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cinnarizine, combinations

N07CA52

Forms & Strengths

Fixed-dose combination tablets containing cinnarizine and dimenhydrinate (typically 20 mg cinnarizine / 40 mg dimenhydrinate)

Adult Dosing

Vestibular disorders/vertigo: 1 tablet orally three times daily after meals
Motion sickness prevention: 1 tablet orally 30 minutes before travel, may repeat every 8 hours if needed

Pediatric Dosing

Safety and efficacy in pediatric patients under 18 years have not been established; use is generally not recommended

Indications

Symptomatic treatment of vertigo of various origins
Prevention and treatment of motion sickness

Mechanism of Action

Cinnarizine acts as a selective calcium channel blocker, reducing vestibular stimulation and labyrinthine excitability
Dimenhydrinate acts as a histamine H1 receptor antagonist with significant anticholinergic and central sedative properties

Contraindications

Hypersensitivity to cinnarizine, dimenhydrinate, or diphenylmethane derivatives
Severe renal impairment (creatinine clearance < 25 mL/min)
Severe hepatic impairment
Pre-existing angle-closure glaucoma
History of seizures or convulsive disorders
Prostate enlargement with urinary retention
Parkinson's disease or extrapyramidal symptoms
Pregnancy and lactation

Adverse Reactions

Somnolence and drowsiness
Dry mouth
Weight gain
Headache
Fatigue
Somnolence
Stomach discomfort
Extrapyramidal symptoms with prolonged use in elderly patients (tremor, rigidity)

Drug Interactions

Central nervous system depressants (alcohol, barbiturates, opioids, sedatives) enhance sedative effects
Anticholinergic drugs (tricyclic antidepressants, atropine) increase anticholinergic adverse effects
Ototoxic medications (aminoglycosides) may have their ototoxic symptoms masked by cinnarizine/dimenhydrinate
Diagnostic skin tests for allergy may yield false-negative results due to antihistamine activity

Curated Content: Needs Vetting Before Put to Clinical Use