Cyclizine

Registered South African indications:

• Labyrinthine disorders
• Antiemetic 
• Motion sickness

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Acute alcohol intoxication

Cautions

• Pregnancy
• Breastfeeding
• Hepatic impairment
• Glaucoma
• Urinary retention
• Obstructive disease of the gastrointestinal tract
• Phaeochromocytoma
• Hypertension
• Epilepsy
• Prostatic hypertrophy
• Severe heart failure 
• Acute myocardial infarction
• Porphyria
• Galactose intolerance
• Lapp lactase deficiency
• Glucose-galactose malabsorption 

Forms avail. in SA and covered in this monograph: sup, tab

Prophylaxis and treatment of nausea and vomiting
Labyrinthine disorders

• Rectal (sup): 100mg, 8hrly as needed
• Oral (tab): 50mg, 8hrly, as needed; Max: 200mg/24hrs

Motion sickness

• Oral (tab): 50mg taken 1-2 hours before departure, may be repeated 8hrly as needed

Paed. forms avail. in SA and covered in this monograph: sup, syr, tab

Prophylaxis and treatment of nausea and vomiting
Labyrinthine disorders

Oral (syr)

• Younger than 2 years: Not established for use
• Between 2-5 years: 12.5mg, 8hrly
• Between 6-12 years: 25mg, 8hrly
• Older than 12 years: See adult dosage

Oral (tab)

• Younger than 6 years: Not established for use
• Between 6-12 years: 25mg, 8hrly; Max dose: 75mg/24hrs
• Older than 12 years: See adult dosage

Rectal (sup)

• Younger than 6 years: Not established for use
• Between 6-12 years: 50mg, 8hrly, as needed
• Older than 12 years: See adult dosage

Motion sickness

Oral (tab)

• Younger than 6 years: Not established for use
• Between 6-12 years: 25mg, 1-2 hours before departure, to be repeated 8hrly as needed
• Older than 12 years: See adult dosage

Pregnancy

• Caution
• In the absence of any definitive human data, the use of cyclizine during pregnancy is not advised

Breastfeeding

• Caution
• Cyclizine is excreted in human milk; however, the amount has not been quantified

Renal Impairment

• No dose adjustment recommended

Hepatic Impairment

• Caution; no dose adjustment recommended

Elderly

• No dose adjustment recommended

Porphyria Information

• Probably not porphyrinogenic (PNP)

Drugs in Sport

• Permitted - No warnings

Central Nervous System Disorders

• Disorientation
• Restlessness
• Nervousness
• Euphoria
• Insomnia 
• Auditory and visual hallucinations 
• Somnolence
• Incoordination headache
• Dystonia
• Dyskinesia
• Extrapyramidal motor disturbances
• Tremor
• Seizures
• Dizziness
• Decreased consciousness
• Transient speech disorders 
• Paraesthesia 
• Generalised chorea
• Asthenia

Cardiovascular Disorders

• Tachycardia 
• Palpitations
• Arrhythmias
• Hypertension
• Hypotension

Respiratory Disorders

• Bronchospasm
• Apnoea

Gastrointestinal Disorders

• Dryness of the mouth, nose and throat 
• Constipation
• Increased gastric reflux
• Nausea and vomiting
• Diarrhoea 
• Stomach pain
• Loss of appetite

Hepatobiliary Disorders

• Hepatic dysfunction
• Hypersensitivity hepatitis
• Cholestatic jaundice 
• Cholestatic hepatitis

Genitourinary Disorders

• Urinary retention

Musculoskeletal Disorders

• Twitching
• Muscle spasms

Skin and Subcutaneous Tissue Disorders

• Urticaria
• Drug rash
• Angioedema
• Allergic skin reactions
• Fixed drug eruption
• Photosensitivity

Immune, Blood and Lymphatic System Disorders

• Agranulocytosis
• Leucopenia
• Haemolytic anaemia
• Thrombocytopenia
• Hypersensitivity reactions
• Anaphylaxis 

Sensory Disorders

• Tinnitus
• Blurred vision
• Oculogyric crisis

• Alcohol
• Central nervous system depressants
• Opioid analgesics
• Anticholinergic agents
• Antimuscarinic agents
• Tricyclic antidepressants
• Monoamine oxidase inhibitors
• Ototoxic drugs

None routine

Cyclizine is a histamine H1 receptor antagonist. It possesses anticholinergic and antiemetic properties. The chemotrigger zone possesses neurons which are rich in muscarinic cholinergic and histamine receptor containing synapses. These types of neurons are involved in the transmission of impulses from the vestibular apparatus to the vomiting centre.  Cyclizine reduces activity along these pathways.

Syrup (per 5ml) 12.5mg

• Aculoid Syrup (Teva Pharmaceuticals)
• Adco-Cyclizine (Adcock)
• Cycloid (Litha Pharma)
• Medazine S (Cipla Medpro)
• Nauzine S (Be-Tabs)
• Triazine Paed Syrup (Pharmacare)
• Valoid Paediatric Syrup (Pharmacare) originator

Tablet 50mg

• Aculoid (Teva Pharmaceuticals)
• Adco-Cyclizine (Adcock)
• Covamet (Adcock) originator
• Cycloid (Litha Pharma)
• Emitex (Pharmacare)
• Medazine (Cipla)
• Nauzine (Be-Tabs)
• Pinaloid (Cipla Medpro)
• Triazine (Pharmacare)
• Valoid (Pharmacare)

Suppository 50mg

• Triazine (Pharmacare)
• Valoid Children's Suppositories (Pharmacare) originator

Suppository 100mg

• Valoid AS (Pharmacare) originator

COMBINATION PREPARATIONS

Cyclizine hydrochloride/ Dipipanone hydrochloride

Tablet 30mg/10mg

• Wellconal (Pharmacare) originator

Cyclizine/ Caffeine hydrate/ Ergotamine

Tablet 50mg/100mg/2mg

• Migril (iNova) originator