JAMA Otolaryngol HNS

Meclizine: Increased fall risk in adults with dizziness?

August 19, 2025

Study details: A large U.S. cohort study analyzed commercial and Medicare Advantage claims for 805,454 adults (median age 52, 62% women) newly diagnosed with dizziness between 2006 and 2015. Meclizine prescriptions filled within 30 days of diagnosis were tracked, and subsequent injurious falls requiring medical evaluation within 60 days were attributed to meclizine exposure. Multivariable analyses adjusted for sociodemographic and clinical factors.

Results:

• A total of 8% of patients received meclizine.
• Among those prescribed meclizine, 9% experienced an injurious fall (10% in ages 18–64, 9% in ages ≥65).
• Adjusted hazard ratios for falls were 2.94 (95% confidene interval [CI], 2.81–3.08) in adults 18 to 64 and 2.54 (95% CI, 2.42–2.66) in those ≥65, indicating a significant association between meclizine use and increased fall risk.

Clinical impact: Despite its frequent use, meclizine is incongruent with guideline recommendations for most vestibular diagnoses. Clinicians should reconsider routine meclizine prescribing for dizziness, given the elevated risk of injurious falls in both younger and older adults.

Source:

Adams ME, et al. (2025, July 24). JAMA Otolaryngol Head Neck Surg. Meclizine Use and Subsequent Falls Among Patients With Dizziness. https://pubmed.ncbi.nlm.nih.gov/40705353/