Increased sedation, drowsiness, impaired psychomotor function, dizziness, and potential for respiratory depression.
Advise patients to avoid or limit alcohol consumption while taking cinnarizine. Warn about increased sedation and impaired ability to perform tasks requiring alertness.
Antihistamines (first Generation, E.g., Chlorpheniramine, Diphenhydramine)Moderate
Database
Enhanced sedation, drowsiness, dizziness, and increased anticholinergic side effects (e.g., dry mouth, blurred vision, urinary retention).
Avoid concomitant use if possible due to additive effects. If co-administration is necessary, monitor closely for excessive sedation and anticholinergic effects. Advise patients about potential for increased drowsiness.
Dopamine Agonists (e.g., Bromocriptine, Pramipexole)Moderate
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Cinnarizine may reduce the efficacy of dopamine agonists used in Parkinson's disease or for hyperprolactinemia, potentially worsening symptoms.
Avoid concomitant use if possible. If co-administration is unavoidable, monitor for reduced efficacy of the dopamine agonist and adjust its dose as needed. Consider alternative anti-vertigo agents.
Mao Inhibitors (e.g., Phenelzine, Selegiline)Moderate
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Increased sedation, drowsiness, and dizziness. Potential for enhanced anticholinergic effects.
Use with caution. Monitor for excessive sedation and anticholinergic effects. Advise patients about potential for increased drowsiness and to avoid activities requiring alertness.
Opioid Analgesics (e.g., Codeine, Tramadol)Moderate
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Increased sedation, drowsiness, respiratory depression, and dizziness. May impair psychomotor function.
Use with caution. Monitor patients closely for excessive sedation and respiratory depression. Consider lower doses of one or both drugs. Advise patients about potential for increased drowsiness and to avoid activities requiring alertness.
Prokinetic Agents (e.g., Metoclopramide, Domperidone)Moderate
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Cinnarizine may antagonize the prokinetic and antiemetic effects of metoclopramide or domperidone, potentially reducing their efficacy.
Avoid concomitant use if possible. If co-administration is necessary, monitor for reduced efficacy of the prokinetic agent. Consider alternative anti-vertigo agents.
Sedative Hypnotics (e.g., Benzodiazepines, Zolpidem)Moderate
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Enhanced sedation, drowsiness, dizziness, and impaired psychomotor function. May increase risk of falls, especially in elderly patients.
Use with caution. Consider lower doses of one or both drugs. Monitor patients closely for excessive sedation. Advise patients about potential for increased drowsiness and to avoid activities requiring alertness.
Tricyclic Antidepressants (e.g., Amitriptyline, Imipramine)Moderate
Database
Increased sedation, drowsiness, dizziness, and enhanced anticholinergic side effects (e.g., dry mouth, constipation, urinary retention, blurred vision).
Use with caution. Monitor for excessive sedation and anticholinergic effects. Advise patients about potential for increased drowsiness and to avoid activities requiring alertness.
Antihypertensives (e.g., Ace Inhibitors, Beta Blockers, Diuretics)Mild
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May cause or exacerbate orthostatic hypotension, leading to dizziness, lightheadedness, or syncope, especially at the start of treatment or with dose increases.
Monitor blood pressure, especially at the initiation of therapy or with dose adjustments. Advise patients to stand up slowly and report symptoms of dizziness or lightheadedness.