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Cinnarizine

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Cinnarizine

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Treatment option:

Medically reviewed

Rosario Oropesa

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

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Overview of Cinnarizine

What is Cinnarizine?

Cinnarizine is a medicinal compound classified as an antihistamine and a calcium channel blocker. It is primarily used to manage symptoms associated with balance disorders and motion sickness. By acting on the vestibular system—the complex apparatus in the inner ear responsible for maintaining equilibrium—it helps to reduce the sensations of spinning and instability.

Mechanism of Action

The substance works through a dual mechanism. As an antihistamine, it inhibits the H1 receptors, which plays a role in reducing nausea and vomiting. Simultaneously, as a calcium channel blocker, it inhibits the influx of calcium ions into the vestibular sensory cells and vascular smooth muscle. This action helps to dampen the overstimulation of the inner ear and can improve local microcirculation.

Common Uses

Cinnarizine is frequently utilized for the following conditions:

  • Motion Sickness: Prevention and treatment of nausea, vomiting, and dizziness associated with travel by sea, air, or land.
  • Vestibular Disorders: Management of symptoms related to Meniere's disease and other labyrinthine disturbances, such as vertigo and tinnitus (ringing in the ears).
  • Circulatory Issues: In some contexts, it is used to support the management of peripheral circulatory symptoms, such as those involving the extremities or cognitive functions related to cerebral blood flow.

Pharmacological Profile

Once ingested, cinnarizine is absorbed through the gastrointestinal tract. It is characterized by its ability to cross the blood-brain barrier, which contributes to its sedative properties and its efficacy in treating central nervous system-related vertigo. The compound is metabolized by the liver and eliminated through both urine and feces.

Regulatory References

  1. WHO Essential Medicines List
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What side effects are possible with Cinnarizine?

Possible Side Effects and Safety Information

The adverse reactions and safety profile of Cinnarizine are based on official regulatory documents, defining both common and clinically significant effects.

Frequency-Classified Adverse Reactions

The following effects are categorized by their official frequency of occurrence:

Classification Adverse Reactions
Common (≥ 1/100 to < 1/10) Somnolence (Drowsiness), Nausea, Weight Increased
Uncommon (≥ 1/1,000 to < 1/100) Vomiting, Upper Abdominal Pain, Dyspepsia, Hypersomnia, Fatigue
Not Known (Cannot be estimated) Extrapyramidal Disorder, Parkinsonism, Cholestatic Jaundice, Hypersensitivity, Lichen Planus

Clinically Significant Adverse Reactions and Constraints

Official labeling documents address specific safety concerns related to body systems and patient groups:

  • Nervous System Effects: Regulatory documents list Extrapyramidal Disorder (including Parkinsonism, Dyskinesia, and Tremor), which are clinically serious reactions. These effects are officially noted to be more likely in older adults during prolonged therapy.
  • Hepatic: The adverse reaction listing includes Cholestatic Jaundice, a liver disorder.
  • Hypersensitivity and Precaution: Cinnarizine is contraindicated in patients with known hypersensitivity to the active substance. Caution is advised for patients with Parkinson’s disease, and use is generally not recommended during pregnancy or lactation as safety has not been established.
  • Duration-Related Patterns: Somnolence may be more pronounced at the start of treatment.
  • General Safety Notes: Concurrent use with substances that depress the Central Nervous System, such as alcohol, may potentiate sedative effects. Patients experiencing drowsiness are advised against driving or operating machinery.
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Overdose and Emergency Response

Overdose Manifestations and Severe Outcomes

Overdose with Cinnarizine is officially documented to present across a spectrum of Central Nervous System (CNS) effects. Common manifestations include somnolence, profound sedation, depressed consciousness, and potential progression to stupor or coma. Severe overdose can lead to life-threatening systemic outcomes, including marked hypotension and circulatory collapse. Furthermore, neurological complications such as tonic-clonic convulsions and respiratory depression are documented in official regulatory labeling.


Population-Specific Considerations

Official information notes a special consideration for the pediatric population, where overdose may paradoxically cause CNS excitation. These presentations include documented signs of agitation, restlessness, hyperkinesia, and an increased risk of convulsions.


Required Emergency Actions and Management

Due to the risk of severe, life-threatening complications, immediate medical attention must be sought for any suspected overdose. Regulatory documents confirm that no specific antidote is known for Cinnarizine. Treatment is officially described as symptomatic and supportive management. Officially listed procedural steps may include gastric decontamination, such as the administration of activated charcoal or gastric lavage, depending on the time elapsed since ingestion. Continuous hospital monitoring and observation may be required until symptoms fully resolve.

