Meclizine May Ease Dizziness but Raises Chances of Injurious Falls, Study Shows
USA: A large U.S. cohort study found meclizine, a common vestibular suppressant for dizziness, is linked to a significantly higher risk of injurious falls in both younger and older adults. The findings, from Dr. Meredith E. Adams and colleagues at the University of Minnesota, were published in JAMA Otolaryngology–Head & Neck Surgery.
Meclizine, an antihistamine with anticholinergic effects, provides short-term relief from vertigo and dizziness. However, routine use is questioned due to sedative properties and potential to impair balance and cognition, which increase fall risk. The new analysis highlights safety concerns when prescribing meclizine, especially for patients vulnerable to falls.
Researchers reviewed data from over 805,000 adults diagnosed with dizziness (2006–2015). Of these, 62,000 (8%) filled a meclizine prescription within 30 days. Outcomes were compared between those who did and did not receive meclizine.
The study led to the following findings:
- 9% of meclizine users experienced an injurious fall within 60 days of prescription, compared with 4% of patients who did not receive the drug.
- After adjusting for sociodemographic and clinical factors, meclizine use was linked to a nearly threefold higher risk of injurious falls among adults aged 18 to 64 years (HR, 2.94).
- Patients aged 65 years and older had a 2.5-fold higher risk of injurious falls associated with meclizine use (HR, 2.54).
- The elevated risk was observed across both younger and older adults, indicating that the harms are not limited to older populations.
- While older adults are already prone to balance issues and falls, younger adults with dizziness were also significantly affected.
“Although meclizine may offer immediate symptom relief, our findings indicate that its use is inconsistent with evidence-based guidelines for common vestibular disorders and may expose patients to unnecessary harm,” the authors noted.
The study highlights the importance of re-evaluating prescribing practices for dizziness. Falls are a major cause of morbidity, hospitalization, and loss of independence in both older and middle-aged adults. The inappropriate use of vestibular suppressants such as meclizine may therefore contribute to preventable adverse outcomes.
The researchers suggest that prospective clinical trials and mechanistic studies are needed to better understand the relationship between vestibular suppressant medications and fall risk. They also emphasized the need for future clinical guidelines that discourage routine meclizine prescriptions for dizziness and instead promote safer, evidence-based management strategies.
"While meclizine has been widely used for decades to treat dizziness, this large-scale study highlights a significant safety trade-off. Clinicians are encouraged to weigh the short-term symptomatic benefits against the long-term risks of falls, and to consider alternative approaches that align with best practice recommendations,' the authors concluded.
Reference:
Adams ME, Karaca-Mandic P, Marmor S. Meclizine Use and Subsequent Falls Among Patients With Dizziness. JAMA Otolaryngol Head Neck Surg. Published online July 24, 2025. doi:10.1001/jamaoto.2025.2052
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