BMA Concise Guide to Medicine & Drugs

Cinnarizine

Brand names Cinaziere, Stugeron

Used in the following combined preparation Arlevert

QUICK REFERENCE

Drug group Antihistamine anti-emetic drug

Overdose danger rating Medium

Dependence rating Low

Prescription needed No

Available as generic Yes

GENERAL INFORMATION

Introduced in the 1970s, cinnarizine is an antihistamine used mainly to control nausea and vomiting, especially motion (travel) sickness. The drug is also used to control the symptoms (nausea and vertigo) of inner ear disorders such as labyrinthitis and Ménière’s disease. Taken in high doses, cinnarizine has a vasodilator effect.

Cinnarizine has adverse effects that are similar to those of most other antihistamines. Drowsiness is the most common problem, but it is usually less severe than with other antihistamines.

INFORMATION FOR USERS

Follow instructions on the label. Call your doctor if symptoms worsen.

How taken/used Tablets, capsules.

Frequency and timing of doses 2–3 x daily. For the prevention of motion sickness, the first dose should be taken 2 hours before travel.

Dosage range Adults 90mg daily (nausea/vomiting); 30mg 2 hours before travel, then 15mg every 8 hours as needed (motion sickness). Children aged 5–12, 15mg 2 hours before travel, then 7.5mg every 8 hours as needed (motion sickness).

Onset of effect Within 2 hours.

Duration of action Up to 8 hours.

Diet advice None.

Storage Keep in original container at room temperature out of the reach of children.

Missed dose Take as soon as you remember. If your next dose is due within 2 hours, take a single dose now and skip the next.

Stopping the drug If you are taking cinnarizine to treat an inner ear disorder, do not stop the drug without consulting your doctor; symptoms may recur. However, when taken for motion sickness, the drug can be safely stopped as soon as you no longer need it.

Exceeding the dose An occasional unintentional extra dose is unlikely to cause problems. Large overdoses may cause drowsiness or agitation. Notify your doctor.

POSSIBLE ADVERSE EFFECTS

Drowsiness is the main adverse effect of cinnarizine. Anticholinergic effects, such as blurred vision and dry mouth, may also occur occasionally. Rarely, the drug may cause gastrointestinal problems. If these side effects become severe, notify your doctor. If you develop a rash, stop taking the drug and consult your doctor.

INTERACTIONS

General note All drugs that have a sedative effect on the central nervous system may increase the sedative properties of cinnarizine. Such drugs include sleeping drugs, antidepressants, anti-anxiety drugs, and opioid analgesics.

SPECIAL PRECAUTIONS

Be sure to tell your doctor if:

· You have low blood pressure.

· You have Parkinson’s disease.

· You have glaucoma.

· You have porphyria.

· You have an enlarged prostate.

· You are taking other medicines.

Pregnancy Safety in pregnancy not established. Discuss with your doctor.

Breast-feeding Safety not established. Discuss with your doctor.

Infants and children Reduced dose necessary.

Over 60 No special problems.

Driving and hazardous work Avoid such activities until you have learned how cinnarizine affects you because the drug can cause drowsiness.

Alcohol Avoid. Alcohol may increase the sedative effects of this drug.

PROLONGED USE

Development or aggravation of extrapyramidal symptoms (abnormal movements) may occur rarely in the elderly after prolonged use of cinnarizine, and treatment should be discontinued.