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Therapeutic Uses of Cinnarizine

Main Therapeutic Uses of Cinnarizine

This medicine is applied across domains where additional symptomatic support is needed, primarily by addressing symptoms related to systemic imbalance and inner ear functional stress. The medicine is commonly used to help with conditions characterized by periods of heightened symptoms, including vertigo, general dizziness, and motion sickness. It helps address symptom clusters that may become intense or disruptive, such as nausea and vomiting. It may assist with symptomatic relief in contexts of increased discomfort like that associated with Ménière's disease and tinnitus.

“The medication supports general well-being when symptoms interfere with routine activities.”

Cinnarizine supports the patient during difficult episodes, and may be part of symptomatic management during periods marked by discomfort. It is relevant in contexts marked by increased discomfort or tension where short-term symptomatic assistance is needed for acute or episodic changes.

Quick Fact: Relevant for Easing Dizziness and Nausea

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Eligibility and Restrictions for Use

Eligibility and Contraindications

Official regulatory labeling strictly defines who can and cannot use Cinnarizine, primarily based on contraindications, age, and existing health conditions.

Absolute Exclusions and Contraindications

The medicine is contraindicated for individuals with a known hypersensitivity to cinnarizine or any component of the formulation. It is generally not recommended or contraindicated for children under the age of five years. Use must also be avoided in individuals with the metabolic condition porphyria.

Conditional and Restricted Use

Specific populations require caution or conditional use. Patients with Parkinson's disease should only use Cinnarizine if the documented advantages significantly outweigh the possible risk of aggravating their condition. The medicine must be used with care in populations with hepatic (liver) or renal (kidney) insufficiency.

Age and Physiological Status

While adults are eligible for standard use, official rules establish eligibility for children from five years and older. Cinnarizine is generally not recommended for women who are pregnant or breastfeeding, as its safety during these physiological states has not been definitively established in humans. Older adults on prolonged treatment should be aware of documented susceptibility to extrapyramidal symptoms.

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What should I know about interactions with other medicines?

Interactions with other medicines and products

Cinnarizine's official interaction profile is defined primarily by its effect on the central nervous system, which results in several documented pharmacodynamic interactions. Medicinal products and substances noted in regulatory documents to interact include Alcohol, Central Nervous System (CNS) Depressants, Tricyclic Antidepressants (TCAs), and other Antimuscarinic Drugs.

Official Interaction Statements:

  • Concurrent use with Alcohol, CNS Depressants (such as opioid analgesics or hypnotics), or TCAs may lead to the potentiation of sedative effects.
  • Co-administration with TCAs or Antimuscarinic Drugs can result in an additive antimuscarinic action.
  • The medicine may mask the warning signs of damage (ototoxicity) caused by co-administered Ototoxic Drugs (e.g., aminoglycoside antibiotics).
  • Administration must be separated by at least 4 days prior to testing with Dermal Reactivity Indicators (allergy skin tests) to prevent a masking effect.
  • Taking the medicine after meals may diminish gastric irritation.
  • Cinnarizine is extensively metabolized mainly via CYP2D6. No specific pharmacokinetic outcomes are listed for co-administered drugs.

Profile Summary: The regulatory profile establishes mandatory constraints for co-administration with other sedating agents and explicit timing rules for diagnostic procedures due to its masking effect. The official information also documents the involvement of the CYP2D6 enzyme in Cinnarizine metabolism.

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Mechanism of Action

Cinnarizine functions primarily as a calcium channel antagonist, modulating cellular processes within the vestibular system and peripheral vasculature. Its main mechanism is the inhibition of calcium ion influx by binding to L-type and T-type voltage-gated calcium channels located on vascular smooth muscle cells and vestibular sensory cells. This antagonism reduces the excitability of these smooth muscle cells, decreasing basal tone and promoting vasorelaxation, particularly in cerebral vessels.

At the cellular level of the inner ear, the reduction of calcium influx into the hair cells and sensory neurons stabilizes the cellular membranes, thereby diminishing the abnormal or excessive signaling originating from the vestibular apparatus. Cinnarizine also exhibits H1-histamine receptor antagonist activity within the central nervous system. This dual action, combining calcium channel blockade and H1-receptor antagonism, leads to the modulation of signal transmission pathways between the inner ear and the brain's emetic centers.

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Dosage and Administration Information

Cinnarizine is administered exclusively by the oral route, typically available as tablets in various strengths. The overall pattern of use is defined by the intended clinical context, ranging from sustained management of chronic conditions to intermittent use for motion sensitivity.

