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- an antihistamine (trade name Antivert) used to treat or prevent motion sickness (同)meclizine_hydrochloride, Antivert
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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/12/30 12:55:48」(JST)
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"Dramamine II" redirects here. For other uses, see Dramamine (disambiguation).
| Systematic (IUPAC) name | |
|---|---|
| (RS)-1-[(4-chlorophenyl)(phenyl)methyl]-4-(3-methylbenzyl)piperazine | |
| Clinical data | |
| MedlinePlus | a682548 |
| Pregnancy cat. | B (US) |
| Legal status | OTC (US); OTC (Canada) |
| Routes | Oral, Sublingual/Buccal |
| Pharmacokinetic data | |
| Metabolism | hepatic |
| Half-life | 6 hours |
| Identifiers | |
| CAS number | 569-65-3 |
| ATC code | R06AE05 |
| PubChem | CID 4034 |
| IUPHAR ligand | 2757 |
| DrugBank | DB00737 |
| ChemSpider | 3894 Y |
| UNII | 3L5TQ84570 Y |
| ChEMBL | CHEMBL1623 |
| Chemical data | |
| Formula | C25H27ClN2 |
| Mol. mass | 390.948 g/mol |
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| Physical data | |
| Boiling point | 230 °C (446 °F) |
| Y (what is this?) (verify) |
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Meclozine (INN,[1] or meclizine) is an antihistamine considered to be an antiemetic. It is sold under the brand names Bonine, Bonamine, Antivert, Postafen, Sea Legs, and Dramamine (Less Drowsy Formulation). Emesafene is a combination of meclozine (1/3) and pyridoxine (2/3). In Canada, Antivert Tab (which is no longer available) was a combination of meclozine and nicotinic acid.[2]
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Classification
Meclozine is a first-generation antihistamine of the piperazine class. Meclozine is structurally and pharmacologically similar to buclizine, cyclizine, and hydroxyzine, but has a shorter half-life of six hours compared to cyclizine and hydroxyzine with about 20 hours. It is used as an antivertigo/antiemetic agent, specifically in the prevention and treatment of nausea, vomiting, and dizziness associated with motion sickness.[3]
Mechanism of action
Meclozine is an antagonist at H1 receptors. It possesses anticholinergic, central nervous system depressant, and local anesthetic effects. Its antiemetic and antivertigo effects are not fully understood, but its central anticholinergic properties are partially responsible. The drug depresses labyrinth excitability and vestibular stimulation, and it may affect the medullary chemoreceptor trigger zone.[3]
Uses
Meclozine is approved by the U.S. Food and Drug Administration (FDA) to treat symptoms of motion sickness and for management of vertigo that stems from diseases affecting the vestibular system. Meclozine's safety and efficacy in children younger than 12 years old has not been established, therefore use in this population is not recommended. Also, meclozine should be taken with caution in the elderly (older than 65 years) because of increased risk of confusion and amnesia.[4]
Motion sickness
Meclozine is effective in inhibiting the symptoms of motion sickness, such as nausea, vomiting, and dizziness. The recommended dose is 25–50 mg orally, taken 1 hour before travel. The dose may be repeated every 24 hours as needed.[3]
The drug is also safe for treating nausea in pregnancy[5] and is a first-line therapy for this use.[6][7] Doxylamine is similarly safe.
Vertigo
Meclozine may be effective in relieving vertigo experienced as a result of inner ear infections or other conditions. The recommended dose is 25–100 mg per day orally, separated into divided doses.[3]
Side effects
Some common side effects such as drowsiness, dry mouth, and tiredness may occur. Meclozine has been shown to have fewer dry mouth side effects than the traditional treatment for motion sickness, transdermal scopolamine.[8] A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling, severe dizziness, and/or trouble breathing.[9]
Drowsiness
Drowsiness may result as a side effect of taking meclozine. Users are advised not to operate heavy machinery while under the influence. The consumption of alcohol while under the influence of meclozine may result in additional drowsiness.
Special considerations in the elderly
As with any anticholinergic agent, meclozine may cause confusion or aggravate symptoms in those with dementia in the geriatric population (older than 65 years). Therefore caution should be used when administering meclozine to the elderly.[10]
Synthesis
(4-Chlorphenyl)-phenylmethanol is halogenated with thionyl chloride before adding acetylpiperazine. The acetyl group is cleaved with diluted sulfuric acid. An N-alkylation of the piperzine ring with 3-methylbenzylchloride completes the synthesis.[11]
Alternatively, the last step can be replaced by a reductive N-alkylation with 3-methylbenzaldehyde. The reductive agent is hydrogen, and Raney nickel is used as a catalyst.[12][13]
Meclozine is obtained and used as a racemate, a 1:1 mixture of the two stereoisomers. Drug forms contain the dihydrochloride.
References
- ^ KEGG Drug: D08163
- ^ DrugBank. Drugbank: Drug card for Meclizine David Wishard: University of Alberta, Canada. Accessed November 7, 2010.
