Cinazin-Plus
Generic Name
Cinnarizine + Dimenhydrinate
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| cinazin plus 20 mg tablet | ৳ 2.00 | ৳ 20.00 |
Description
Overview of the medicine
Cinazin-Plus is a combination medicine containing Cinnarizine and Dimenhydrinate, primarily used to treat symptoms of vertigo, dizziness, nausea, and vomiting associated with Meniere's disease and other vestibular disorders. Cinnarizine works by blocking calcium channels and acting as an antihistamine, while Dimenhydrinate is an antihistamine with antiemetic and anticholinergic properties.
Uses & Indications
Dosage
Adults
One tablet (Cinnarizine 20 mg + Dimenhydrinate 40 mg) two to three times daily, preferably after meals. The duration of treatment should not exceed 4 weeks unless reviewed by a physician.
Elderly
Similar to adults, but caution should be exercised due to increased susceptibility to side effects, particularly anticholinergic effects and sedation.
Renal_impairment
Use with caution. Dosage reduction may be necessary in patients with moderate to severe renal impairment. Consult a physician.
How to Take
Take the tablet orally with water, preferably after meals to minimize gastric irritation.
Mechanism of Action
Cinnarizine, an antihistamine and calcium channel blocker, inhibits calcium influx into vestibular sensory cells, reducing their excitability. Dimenhydrinate, another antihistamine, primarily acts on the H1 receptors in the brain, including the vestibular system and chemoreceptor trigger zone (CTZ), to reduce nausea, vomiting, and dizziness. The combination provides a synergistic effect.
Pharmacokinetics
Onset
Onset of action typically occurs within 30 minutes to 1 hour.
Excretion
Cinnarizine metabolites are primarily excreted in feces (approximately 60%) and urine (approximately 40%). Dimenhydrinate metabolites are primarily excreted in the urine.
Half life
Cinnarizine has a plasma half-life of 4 to 24 hours. Dimenhydrinate (diphenhydramine component) has a half-life of 1 to 4 hours.
Absorption
Both cinnarizine and dimenhydrinate are well absorbed from the gastrointestinal tract after oral administration. Peak plasma concentrations of cinnarizine are reached in 1-3 hours, and dimenhydrinate (as diphenhydramine) in 1-2 hours.
Metabolism
Both drugs are extensively metabolized in the liver. Cinnarizine primarily via CYP2D6. Dimenhydrinate is metabolized to diphenhydramine and chlorotheophylline.
Side Effects
Contraindications
- Hypersensitivity to cinnarizine, dimenhydrinate, or diphenhydramine.
- Acute angle-closure glaucoma.
- Prostatic hypertrophy with urinary retention.
- Epilepsy or other convulsive disorders.
- Porphyria.
- Severe hepatic or renal impairment.
Drug Interactions
Antihypertensives
May enhance the hypotensive effect.
CNS depressants (alcohol, sedatives, hypnotics)
May enhance the sedative effects.
Ototoxic drugs (e.g., aminoglycoside antibiotics)
May mask the warning signs of ototoxicity.
Anticholinergic drugs (e.g., tricyclic antidepressants, MAO inhibitors)
May enhance anticholinergic side effects such as dry mouth, blurred vision, and urinary retention.
Storage
Store in a cool and dry place, below 30°C, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include drowsiness, dizziness, ataxia, hallucinations, dry mouth, blurred vision, urinary retention, and rarely, convulsions. Treatment is symptomatic and supportive, including gastric lavage and activated charcoal.
Pregnancy & Lactation
Not recommended during pregnancy unless clearly necessary and the potential benefits outweigh the potential risks. Avoid during breastfeeding as both active ingredients are excreted into breast milk.
Side Effects
Contraindications
- Hypersensitivity to cinnarizine, dimenhydrinate, or diphenhydramine.
- Acute angle-closure glaucoma.
- Prostatic hypertrophy with urinary retention.
- Epilepsy or other convulsive disorders.
- Porphyria.
- Severe hepatic or renal impairment.
Drug Interactions
Antihypertensives
May enhance the hypotensive effect.
CNS depressants (alcohol, sedatives, hypnotics)
May enhance the sedative effects.
Ototoxic drugs (e.g., aminoglycoside antibiotics)
May mask the warning signs of ototoxicity.
Anticholinergic drugs (e.g., tricyclic antidepressants, MAO inhibitors)
May enhance anticholinergic side effects such as dry mouth, blurred vision, and urinary retention.
Storage
Store in a cool and dry place, below 30°C, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include drowsiness, dizziness, ataxia, hallucinations, dry mouth, blurred vision, urinary retention, and rarely, convulsions. Treatment is symptomatic and supportive, including gastric lavage and activated charcoal.
Pregnancy & Lactation
Not recommended during pregnancy unless clearly necessary and the potential benefits outweigh the potential risks. Avoid during breastfeeding as both active ingredients are excreted into breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2 to 3 years from the date of manufacture.
Availability
Available in pharmacies nationwide in Bangladesh
Approval Status
Approved by DGDA
Patent Status
Generic available
Clinical Trials
The efficacy and safety of the cinnarizine/dimenhydrinate combination have been evaluated in various clinical trials for the treatment of vertigo and related symptoms.
Lab Monitoring
- No routine lab monitoring is generally required. However, for prolonged therapy or in patients with hepatic/renal impairment, periodic monitoring of liver and kidney function tests may be advisable.
Doctor Notes
- Counsel patients regarding potential drowsiness and avoidance of activities requiring alertness.
- Caution in elderly patients due to increased risk of anticholinergic effects and falls.
- Monitor for signs of urinary retention or glaucoma exacerbation in predisposed patients.
- Review treatment periodically, especially for prolonged use.
Patient Guidelines
- Take Cinazin-Plus exactly as prescribed by your doctor.
- Do not exceed the recommended dose.
- This medicine may cause drowsiness; avoid driving or operating heavy machinery.
- Avoid alcohol while taking this medication.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Cinazin-Plus may cause drowsiness, dizziness, or blurred vision. Patients should be advised not to drive or operate machinery if they experience these side effects.
Lifestyle Advice
- Avoid activities that require mental alertness if you experience drowsiness. Ensure adequate hydration.
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