Administration Pattern

The medicine should preferably be taken after meals to help reduce the possibility of gastric irritation. The tablets may be swallowed whole with water or, depending on the specific formulation, may be sucked or chewed.

Standard Adult Dosing Regimens

Dosing frequency is typically either sustained (divided daily doses) or intermittent (preemptive use). The total daily intake for the single-ingredient product should not exceed 225 mg.

  • For Vestibular/Balance Management: The usual regimen is 25 mg taken three times daily or sometimes 75 mg once daily; the dosage may be progressively increased.
  • For Motion Sensitivity Prophylaxis: The protocol is to take an initial dose of 25 mg (or 30 mg) 30 minutes to 2 hours before the start of travel, repeating this dose every 6 to 8 hours during a prolonged journey.

Population-Specific Use

Cinnarizine is not recommended for use in children under 5 years of age. For children between the ages of 5 and 12 years, the required dosage is approximately half of the corresponding adult dose.

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Recent Clinical Evidence

Cinnarizine: Recent Clinical Evidence

Overview of Studies

Cinnarizine is an antihistamine primarily used to manage symptoms associated with vestibular disorders and motion sickness. Research has evaluated the compound's effect on inner ear function and associated symptoms, such as vertigo and dizziness. Studies have explored its role as a calcium channel blocker, which may help stabilize the vestibular apparatus.

Evidence from clinical trials suggests that Cinnarizine is associated with a reduction in the frequency and intensity of vertigo attacks in patients diagnosed with Ménière’s disease. In studies focusing on chronic vestibular vertigo, Cinnarizine was examined for its potential to improve balance and reduce perceived symptoms.

Comparative and Adjunctive Research

Comparative studies have investigated Cinnarizine's performance against other anti-vertigo medications. The results of these trials have often been mixed, and no definitive consensus on its superiority over other standard treatments has been widely established. Research has also explored the adjunctive use of Cinnarizine alongside vestibular rehabilitation therapy. These studies examined whether the combination was associated with better long-term functional recovery compared to rehabilitation alone.

Safety and Tolerability

Clinical data on Cinnarizine's safety profile is extensive. Common side effects noted in trials are generally mild and transient, frequently including drowsiness and gastrointestinal discomfort. Long-term use has been investigated, with studies reporting acceptable tolerability, though dose-dependent side effects, particularly central nervous system effects, may be observed. Research into the use of Cinnarizine in specific populations, such as the elderly, continues to be a subject of study, focusing on the potential for increased sedation and its impact on gait and balance.

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Frequently Asked Questions (FAQ)

Common questions about Cinnarizine (FAQ)


Q: How quickly does Cinnarizine usually start working for travel sickness?

Official regulatory documents describe the time it takes for Cinnarizine to reach its highest concentration in the bloodstream. This peak level is typically achieved within 1 to 3 hours after the medicine is taken. This measurement indicates when the medicine is exerting its maximum effect in the body.


Q: What is the typical duration of effect after taking a Cinnarizine tablet?

The pharmacological duration of effect is generally related to the time it takes for the medicine to be eliminated from the body. Official documents describe the elimination half-life of Cinnarizine as typically ranging from 4 to 24 hours. This range may be a factor in the timing of repeated doses for prolonged travel.


Q: Does Cinnarizine cause drowsiness in everyone who takes it?

Drowsiness, also known as somnolence, is a known and officially listed adverse reaction to Cinnarizine. However, official regulatory labeling classifies it as a Common effect. This means that while many patients may experience it, this reaction is not expected to occur in every individual who takes the medicine.


Q: Are there any long-term safety concerns associated with taking Cinnarizine?

Official safety data sheets include a hazard statement concerning long-term use. This statement indicates that the medicine may cause damage to organs through prolonged or repeated exposure. Regulatory information also highlights the potential for extrapyramidal symptoms with prolonged use, especially in older adults.


Q: What happens if I miss a dose of Cinnarizine? (Non-directive query)

Official guidance describes the protocol that if a dose is forgotten, the recommendation is to take it as soon as the patient remembers. If it is nearly time for the next scheduled dose, the guidance typically states that the forgotten dose should be omitted.


Q: Is Cinnarizine safe to take with common pain relievers like paracetamol?

The official regulatory interaction profile for Cinnarizine does not specifically mention paracetamol (acetaminophen). The documented interaction warnings primarily focus on drug classes that increase sedative effects or share antimuscarinic properties.


Q: Can I take Cinnarizine if I already take medication for high blood pressure?

