Cinnarizine (tablets): indications for use, instructions, side effects and contraindications

Cinnarizine is one of the main drugs prescribed to normalize cerebral circulation. The fact is that a local disturbance of blood flow restricts or completely stops the delivery of essential nutrients (oxygen and glucose) to the corresponding tissues and cells.

Such processes lead to a sharp decrease in the level of adenosine triphosphate (ATP) and other substances, a change in the polarization of cell membranes and the release of amino acids from them, in particular glutamate.

Glutamate receptors are associated with calcium channels, so exposure to them causes a massive influx of calcium ions.

It activates the proteolytic enzymes phospholipase and cyclooxygenase, stimulates the accumulation of prostaglandins, thromboxanes and leukotrienes, which have a vasoactive (i.e. vasoconstrictor) effect on the arteries of the brain and peripheral blood vessels.

The movement of calcium ions through the cell membrane occurs through slow channels (through fast channels, potassium and sodium ions are transported). During hypoxia, age-related changes in the structure of nerve cells through these transport channels, calcium is released from its intracellular sources (structures of calcis and calmodulin protein).

An increase in their number increases the sensitivity of nerve cells to blood flow disturbances. Thus, a vicious circle is created that is able to break the slow calcium channel blocker. L-type, diphenylpiperazine derivative Cinnarizine.

Unlike his other drugs in this group, this medication is selective in in relation to the vessels of the brain, its activity is also manifested in the effect on the peripheral blood flow. Taking Cinnarizine in a therapeutic dosage does not have a significant effect on total blood pressure, so the drug can be used in almost all categories of patients.

In addition to calcium channels, Cinnarizine is also able to block H1 receptors that are sensitive to histamine. Therefore, the drug can be attributed to the group of antihistamines, that is, antiallergic medicines. However, due to its excessive effect on cerebral blood flow, Cinnarizine is not prescribed for short-term or long-term treatment of allergies.

According to the instructions for use, the drug has the following effect on the body:

• selectively inhibits spasm of smooth muscle tissue, the main component of the vascular wall;
• by blocking calcium channels, it prevents vasoactive substances such as norepinephrine and serotonin from affecting the state of blood vessels;
• stimulates microcirculation, acting on erythrocytes and improving the rheological properties of blood;
• inhibits the activity of cells of the vestibular apparatus;
• eliminates the increased susceptibility of cells to oxygen starvation;
• restores oxygen absorption by tissues.

Such a complex effect of Cinnarizine alleviates the symptoms of cerebral cerebrovascular accident:

• dizziness;
• noise in ears;
• weakness and drowsiness;
• attention disorders, clinical signs of dementia (it accompanies an inadequate blood supply to brain cells in almost 30% of cases);
• headache, including migraine;
• oscillatory movements of the pupils (nystagmus);
• nausea and vomiting caused by disorders of vestibular function (such symptoms are called "seasickness").

Regardless of how you take Cinnarizine, it is effective as in cerebral disorders due to atherosclerotic changes in the vessels, and with hypoxia provoked by cervical osteochondrosis or traumatic brain injury. Pediatricians also use Cinnarizine, the instructions for use of which indicate children under 5 years of age in contraindications to taking the drug.

There have been no reliable results of clinical studies regarding the ratio of benefits and harms from the drug to the child's body. But to date, a lot of positive feedback from doctors has been accumulated about the experience of its use in newborns and infants. up to a year for the correction of cerebral circulation caused by pathologies of intrauterine development, complications during childbirth, or trauma. However, the original Cinnarizine in the form of a solution for injections is not produced, therefore, its analogues or complex preparations are used in children's practice.

When taken orally in the form of tablets, the drug is rapidly absorbed from the gastrointestinal tract, the maximum concentration is reached within 3 hours. Its bioavailability is approximately 90%. Cinnarizine is completely metabolized in the liver and excreted from the body in the form of metabolites through the kidneys and the digestive system (with feces). The half-life is 2 to 4 hours, so the tablets should be taken several times a day.

Cerebral circulation disorders often bother people after 50-60 years old. Cinnarizine is quite common in old age. The vasodilating effect of the drug rarely causes complications from the cardiovascular system. In addition, the price of the drug is low, so people with low income can afford long-term treatment.

Cinnarizine (tablets): indications for use, release form, compatibility with other drugs

Cinnarizine is only available in pill form. Each contains 25 mg of the active ingredient of the same name. When prescribing the drug Cinnarizine, the indications for the use of which are described in detail in the instructions, it is important to discuss with the doctor the dosage required specifically in your case.

