosis can take an extended period of time.
For a person experiencing frequent severe debilitating vertigo accompanied by vomiting and diarrhea, the benefits of using this very effective drug clearly outweigh the risk of side-effects, providing that the patient is able to abstain from use for at least 48 hours prior to any diagnostic test that may induce dizziness.
Best to seek advice on proper use of any medication from registered pharmacists or the prescribing physician.
Where to find a dr for vertigo dizziness in Springfield mo area
This article may be helpful.
My husband is 83. He has broken a bone in his neck as a result of falling from a vertigo spell. He cannot exercise due to his Neck brace.
He still has dizziness. is meclizine ok? What can we do?
Hi Diane,
I have to always advise that you take all medications as prescribed and discuss any changes with the prescribing doctor.
Healing the broken bone in his neck is top priority.
Once your husband is cleared for physical activity by his doctor, you may want to seek out vestibular physical therapy for treatment of vertigo and imbalance.
This article can help you search for a local vestibular PT.
I suggest you write up a case summary using this article, to share with all his providers.
In the meantime, the meclizine may help him with the quality of life day to day.
Best wishes to you both!
My mother is taking this medication, she is 77. It appears to me that she is more off balance and is becoming very forgetful. Should she be taking this medication. She is retired DMV officer and believes she can drive very well. I have finally convinced her to take extreme caution when driving, especially when making left turns. Do you believe she is safe driving walking, and other activities?
Hi Donald,
I suggest you report these new or worsening symptoms to your mother‘s primary physician. They could be a medication side effect or an unrelated health issue, so individual medical attention is appropriate in this case.
You can direct your questions and concerns about this medication to the prescribing doctor or a pharmacist.
Your mother is lucky to have you as her health advocate!
If you want to search online for a doctor who treats dizziness and vertigo, this article may help.
I have token vertigo pills and the result made me sleepier or weak. I quit taking it and it is not worth it for me and yeah, I guess it is possible I had 3 or 4 yesterday and I am just going to assume that is too much for me. I quit and yeah I will forget it and move on as I am luckily strong enough to move but, not properly.
At age 64
Vertigo is beginning to cause problems and meclizine causes hives, skin rash and uncontrollable itching for me.
Hi Scott,
I suggest you find a vestibular physical therapist to see if you can get resolution to the vertigo.
You can use this article to search for local providers.
Best wishes!
Epley maneuver I had it done I feel great
I have been taking Meclizine since may 2022 dr has taken me off the drug & put me on Dramamine but it only comes in 25mg & this the same dosage as meclizine so what’s the difference between the 2 I havent begun my Dramamine but will start tomorrow do u think I will feel the difference?
Hi Linda,
They are different antihistamines.
You can learn more here.
Best wishes
I was prescribed Meclizine by ER which was the wrong diagnosis. After several specialists, one which was concerned about balance particularly with regular use. After much concern on my part, I started taking it regularly by my PCP who was unsure of my diagnosis. I am 73 years old. I had no warning of any side effects, but fell while just walking. I do have physical therapy referral to them, plus was neurolgist, and cardiologist. Fall was really scary though I didn’t hit my head, injured wrist and knees and then had a dissociative episode due to the trauma. Though I don’t think my PCP had any idea this could happen.
Am I mistaken, or can you not purchase this medication OVC? (over the counter,….without a prescription).
Hi Robert,
The over the counter brand names that people often use instead of prescription meclizine are Bonine and Dramamine. You can find them at most drug stores.
Be sure you talk to your doctor before starting any new medications.
If you have meniere’s disease, which I have had for 30 years, what other choices are there?
Hi Robert,
There are a few options for medications for Meniere’s disease, so each patient should seek individual medical advice from the prescribing physician.
The medication management also depends on which country you live in, since the prescription drugs available and prescribing habits may vary from country to country.
Meniere’s disease is frequently managed with diuretic medications or water pills. That may help prevent vertigo attacks.
There are different water pills that may be prescribed, such as HCTZ.
Other patients may take a histamine analogue like betahistine to reduce vertigo attacks.
Reducing salt intake is an important dietary change for people with Meniere’s disease.
There are higher levels of management that patients may need if dietary changes and medications do not help.
Also patients with Meniere’s disease may have co-occuring issues that can be treated with vestibular PT to reduce overall discomfort.
I discuss that more in this article.
I hope that helps!
My husband suffers from Meniere’s disease.
Meclizine did nothing for him except help him sleep through the worst of it.
I joined a Meniere’s disease support group on FB to talk to other sufferers.
Antiviral threapy has shown great promise in stopping the vertigo, the ear fullness and pain remain as does the hearing loss.
Goggle “Antiviral therapy used to treat Meniere’s disease
There is a lot of information a out it.