- ^ a b c d Clinical Pharmacology. Clinical Pharmacology, revised November 20, 2009, accessed November 7, 2010.[broken citation]
- ^ MICROMEDEX 2.0. Accessed November 7, 2010.[broken citation]
- ^ Källén B, Mottet I (2003). "Delivery outcome after the use of meclozine in early pregnancy". European Journal of Epidemiology 18 (7): 665–669. PMID 12952140. http://www.kluweronline.com/art.pdf?issn=0393-2990&volume=18&page=665. Retrieved 2010-09-17.
- ^ "Antiemetische Therapie bei Schwangerschaftserbrechen [Antiemetic therapy in pregnancy]" (in German). Arznei-Telegramm 40: 87–89. 2009. http://www.arznei-telegramm.de/html/2009_10/0910087_01.html.
- ^ Embryotox: Meclozin (German)
- ^ Dahl E, Offer-Ohlsen D, Lillevold PE, Sandvik L. Transdermal scopolamine, oral meclozine, and placebo in motion sickness. Clinical Pharmacology And Therapeutics [Clin Pharmacol Ther] 1984 Jul; Vol. 36 (1), pp. 116-20. Available from: MEDLINE: Ipswich, MA. PMID 6734040
- ^ Meclizine - oral, Antivert, D-vert, Dramamine II. Accessed November 7, 2010.
- ^ Merck Manuals, Online Medical Library: Meclizine (Drug Information Provided by Lexi-Comp), revised January 2010, accessed November 7, 2010.
- ^ J.-H. Fuhrkop, G. Li (2003). Organic Synthesis. Concepts and Methods. Wiley. p. 237. ISBN 978-3-527-30272-7.
- ^ US 2 709 169 (UCB, 1955)
- ^ A. Kleemann, J. Engel, B. Kutscher, D. Reichert (2001). Pharmaceutical Substances. Synthesis, Patents, Applications (4 ed.). Thieme. ISBN 3-13-115134-X.
External links
- University of Berlin's Institute of Biochemistry
- Numark Pharmacies Information Page on Meclozine
- Rxlist Medical Dictionary
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UpToDate Contents
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- 1. 回転性めまいの治療 treatment of vertigo
- 2. 乗物酔い motion sickness
- 3. コーガン症候群 cogans syndrome
- 4. 妊娠の悪心および嘔吐の治療および転帰 treatment and outcome of nausea and vomiting of pregnancy
- 5. メニエール病 meniere disease
English Journal
- Preparation of an oral thin film containing meclizine hydrochloride: In vitro and in vivo evaluation.
- Zhao Y1, Quan P1, Fang L2.
- International journal of pharmaceutics.Int J Pharm.2015 Oct 9. pii: S0378-5173(15)30274-X. doi: 10.1016/j.ijpharm.2015.10.008. [Epub ahead of print]
- Oral thin film (OTF) is a preparation of postage stamp size, with advantages of flexible, tasty and without water for oral administration. A commercial product (Zentrip®) was developed for people who suffered from motion sickness. In order to improve the mechanical strength of Zentrip®, OTF contai
- PMID 26456247
- Advances in treatment of achondroplasia and osteoarthritis.
- Klag KA1, Horton WA2.
- Human molecular genetics.Hum Mol Genet.2015 Oct 6. pii: ddv419. [Epub ahead of print]
- Achondroplasia (ACH) is the prototype and most common of the human chondrodysplasias. It results from gain-of-function mutations that exaggerate the signal output of the fibroblast growth factor receptor 3 (FGFR3), a receptor tyrosine kinase that negatively regulates growth plate activity and linear
- PMID 26443596
- Meclizine, a pregnane X receptor agonist, is a direct inhibitor and mechanism-based inactivator of human cytochrome P450 3A.
- Foo WY1, Tay HY2, Chan EC3, Lau AJ4.
- Biochemical pharmacology.Biochem Pharmacol.2015 Oct 1;97(3):320-30. doi: 10.1016/j.bcp.2015.07.036. Epub 2015 Jul 31.
- Meclizine is an agonist of human pregnane X receptor (PXR). It increases CYP3A4 mRNA expression, but decreases CYP3A-catalyzed testosterone 6β-hydroxylation in primary cultures of human hepatocytes, as assessed at 24h after the last dose of meclizine. Therefore, the hypothesis to be tested is that
- PMID 26239802
Related Links
- Thesaurus Legend: Synonyms Related Words Antonyms Noun 1. meclizine hydrochloride - an antihistamine (trade name Antivert) used to treat or prevent motion sickness Antivert, meclizine antihistamine - a medicine used to treat ...
- Meclizine, a piperazine-derivative H 1 -receptor antagonist similar to buclizine, cyclizine... ... Meclizine, a piperazine-derivative H 1-receptor antagonist similar to buclizine, cyclizine, and hydroxyzine, is used as an antivertigo ...
Related Pictures
★リンクテーブル★
| リンク元 | 「メクロジン」「meclizine hydrochloride」 |