To ensure pharmacological effectiveness, the manufacturer adds the following excipients during the release of the medication:

• lactose (as monohydrate);
• potato starch;
• calcium stearate;
• medical polyvinylpyrrolidone;
• silica;
• petroleum jelly oil.

Cinnarizine (tablets) has a round shape with a beveled (horizontal stripe) in the middle, light cream or white. The package contains 50 pieces.

Indications for the use of Cinnarizine are the following pathologies:

• disorders of cerebrovascular circulation as a result of cerebral atherosclerosis, encephalopathy and other similar diseases;
• residual effects after traumatic brain injury, hemorrhagic or ischemic stroke;
• dizziness, headache due to cerebral hypoxia;
• prevention of migraine attacks;
• concentration disorders;
• rapid psychological fatigue;
• dementia, including senile, alcoholic or narcotic;
• mood swings, depression;
• nausea, vomiting, tinnitus, impaired coordination;
• prevention of "sea" or "air" sickness, motion sickness in transport (kinetosis);
• deterioration or complete loss of memory is also sometimes treated with the drug Cinnarizine, the indications for use described in the instructions confirm this;
• disorders of peripheral circulation, which manifest themselves as the formation of trophic ulcers, intermittent lameness, Raynaud's disease, Buerger's disease, the appearance of cyanotic skin coloration, hands and feet cold to the touch, paresthesia;
• diabetic angiopathy;
• Meniere's disease;
• epilepsy (relief of symptoms of concomitant disorders of cerebral circulation, especially at an early age. In this case, they can also assign Sabril);
• mental retardation in children.

Cinnarizine tablets have a complex effect on the cardiovascular and nervous system, therefore, it can enhance the effect of the following groups of medicines:

• tricyclic antidepressants (Azafen, Amitriptyline, Clomipramine, Melipramine);
• hypnotics (Nitrozepam, Zopiclone, Reslip, Somnol, Phenobarbital);
• sedatives (Valerian, Glycine, Persen, motherwort extract, Novo Passit, Validol);
• antihypertensive medications (there is a risk of a strong uncontrolled decrease in blood pressure), these are Clonidine, Pentamin, Anaprilin, Captopril, Losartan, Adelfan, Sinipress);
• nootropic and vasodilating drugs (their effect on blood vessels is enhanced), Piracetam, Aminalon, Bilobil, Cortexin, Memotropil, Phenibut, Encephabol.

Cinnarizine: instructions, dosage and how to take during pregnancy

The dosage of the drug depends on the initial disease and is selected by the doctor individually. This is also due to the fact that most pathologies of cerebral circulation, especially in old age, require additional treatment with antihypertensive and sedatives.

Cinnarizine instructions for use recommend taking in the following amount:

• for disorders of cerebral circulation: by 25-50 mg(1-2 tablets) three times a day;
• with disorders of peripheral circulation: by 50-75 mg(2-3 tablets) three times a day;
• with vestibular disorders: 25 mg (1 tablet) three times a day;
• with a tendency to motion sickness: 25 mg (1 tablet) an hour and a half before the trip; for a long trip, take in the same dosage every 6 hours;
• with dizziness, doctors note that the effect of the use of Cinnarizine depends on its dose, therefore, treatment begins with a daily dose of 75 mg, and then it is increased to the optimal one.

When it is necessary to take 75 mg of the drug at a time, doctors recommend replacing it with Stugeron Forte. 1 tablet of this medication contains just 75 mg of the active ingredient. The instruction for Cinnarizin describes that the drug should be taken after meals (this is due to its negative effect on the mucous membrane of the digestive tract) without chewing. The tablet is washed down with a sufficient amount of water at room temperature.

Special caution during treatment with Cinnarizine is necessary for patients with concomitant arterial hypertension.. Long-term therapy should be carried out under the obligatory control of the general blood picture (concentration of formed elements, hemoglobin), liver enzymes (ALT and AST). It is also recommended to regularly donate urine to assess the condition of the kidneys.

This drug is a blocker of histamine receptors, which are known for their sedative side effects and also crosses the blood-brain barrier. Before taking Cinnarizine, this should be taken into account by people whose profession is associated with the need concentrate attention (for example, drivers, operators of various industrial equipment, etc.).