Caution is advised because Cinnarizine has documented vasodilatory effects, meaning it can widen blood vessels. This effect may have implications for blood pressure control and can potentially cause or exacerbate low blood pressure, known as hypotension.


Q: Can Cinnarizine be crushed or split, according to the manufacturer's guidelines?

Official guidance specifies several allowed methods for taking the tablet, including swallowing it whole with water or, depending on the formulation, sucking or chewing it. There is no instruction in the official material authorizing the crushing or splitting of the tablets.


Q: What evidence exists regarding the use of Cinnarizine in children?

Regulatory documents establish clear rules for pediatric use based on clinical evaluation. The medicine is not recommended for use in children under 5 years of age. For children aged 5 to 12 years, official guidelines specify that the dosage established is approximately half the corresponding adult dose.


Q: Can Cinnarizine interact with herbal supplements like St. John's Wort?

Official guidance advises a general caution when using Cinnarizine with certain herbal remedies or supplements. This concern focuses on products that may cause side effects similar to Cinnarizine, such as increased sleepiness, dry mouth, or difficulty with urination.


Q: Are there different strengths or formulations of Cinnarizine available?

The medicine is primarily available as an oral tablet formulation. Regulatory information confirms that these tablets come in various strengths, with common examples including 15 mg, 25 mg, and 75 mg formulations.


Q: What should be done if Cinnarizine causes an allergic reaction?

Known hypersensitivity (a severe allergic reaction) to Cinnarizine is listed as a formal contraindication. If any signs of a severe reaction, such as facial swelling, rash, or difficulty breathing, are observed, established safety protocol is to seek emergency medical attention.


Q: Is Cinnarizine primarily a preventative medicine, or can it treat symptoms already started?

Official regulatory documents define the medicine’s use for two distinct purposes. It is approved for prophylaxis, which is the prevention of symptoms like motion sickness. It is also approved for the symptomatic relief of existing symptoms associated with balance disorders and vertigo.


Q: Is Cinnarizine known to cause dry mouth, and why does this happen?

Dry mouth has been reported as an adverse reaction to Cinnarizine. Official documents indicate that this medicine has antimuscarinic properties, which refers to its effects on a specific class of receptors in the body. This mechanism is cited as a potential reason for experiencing dry mouth.


Q: Are there specific food types or drinks that should be avoided when taking Cinnarizine?

The main dietary interaction caution provided in official guidance is the warning against concurrent use with alcohol. Beyond this, authoritative guidance generally indicates that patients are not restricted from eating and drinking normally while using the medicine.


Q: Why is Cinnarizine contraindicated for people with Parkinson's disease?

Caution is advised for patients with Parkinson’s disease because of the medicine's known effects on the central nervous system. Regulatory documents note that the medicine's properties, including its dopamine receptor blocking activity, can induce or exacerbate movement disorders, such as those related to Parkinson's disease.


Q: Are there specific instructions for what to do in case of accidental overdose (informational/general)?

Official documentation reports a variety of effects associated with acute overdoses, including vomiting, extrapyramidal symptoms (movement problems), and changes in the level of consciousness. Due to the clinical seriousness of these effects, established safety protocol is to seek emergency medical advice in the event of an overdose.


Q: Can people with glaucoma safely use Cinnarizine?

Caution is advised for patients with glaucoma due to a documented effect of the medicine. Regulatory documents note that Cinnarizine possesses anticholinergic effects, which can potentially affect the eye pressure of individuals with this condition.


Q: Can Cinnarizine make existing symptoms of depression or anxiety worse?

Official safety documents list central nervous system (CNS) adverse reactions, which can include serious effects like Extrapyramidal Disorder. While not a direct psychological effect, the medicine's influence on CNS function means that specific caution is warranted for individuals with existing conditions affecting the nervous system.

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How should Cinnarizine be stored and disposed of?

How to Store and Dispose of Cinnarizine

The official storage conditions for Cinnarizine tablets are mandated to ensure product stability and safety. The medicine must be stored at a temperature not exceeding 30 C, though some labels specify storage below 25 C.

Storage and Handling

  • The product must be protected from light and stored away from moisture.
  • It is mandatory to keep Cinnarizine out of the sight and reach of children.
  • The medication must not be used after the expiry date printed on the packaging.

Disposal Requirements

  • Unused or expired Cinnarizine must not be thrown away via wastewater or household waste.
  • Disposal must be completed in accordance with local requirements for pharmaceutical waste, often through community drug take-back programs. If such programs are unavailable, official guidance advises mixing the medicine with an undesirable substance before discarding it in a sealed bag within the household trash.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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