Many ENT’s and MD specialists have not heard of this treatment so copy the information and take it with you.
My husband took Valtrex 500mg 2xday after about 6 weeks the vertigo stopped its been 3 years since he had and attack.
His acupuncturist turned him onto a herb tea for the ear fullness and pain it really helps.
LOOK INTO THE ANTIVIRAL THERAPY!!
The drug is the same. Over the counter dosing guidelines both for indications and amount to take are typically lower than what may be prescribed by your physician.
Depending upon your insurance, it may save a few dollars to obtain it by prescription.
However, if your doctor wants you to take it on an “as needed” basis, I suggest carrying a box of CHEWABLE meclizine as a dose can be taken anywhere without needing to get water to swallow it with, and it’s typically absorbed faster.
I thought I had vertigo, but was diagnosed with crystals in my ear getting out of line. the therapist said there was no medication for the condition. The only thing I could do was lay with my head off the bed on the left and right side three times each sitting up each time and then laying back down. Giving each time 3 to 5 minutes.
Hi Patricia,
Thank you for sharing your story!
This article discusses BPPV treatment.
This article discusses vestibular rehab.
This article can help you search for a vestibular provider who can perform hands on treatments for BPPV crystals.
I have a script, but barely use it. While my regular doctor prescribed it, I have been treated by ENTs and was extensively tested (including an MRI and hearing tests, eye movement tests,etc.), as well as given epley movements. It did not resolve the problem. I was also given an anti-viral as apparently an active infection was the root cause at the time. However, I had had vertigo off and on for years, including ear infections in my 30’s and 40’s and complaints of balance issues in my 20’s.
I had rehab, but I believe the worst of it (I had rapid eye movement when laying on my sides, could see and feel movement, had bouts if I turned on my side, and felt like I was walking on a cruise ship when upright and walking or standing still).
A couple years later, a vestibular specialist suggested it was related to nerve damage. My brain just isn’t getting the proper signals from my inner ears. I also have chronic post nasal drip, a constantly runny nose which runs worst when I eat. So lots of fluid in my inner ears all the time.
The vertigo is constantly present, but tolerable. I will have what I call “vertigo days”. Those are days when I can activelyfeel movement more that usual. I tend to list to my left.
Then I have bad vertigo days. And only then willI I reach for my meds, which are usually expired by then. So I just cope. Today I’m here because this is a bad day and my meds are 2 years expired and it’s the weekend so I can’t ask for a refill. I turned over in bed and had doozy of spell and I’m ship-walking. If anyone has been on a cruise for the first time, they know what I mean.
All this started with a sudden sensation of the floor opening up while i was in the shower about 15-20 years ago and i fell against the shower wall. I do not fear falling. I do not fear breaking any bones. I’m nearly 70, but exercise with weights, pilates, core work, and floor work entry other day.
I had only one really scary, I could have really be injured incident and that was when I was falling backwards without any awareness whatsoever. Only when I reached a point when my feet shifted at whatever angle my entire body had reached did I realize I was falling back and I grabbed a big service table in front of me to pull myself forward. I was falling straight back onto a hard cafeteria floor at work. I could have sustained severe TBI.
I no longer drive although I have had to drive for emergency reasons, but otherwise do not. Several dx have been suggestions. No one really said definitively this is why you have vertigo, we found the error cause. I think I have a combo of nerve damage, excessive fluid in my inner ears, and who knows what else.
My mom suffered debilitating vertigo, which would sometimes “fix” (i.e. she would see the world upside down). Hers was sudden bouts, while I usually have warnings that today will be a “bad vertigo day”.
I was offered rehab by the vestibular specialist, but couldn’t participate as they did not have evening hours. I’m retired now and can do it. I might give it try.
This is long, but hopefully with so many details of my journey, other sufferers will find relatable details.
I wanted to add I do not restrict my movements asI believe my brain would become accustomed. I’m other words I bend down, twist, roll over in bed behave normally. Only on really bad days like today willI restrict body and head movements. I’m taking a musinex, in the hop it’ll dry up some of the fluid in my sinuses and ears. Thanks for reading
Yes my doctor prescribe this to me I’m very afraid to use it I have so many other health issues don’t need to invite another one it was prescribed by my car just I think not worth the risk
Hi Mary,
You should take all medications as prescribed by your doctor and discuss any concerns with your doctor before making any changes.
I hope you feel better soon!
If you want to look for a doctor or physical therapist who treats vertigo and dizziness, you can search online here.
Been on meclizine along with Naprosyn and muscle relaxer and one more med still dizzy and off balance and vision blurry seems like it’s making me dizzy and off balance instead of making it go away
I have vertigo what should do?
Hi Lucille,
Be sure to notify your primary doctor.
You can go to the emergency room if needed.
You can use this article to help you find a provider who specializes in vertigo.
