Cinnarizine


Generic Medicine Info
Indications and Dosage
Oral
Labyrinthine disorder
Adult: For symptoms of labyrinthine disorders, including dizziness, vertigo, tinnitus, nystagmus, nausea and vomiting: As tab: 25 mg or 30 mg tid. As cap: 75 mg once daily. Dosage recommendations may vary among individual products or between countries (refer to detailed product guidelines).
Child: As 15 mg tab: 5-12 years 15 mg tid; >12 years Same as adult dose.

Oral
Cerebrovascular disorders
Adult: As cap: 75 mg once daily.

Oral
Prophylaxis of motion sickness
Adult: As 15 mg tab: Initially, 30 mg to be taken 2 hours before travel, then 15 mg 8 hourly during the journey if necessary. As 25 mg tab: 25 mg to be taken at least 30 minutes before travel, may be repeated 6 hourly if necessary. Dosage recommendations may vary among individual products or between countries (refer to detailed product guidelines).
Child: As 15 mg tab: 5-12 years Initially, 15 mg to be taken 2 hours before travel, then 7.5 mg 8 hourly during the journey if necessary; >12 years Same as adult dose. As 25 mg tab: 6-12 years 12.5 mg to be taken at least 30 minutes before travel, may be repeated 6 hourly if necessary; ≥13 years Same as adult dose. Dosage recommendations may vary among individual products or between countries (refer to detailed product guidelines).

Oral
Peripheral circulatory disorders
Adult: As 25 mg tab: 50-75 mg 2-3 times daily. Max: 225 mg daily.
Administration
Should be taken with food.
Special Precautions
Patient with Parkinson's disease. Avoid use in a patient with porphyria. Renal and hepatic impairment. Children. Pregnancy. Not recommended for use during breastfeeding.
Adverse Reactions
Significant: Epigastric discomfort, drowsiness; new-onset or aggravation of parkinsonian symptoms.
Gastrointestinal disorders: Nausea, vomiting, dry mouth.
General disorders and administration site conditions: Fatigue.
Immune system disorders: Hypersensitivity reaction.
Investigations: Increased weight.
Nervous system disorders: Headache.
Psychiatric disorders: Hypersomnia.
Skin and subcutaneous tissue disorders: Hyperhidrosis, lichenoid keratosis (including lichen planus).
Patient Counseling Information
This drug may cause drowsiness, if affected, do not drive or operate machinery.
Monitoring Parameters
Monitor for new-onset or aggravation of parkinsonian symptoms.
Overdosage
Symptoms: Vomiting, extrapyramidal symptoms, hypotonia, seizures, and altered consciousness (ranging from somnolence to stupor and coma). Management: Supportive and symptomatic treatment.
Drug Interactions
May potentiate sedative effects with CNS depressants (e.g. barbiturates, hypnotics, opioid analgesics, antipsychotic agents, anxiolytics) or TCAs.
Food Interaction
Alcohol may potentiate the sedative effects of cinnarizine.
Lab Interference
May cause a false-negative result to dermal reactivity indicators when used within 4 days before skin testing.
Action
Description: Cinnarizine, a piperazine derivative, has antihistamine, sedative, and Ca channel blocking activity. It selectively inhibits the Ca influx into the depolarised cells in the vascular smooth muscle, thus decreasing the availability of free Ca ions for induction and maintenance of contraction. It has also been shown to be a non-competitive antagonist of smooth muscle contractions caused by various vasoactive agents (including histamine). Additionally, it suppresses nystagmus and other autonomic disturbances by preventing the stimulation of the vestibular system.
Pharmacokinetics:
Absorption: Absorbed from the gastrointestinal tract (relatively slow). Time to peak plasma concentration: 1-4 hours.
Distribution: Plasma protein binding: 91%.
Metabolism: Extensively metabolised primarily by CYP2D6 isoenzyme.
Excretion: Via faeces (approx 67%) and urine (approx 33%) as metabolites. Elimination half-life: 4-24 hours.
Chemical Structure

Chemical Structure Image
Cinnarizine

Source: National Center for Biotechnology Information. PubChem Database. Cinnarizine, CID=1547484, https://pubchem.ncbi.nlm.nih.gov/compound/Cinnarizine (accessed on Jan. 21, 2020)

Storage
Store between 15-30°C. Protect from light.
MIMS Class
Antivertigo Drugs / Peripheral Vasodilators & Cerebral Activators
ATC Classification
N07CA02 - cinnarizine ; Belongs to the class of antivertigo preparations.
References
Anon. Cinnarizine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 03/02/2022.

Buckingham R (ed). Cinnarizine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/02/2022.

Dizzinon Forte 75 mg Capsule (Lloyd Laboratories, Inc.). MIMS Philippines. http://www.mims.com/philippines. Accessed 03/02/2022.

Joint Formulary Committee. Cinnarizine. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/02/2022.

Stugeron (Johnson & Johnson Pte Ltd.). MIMS Singapore. http://www.mims.com/singapore. Accessed 14/03/2022.

Stugeron 15 mg Tablets (Janssen-Cilag Limited). MHRA. https://products.mhra.gov.uk. Accessed 03/02/2022.

Stugeron 25 mg Tablets (Johnson & Johnson Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 03/02/2022.

Disclaimer: This information is independently developed by MIMS based on Cinnarizine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2022 MIMS. All rights reserved. Powered by MIMS.com
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