Cinnarazine: Alcohol should be avoided while taking cinnarazine

Domperidone Bioavailability of Domperidone is decreased by pretreatment with cinnarazine or alkali

Domperidone may reduce the hypoprolactinemic effect of Bromcriptine.

GIT actions of domperidone may be antagonised by antimuscarinics and opiod analgesics

Domperidone produces a rise in thyroid stimulating hormone in hypothyroid women

. Chronic alcoholics are at particular risks of liver damage following overdose.

Vertigo,

Tinnitus,

nausea and vomiting

Cinnarazine- Parkinsonism, tardive dyskinesia, depression, drowsiness, GI upset, headache

Domperidone -Hyperprolactinemia, galactorrhea, breast enlargement and soreness, reduced libido, dry mouth, thirst, headache, nervousness, drowsiness, diarrhea, skin rash, and itch, increased serum prolactin( more in females than in males)

Rare- sedation,extrapyrimidal dystonic reactions, parkinsonism, tardive dyskinesia.

Hypersensitivity to domperidone Parkinson's disease

Special precautions:

Cinnarazine Hypotensive patients

Children for motion sickness- use half the adult dose as a short term course.

Not recommended for nursing mothers

Use during pregnancy not recommended

Caution in elderly patients

Indication:

Vertgo, Tinnitus, nausea and vomiting, motion sickness

Dosage

Vertigo- 1 tablet b.i.d until symptoms improve

Motion sickness- medication to be taken half an hour before journey-

Adults- 1-2 tab

Children 2-7 years- 1/2 tablet

Pharmacology:

Combined effect of cinnarazine and domperidone for depressant effect of labyrinth, during stimulation in a rotation chair and in a parallel was evaluated.

The study was done comparing the efficacy of domperidone(30mg) , cinnarzine( 40mg) with domperidone and cinnarazine (30mg + 40mg) combination. At 15min, 30min, 1,2,3,and 4 hour intervals.

The duration and amplitude of nistagmus were recorded.. It was found that the combination of domperidone and cinnarazine was more efficacious than individual drugs and placebo.

Pharmacokinetics:

Cinnarazine- Following administration of 75mg cinnarazine to fasting subjects, the peak plasma concentration was acheived in 1- 4 hrs. The plasma half life of the drug was about 3 hrs.

Domperidone -About 93% of domperidone was rapidly absorbed following oral administration. The peak plasma concentration is obtained within 30 minutes of oral adnmistration and is in the range of 15-19ng/ml following oral administration of 20mg of domperidone.

The systemic bioavailability following oral administratin is 13-17%. Administering the drug 90 minutes after meals may increase the bioavailability.

Only small amounts of domperidone cross the placenta or reach breast milk.. It undergoes extensive biotransformation with < 1% excreted in urine.

Bioavailability may be increased if administering 90 minutes after meals.

Not recommended for nursing mothers

Use during pregnancy not recommended