I hope you feel better soon.
I have gone to many different specialists, many visits and in several cities in VA and NC. None even show an interest in helping me. That’s why I am so glad I found your blog!
I have had a bad back for 30+ yrs. Two and one half yrs ago I had procedure on my left leg due to PAD I have in both thighs. I was in extreme pain the duration of procedure and up to including this moment.
I now also have shortness of breath, chest pain, numbness both hands, both legs and feet, extreme cramps hands and feet, vertigo, sore throat, lips, gums, tongue, legs and feet stay swollen, etc. Only treatment is Meclizine for vertigo and at my age 74 I think I shouldn’t be taking that. I believe it’s making some of my symptoms worse. Is that likely? Thanking you in advance
Hi Teresia,
I’m sorry to hear all that you have gone through!
If you have not already consulted a vestibular physical therapist, you can use this article to search for one in your area.
You may also want to consult an orthopedic physical therapist for the pain issues.
You can use this directory to search for someone nearby.
I hope one or both of those consultations is helpful to get your questions answered and improve your quality of life.
I wish you all the best!
I’m just starting Meclizine And I’m very nervous about it I’ve had bouts of dizziness and falling constantly in the past 2 to 3 weeks. Why is there a need to chew it before swallowing it? That’s the directions on my bottle.
Hi Susan,
You should always take medications as prescribed.
You can ask your doctor or pharmacist if you have a question about how to properly take this medication.
Is nystigmus always a component of menieres ? when I have an attack, I can feel my eyes firing and my vision is chaotic.. Im wondering if a muscle relaxer might help to control the eye muscles….I can feel the eye muscles firing if I place my fingertips over my eyes and press lightly.
The best approach to Meniere’s is to take steps to prevent an attack through dietary changes and medications prescribed by your doctor.
Your doctor can also advise on which medications may be helpful during a Meniere’s attack.
I suggest medicine practitioners then find a cure for vestibular disease such as BPPV and Menieres. Cause the cloudiness I experience or the outright debilitating vertigo I experience is not an acceptable trade off for the regular use of Meclizine.
Hi TC,
You are not alone in your frustration regarding vertigo!
Medication may still help short term use while waiting for proper treatment, or for cases where a recovery is not likely or a recurrence is probable.
The best way to determine if recovery is possible is to consult with an Otoneurologist, an Otologist, or a Neurotolgist, – or a vestibular physical therapist.
You can use this article to search for those types of providers in your area.
Best wishes!
The key to managing your vertigo is to find the root cause. I hope you can find that and work with a skilled provider to maximize your quality of life.
I just stumbled upon this information today when I was trying to figure out if I could take 2 Dramamine (Meclizine 25mg). I was on UpToDate when I saw the risk of long term use. I’m a bit concerned because although I’m only 25 I have been taking Meclinzine 25mg for at least 7 years intermittently, but within the last year I’ve taken it nearly daily. I actually do have terrible memory that has only worsened, but 1 year ago was diagnosed with ADHD, so I thought that may be the culprit. I ca. remember memories of when I was a child, but I can’t remember as clearly the last 4-5 years of my life, which I e just brushed off as me being “spacey”. Hopefully, this is not because of the Meclizine, but I will be scheduling an appointment with my PCM ASAP because I suffer from motion sickness very easily (daily) and have had vertigo attacks in the past. I will discontinue use of Meclizine for now, but I just wish people were aware of this and hopefully haven’t done the same thing as me.
Hi Victoria,
I’m so sorry to hear what you are going through!
Perhaps when you meet with your doctor to discuss safe use of medications, you can also ask for a referral to vestibular physical therapy.
In the meantime, I encourage you to take all medication as prescribed.
This article has two online directories that can help you search for vestibular physical therapy providers.
This article explains what a vestibular physical therapist is here.
That’s what I am! We are really into helping people with dizziness and vertigo without using medication.
If you cannot find a vestibular PT near you, then you can also look on Vestibular.org directory for a Neurotologist, an Otologist, or an Otoneurologist, which are very specialized physicians who may be able to help.
I wish you all the best!
Sincerely,
Dr. Kim Bell, DPT
Doctor of Physical Therapy
Specializing in Vestibular Rehabilitation
Thank you so much for this article ma’am!
Unfortunately, I’m stationed overseas in South Korea, so it’s a bit harder to seek out specialty care on my own.
Thankfully I did see my primary doctor last week and he put in a referral for me to see Neurology at a local hospital.
He did some of the head maneuvers (“Epleys” I believe) to see if I was potentially suffering from BPPV.
Unfortunately, I didn’t seem to fit the bill for that based off of the results.
Hopefully it’s nothing!
I’m assuming if neurology doesn’t find anything substantial I’ll be referred to ENT, which I’m surprised that wasn’t the first step.