Pharmacological Classification: Antihistamine, antiemetics and antivertigo preparations.
Pharmacology: Cinnarizine inhibits contractions of vascular smooth muscle cells by blocking calcium channels.
Cinnarizine increases erythrocyte deformability and decreases blood viscosity in vitro.
Cinnarizine inhibits stimulation of the vestibular system.
The peak plasma levels of cinnarizine are obtained 1-3 hrs after intake. Cinnarizine disappears from plasma with a t½ of 4 hrs.
Cinnarizine is completely metabolised. About 1/3 of these metabolites are eliminated in the urine and 2/3 in the faeces.
The plasma protein-binding of cinnarizine is 91%.
Control of vestibular symptoms of both peripheral and central origin and of labyrinthine disorders including vertigo, dizziness, tinnitus, nystagmus, nausea and vomiting; prophylaxis of motion sickness; adjunct therapy for symptoms of peripheral arterial disease.
Adults and Children >12 years: Peripheral Circulatory Disorders: Two to three 25-mg tab 3 times daily.
Disorders of Balance: One 25-mg tab 3 times daily.
The maximum recommended dosage should not exceed 225 mg (9 tabs) daily, if necessary the dosage may be divided over 2 or 3 intakes/day. As the effect of Vertigon on vertigo is dose dependent, the dosage should be increased progressively.
Motion Sickness: Adults: 25 mg may be taken 2 hrs before the start of the journey and 12.5-25 mg may be repeated every 8 hrs during the journey when necessary.
Children 8-12 years: 12.5 mg 3 times daily when necessary; 5-7 years: 6.25 mg 3 times daily when necessary.
As with other antihistamines, Vertigon may cause epigastric distress; taking it after meals may diminish gastric irritation.
Symptoms: Overdose may be fatal especially in infants and children in whom the main symptoms are central nervous system (CNS) stimulation and antimuscarinic effects including ataxia, excitement, hallucinations, muscle tremor, convulsions, dilated pupils, dry mouth, flushed face and hyperpyrexia. Deepening coma, cardiorespiratory collapse and death may occur within 18 hrs. In adults, the usual symptoms are CNS depression with drowsiness, coma and convulsions. Hypertension may also occur.
Treatment: Treatment is symptomatic and supportive.
Known hypersensitivity to cinnarizine and patients with Parkinson's disease.
Effects on the Ability to Drive or Operate Machinery: Vertigon may lead to drowsiness and impaired concentration which may be aggravated by simultaneous intake of alcohol or other central nervous system depressants.
Patients should not operate hazardous machinery or drive motor vehicles or perform potentially hazardous tasks where loss of concentration may lead to accidents.
Use in pregnancy & lactation: The safety of Vertigon in pregnant and lactating women has not been established.
The safety of Vertigon in pregnant and lactating women has not been established.
The most common antihistaminic side effect of cinnarizine is sedation which can vary from slight drowsiness to deep sleep including inability to concentrate, lassitude, dizziness and incoordination. Sedative effects, when they occur, may diminish after a few days.
Other side effects include GI disturbances eg, nausea, vomiting, diarrhoea or constipation, anorexia or increased appetite and epigastric pain.
Somnolence and GI disturbances are usually transient and may often be prevented by achieving the optimum dosage gradually.
Cinnarizine may also produce antimuscarinic effects eg, blurred vision, difficulty in micturition, dysuria, dryness of mouth and tightness of chest.
Central effects may include muscular weakness, headache and euphoria.
Weight gain, perspiration or allergic reactions may be observed. Cases of lichen planus and lupus-like symptoms and an isolated case of cholestatic jaundice have been reported.
In elderly people, cases of aggravation or an appearance of extrapyramidal symptoms sometimes associated with depressive feelings have been described during prolonged therapy. The treatment should be discontinued in such cases.
Cinnarizine may enhance the sedative effect of CNS depressants including alcohol, barbiturates, hypnotics, narcotic analgesics, tricyclic antidepressants, sedatives and tranquilisers.
The side effects of anticholinergic substances eg, atropine and tricyclic antidepressants may be enhanced by the concomitant administration of antihistamines.
Monoamine oxidase inhibitors may enhance the antimuscarinic effects of antihistamines.
Store in a cool, dark and dry place.
N07CA02 - cinnarizine ; Belongs to the class of antivertigo preparations.
Tab 25 mg x 4 x 5 x 10's.
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