Cerebral circulatory disorders:

• Prophylaxis and maintenance therapy for symptoms of cerebral vascular spasms and arteriosclerosis such as dizziness, ear buzzing (tinnitus), vascular headache, unsociability and irritability, fatigue, sleep rhythm disorders such as premature awakening, involutional depressions, loss of memory and lack of concentration, incontinence and other disorders due to aging.
• Sequel of cerebral and cranial trauma.
• Post-apoplectic disorders.
• Migraine.

Peripheral circulatory disorders: Prophylaxis and maintenance therapy for symptoms of vascular spasms and arteriosclerosis (obliterating arteritis, thromboangitis obliterans, Raynaud's disease, diabetes, acrocyanosis, perrio, etc.) such as: intermittent claudication, trophic disturbances, pregangrene, trophic and varicose ulcers, paraesthesia, nocturnal cramps, cold extremities.

Disorders of balance:

• Prophylaxis and maintenance therapy for symptoms of labyrinthine arteriosclerosis, vestibular irritability, Meniere's syndrome, such as vertigo, dizziness, giddiness, syncopal attacks, tinnitus, nystagmus, nausea and vomiting.
• Prophylaxis of motion sickness.

Description

Cinnarizine's actions in the treatment of peripheral vascular disease are due to its anti-vasoconstrictor properties, its action on blood hyperviscosity and its anti-ischaemic effect. Anti-vasoconstriction is thought to be through a calcium blocker mechanism and is evident selectively in vascular smooth muscle. Increased peripheral muscle blood flow may be mediated by prevention of calcium entry into ischaemic erythrocytes, thereby prescribing flexibility.

Pharmacology

Cinnarizine acts as an antihistamine, labyrinthine sedative and a peripheral antivasoconstrictor. Cinnarizine is a selective calcium antagonist, inhibiting the influx of Ca²⁺ intracellularly. It prevents the Ca²⁺ dependent contraction of arterial smooth muscle by inhibiting Ca²⁺ influx through smooth muscle calcium channels and thereby, improves vestibular symptoms and prevents peripheral arterial disease

It is mainly used for the symptomatic treatment of nausea and vertigo due to Meniere's disease and other labyrinthine disturbances and for the prevention and treatment of motion sickness. It is also used in the management of various vascular disorders.

Usual adult dose: 15 to 30 mg three times daily.

Children (5 to 12 years): Half of the adult dose.

Motion sickness: A dose of 30 mg two hours before the start of the journey and 15 mg every 8 hours during the journey.

Peripheral arterial diseases: 75 mg two or three times daily.

There are no specific contraindications. It has been found to decrease blood pressure significantly. However, the drug should be used with reasonable caution in hypotensive patients.

Side effects such as somnolence and gastrointestinal disturbances are extremely rare. They are transient and may be readily prevented by achieving the optimal dosage gradually. Allergic skin reactions and fatigue have been reported on rare occasions. An aggravation or appearance of extrapyramidal symptoms has been reported extremely rarely in elderly people during prolonged therapy. The treatment should be reduced or stopped in such cases.

Cinnarizine may cause drowsiness; patients affected in this way should not drive or operate machinery. Avoid alcoholic drink.

Pregnancy & Lactation

The safety of Cinnarizine in human pregnancy has not been established although studies in animals have not demonstrated teratogenic effects. Therefore, it is not advisable to administer Cinnarizine in pregnancy