In addition, doctors avoid prescribing Cinnarizine for patients with Parkinson's disease, in which case the specialist will most likely prescribe Selegiline or Artane. It should also be borne in mind that the medicine can distort the results of the allergy test. Therefore, if it is necessary to carry out such tests, it is canceled several weeks before the examination.

In experiments with animals, the use of Cinnarizine did not affect the condition and development of the fetus.. However, during pregnancy, the drug is prescribed only for strict medical reasons. In addition, to date, there is no clinical data on the experience of using Cinnarizine in women at different periods of bearing a child.

There is also no data on whether the active substances of the drug pass into breast milk. Nevertheless, in order to avoid a negative effect on the newborn, therefore, before taking Cinnarizine, it is better to stop breastfeeding and transfer the baby to the formula.

It was mentioned above that this drug enhances the action of other medicines that stimulate cerebral circulation and improve the ability to concentrate and perceive information (nootropics). therefore Combination drugs containing both cinnarizine and piracetam have been developed. This is:

• Phezam;
• Kombitropil;
• NooKam;
• Omaron;
• Piracesin;
• Fescetam.

The listed funds contain 400 mg of piracetam and 25 mg of cinnarizine, they are not available in ampoules, only in capsules. The indications for use are the same. In addition, neurologists sometimes prescribe these drugs for learning disabilities in children. Although many pediatricians and psychologists are opposed to such tactics, urging parents not to look for a "magic" pill, but to reconsider their communication with the child.

Cinnarizine: side effects, contraindications, analogs

When conducting studies of the drug Cinnarizine, side effects and the likelihood of their occurrence was evaluated based on clinical trials when the effect of treatment with the original drug was compared with placebo. As a result, the following data were obtained.

Patients often complained about:

• drowsiness (8.3%);
• nausea (1.5%;);
• weight gain (2.1%).

Relatively rarely, patients have encountered:

• headache;
• discomfort in the mouth;
• nausea;
• pain in the abdominal region;
• heartburn;
• increased sweating;
• feeling of constant fatigue.

In less than one case per thousand patients, the following side effects of Cinnarizine were noted:

• biliary dyskinesia;
• the appearance of symptoms of parkinsonism;
• tremor of the limbs;
• keratosis;
• lichen-type rashes;
• erythematous rash;
• muscle rigidity.

Contraindications to taking Cinnarizine are:

• hypersensitivity and possible risk of allergy to the active component of the drug or to the excipients contained in the tablets;
• children under 5 years of age;
• pregnancy and lactation.

When taken in the amount recommended by the doctor, an overdose of Cinnarizine is almost impossible.

Exceeding the required amount of the drug can manifest itself with the following symptoms:

• drowsiness up to stupor or coma;
• a sharp drop in blood pressure;
• nausea;
• seizures (in children).

There is no specific antidote to Cinnarizine. In a hospital, symptomatic and supportive treatment is carried out. In the first hour after an overdose, gastric lavage, taking activated charcoal can alleviate the patient's condition, then the drug is absorbed into the blood and these measures are useless.

Also, one cannot ignore the issue that is actively discussed in many forums, namely, the differences between Cinnarizin and Stugeron. The price of these drugs varies significantly. The domestically produced medicine Cinnarizin costs from 25 to 50 rubles, while the price of the same number of Stugeron tablets (Hungary) is four times more - 200 rubles.

Yes, the active ingredient in these drugs is the same, but you should take into account the difference between the generic (which is Stugeron) and its analogues. Initially, the pharmaceutical corporation develops a drug, conducts numerous clinical trials of its effectiveness and safety. And only a few years later, the company registers a new drug and launches it on the market.

Expensive research is the reason for the high price of the medicine. When the license expires, other manufacturers also gain access to the recipe. Accordingly, numerous and often cheaper analogs appear on the market. However, there are no complete studies on the pharmacokinetics and bioavailability of new drugs. Thus, Stugeron is a safer and more effective medication than the domestic Cinnarizine.

Other analogues of this medicine are:

• Vertizin;
• Cynedil;
• Cinnaron;
• Qinnasan.

Cinnarizine, contraindications to which are few, is one of the most common drugs for the correction of cerebral circulation disorders. It is often prescribed along with the equally famous Nootropil (piracetam). Patients most often note the onset of drowsiness, but it usually goes away after some time and does not require discontinuation of the drug. Doctors note the high effectiveness of the drug, but emphasize the need to comply with the dosage regimen.