Dimenhydrinate/Cinnarizine

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Contents

[edit] BRAND NAMES

[edit] STRUCTURE

[edit] MECHANISM OF ACTION

Both cinnarizine and dimenhydrinate are known to be effective in the treatment of vertigo. The combination product is more effective than the individual compounds:

  • Dimenhydrinate, an anti-nauseant/antimemetic is the 8-Chlorotheophylline salt of diphenhydramine. 8-Chlorotheophylline, a mild central nervous system stimulants was added in order to counteract drowsiness.
    Dimenhydrinate acts as antihistamine (H1-antagonist) with anticholinergic (antimuscarinic), exerting parasympatholytic and centrally-depressant effects. its antiemetic and antivertiginous effects may be related to the central anticholinergic actions on the central vestibular system: Dimenhydrinate diminish vestibular stimulation and depress labyrinthine function.
  • Cinnarizine is an histamine H1 antagonist, a calcium channel blocker that inhibits contractions of vascular smooth muscle cells by blocking T-type voltage gated calcium channels and a muscarinic acetycholine receptors antagonist.
    Cinnarizine reduces the vestibular sensitivity, preventing acute episodes of vertigo.

[edit] INDICATIONS

  • Treatment of vertigo symptoms of various origins

[edit] DOSAGE

  • Adults and Elderly: 1 tablet (20 mg cinnarizine/40 mg dimenhydrinate) three times daily, to be taken unchewed with some liquid after meals to minimise any gastric irritation.

[edit] CONTRAINDICATIONS

  • Hypersensitivity to Dimenhydrinate or Cinnarizine
  • Severe hepatic impairment
  • Severe renal impairment
  • Patients with angle-closure glaucoma
  • Urine retention due to an enlargement of the prostate gland
  • Patients with convulsions

[edit] WARNINGS AND PRECAUTIONS

  • May reduce blood pressure: Use with caution in hypotensive patients.
  • Use with caution in patients with conditions that might be aggravated by anticholinergic therapy, e.g. raised intra-ocular pressure, pyloro-duodenal obstruction, prostatic hypertrophy, hypertension, hyperthyroidism or severe coronary heart disease.
  • Avoid alcoholic beverages.
  • May cause drowsiness, especially at the start of treatment. Patients affected in this way should not drive or operate machinery.

[edit] INTERACTIONS

  • The effects of hypnotic, sedative and tranquilizing drugs may be synergistic if given concomitantly.
  • Concomitant administration of medicines that prolong the QT interval of the ECG (such as Class Ia and Class III antiarrhythmics: disopyramide, amiodarone, sotalol) should be avoided

[edit] PREGNANCY AND LACTATION

  • Should not be used during pregnancy
  • Dimenhydrinate and cinnarizine are excreted in human breast milk. the drug should not be taken by women who are breast feeding.

[edit] SIDE EFFECTS

The most frequently occurring are somnolence (including drowsiness, tiredness, fatigue, daze) and dry mouth. These reactions are usually mild and disappear within a few days even if treatment is continued.

[edit] RELATED LINKS

[edit] BIBLIOGRAPHY

[edit] REFERENCES

Vertigo
Betahistine   Cinnarizine   Dimenhydrinate/Cinnarizine   Flunarizine   Piracetam   Prochlorperazine
Antiemetics
5-HT3 receptor antagonists Dolasetron   Granisetron   Ondansetron   Palonosetron   Tropisetron
Dopamine antagonists Alizapride   Bromopride   Clebopride   Domperidone   Metoclopramide   Prochlorperazine   Thiethylperazine
H1 antagonists Dimenhydrinate   Meclizine
NK1 receptor antagonists‎ Aprepitant   Fosaprepitant   Maropitant
Motion sickness‎ Cinnarizine   Dimenhydrinate   Meclizine   Meclizine/Pyridoxine   Scopolamine (Patch)
Pregnancy Meclizine/Pyridoxine   Ondansetron
Veterinary Maropitant