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Cinnarizine

Antihistamine · Antihistamine, Antiemetic

AntihistamineAntihistamine, Antiemetic
CDSCO approved
EXCRETION
not curated
INTERACTIONS
none in our sources
PREGNANCY
not curated

Mechanism

Cinnarizine is an H1 receptor antagonist, acting as an inverse agonist. It exhibits membrane stabilizing activity. As a first-generation antihistamine, it penetrates the blood-brain barrier to some extent, leading to variable CNS depression depending on its affinity for central H1 receptors.

Indications

Nausea and vomitingNasal allergies (seasonal allergic rhinitis, hayfever)Vasomotor rhinitisPreventing urticariaUrticarial rashesPruritusInsect bites and stingsDrug allergiesvertigo (Méniére’s disease and other types)motion sicknessvertigo

Dosing

Adult
25–50 mg oral
Geriatric
Use of first-generation antihistamines is potentially inappropriate due to higher toxicity and availability of safer alternatives (STOPP criteria).

Contraindications

  • Elderly patients (potentially inappropriate due to availability of safer alternatives; STOPP criteria)

Side effects

Common
Sedationmild g.i. upset

Drug interactions

Alcohol
Moderate
Database

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
Database

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
Database

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
Database

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
Database

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
Database

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
Database

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.

Related guidelines

Other Antihistamine drugs

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Sources: KD Tripathi 7e, BNF·Verified: 2026-05-10 · House clinical team