Cinnarizine - Uses, Dosage, Side Effects, Interactions, and Precautions

Overview:

Cinnarizine is an antihistamine used to treat nausea and vomiting due to motion sickness. It is also known as drowsy histamine as it makes you sleepy compared to other antihistamines. Cinnarizine is an FDA-approved (Food and Drug Administration) therapy for vestibular disorder as it intercepts the signal between the middle ear and the hypothalamus, reducing the impulse to vomit.

Drug Group:

Cinnarizine is a type of medication called an antihistamine. These drugs block the effects of histamine in the brain and reduce travel sickness symptoms. Each tablet contains 15 mg of Cinnarizine and 162.5 mg of lactose anhydrous.

What Is Cinnarizine Used For?

Cinnarizine is considered the first-line pharmacotherapy for managing vertigo, tinnitus, Meniere’s disease, and other middle ear disorders. It helps to treat problems affecting the inner ear and balance. The antihistamine is primarily used to treat nausea and vomiting associated with motion sickness. Cinnarizine blocks the histamine action and reduces allergy symptoms such as hives, itchy skin, or facial swelling. Cinnarizine is also used to treat body balancing problems caused by Meniere disease (a disorder of the inner ear), vertigo (spinning sensation or dizziness, and hearing loss.

How Does Cinnarizine Work?

Cinnarizine is an antihistamine and a calcium-channel blocker. It is a non-competitive antagonist of smooth muscle contraction caused by various vasoactive agents, including histamine. It acts on the smooth muscle by selectively inhibiting the transport of calcium ions across cell membranes into depolarized cells. This reduces the availability of free calcium for the induction and maintenance of contraction. Cinnarizine helps to improve blood flow in the inner ear and reduce symptoms caused by vertigo, tinnitus (ringing in the ears), and Meniere’s disease.

What Is the Onset of Action of Cinnarizine?

The absorption of Cinnarizine is relatively slow after oral administration and reaches the peak serum concentration after three to four hours. The plasma protein binding of Cinnarizine is 91 %. The drug undergoes extensive metabolism, mainly through CYP2D6. Two-thirds of the metabolites are excreted with the feces, and the remaining unchanged metabolites and glucuronide conjugates are excreted during the first five days of a single dose.

Habit-Forming:

There have been no reports of habit-forming tendencies in people taking Cinnarizine.

Expiry Date:

Avoid taking this medicine after it expires. Check for the expiry on the back of the medicine pack.

What Is the Dosage of Cinnarizine?

The recommended dose of Cinnarizine is 25 mg to 75 mg daily in divided doses.

Taking too much Cinnarizine can cause severe side effects such as sleepiness, confusion, weak or shaky, fast, uneven, or pounding heartbeat.

How to Use Cinnarizine?

Cinnarizine tablets may be taken with or without food or one to two hours before traveling. However, taking medicine after a meal is best to avoid stomach upset. The tablet should be swallowed whole with a glass of water and not crushed or chewed. Like all other medicines, Cinnarizine should be stored in a cool, dry place away from the reach of children and pets.

Missed Dose:

In case of a missed dose of Cinnarizine, take it soon after you remember. However, do not take two tablets together as it may cause adverse reactions. Always space the doses at least eight hours apart.

What Are the Drug Warnings and Precautions?

• Hypersensitivity - Cinnarizine should not be taken if you are allergic to the drug or its components, as it can cause severe adverse effects.

• Pregnancy and Breastfeeding - Cinnarizine is a pregnancy category C drug and is usually not recommended during pregnancy or breastfeeding.

• Alcohol - Avoid intake of alcohol while taking Cinnarizine, as it can cause increased drowsiness, dizziness, and lack of concentration.

• Geriatrics - Cinnarizine should be cautiously administered in older people as it may have aggravated side effects like muscle stiffness, trembling, or jerky body movements and may cause them to fall.

• Mind Alertness - Cinnarizine is known to cause drowsiness, dizziness, and lack of concentration and should not be taken while driving or operating machinery that may require mental alertness.

• Parkinson's Disease - Taking Cinnarizine can aggravate or worsen the condition when taken by people with Parkinson’s disease.

• Galactose Intolerance - Cinnarizine tablets contain lactose. Patients with rare hereditary problems of galactose intolerance or glucose-galactose malabsorption should avoid taking Cinnarizine.

• Children - Cinnarizine should not be given to children under five of age, as it can cause severe adverse effects.

• Renal and Hepatic Insufficiency - Cinnarizine must be administered with v=cautio in patients with hepatic and renal dysfunction.

What Are the Side Effects of Cinnarizine?

Cinnarizine can cause side effects such as

• Sleepiness.

• Dry mouth.

• Sweating.

• Headache.

• Weight gain.

• Skin problems.

• Lethargy.

• Indigestion.

Some serious side effects may include

• Slow, twitchy, or jerky body movements.

• Muscle stiffness.

• Yellowing of the skin or eyes- may be a sign of liver problems.

• Joint pain.

• Skin rash, especially in body parts exposed to the sun, such as arms, cheeks, and nose.

• Anaphylaxis.

What Are the Interactions of Cinnarizine?

Certain medicines may interfere with the effectiveness of Cinnarizine and may also increase the risk of side effects.

Drug Interactions:

• Central nervous systems depressants, such as Diazepam, Clonazepam, Alprazolam, and Triazolam. Taking these drugs together can increase the risk of drowsiness or sleepiness.

• Non-benzodiazepine sedative-hypnotics, such as Zolpidem, Eszopiclone, and Zaleplon as it increases the sedating effect of the drug.

• Barbiturates, such as Mephobarbital, Phenobarbital, and Pentobarbital sodium.

• Tricyclic antidepressants include Amitriptyline, Amoxapine, Desipramine, Doxepin, Imipramine, Nortriptyline, Protriptyline, Trimipramine, and Zopiclone.

• Opioid painkillers, such as Morphine, Codeine, Tramadol, and Fentanyl as it can cause severe adverse effects.

Skin Prick Test - It is advised to stop taking Cinnarizine at least 48 hours before taking any skin prick tests. The antihistamine may lessen the skin reaction indicating an allergy or make the test results unreliable.

Food Interaction:

• Alcohol - It is advised to avoid alcohol while taking Cinnarizine as it may cause increased drowsiness, dizziness, and lack of concentration.

What Are the Common Brands or Trade Names of Cinnarizine?

1. Tablet Cinna 25 mg.

2. Tablet Stugeron 25 mg.

3. Tablet Axcel Cinnarizine 25 mg.

4. Tablet Vertizine 25 mg.

5. Tablet Syzeron 25 mg.

6. Tablet Cinz 25 mg.

7. Tablet Neurozine 75 mg.

8. Tablet Cinvert 25 mg.

9. Tablet Cinaver 25 mg.

10. Tablet Diznil 25 mg.