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Vestibular Suppressant — Vertigo Pregnancy: Use with caution — limited data; avoid if possible; consider alternative antiemetics if required

Cinnarizine

Brand names: Stugeron

Adult dose

Dose: 15–30 mg
Route: Oral
Frequency: Three times daily (30 mg TDS for Menière's disease; 15 mg TDS for labyrinthine disorders)
Max: 90 mg/day
Antihistamine (H1) with calcium channel blocking properties — used for symptomatic relief of vertigo, tinnitus, nausea, and vomiting in vestibular disorders (Menière's disease, labyrinthitis, vestibular neuritis). Less sedating than cinnarizine at low doses.

Paediatric dose

Dose: Seek specialist opinion mg/kg
Route: Oral
Frequency: Three times daily
Max: Not established in children under 12 years
BNFc: cinnarizine not licensed in children under 5 years; 5–12 years 15 mg TDS; ≥12 years adult dose

Dose adjustments

Renal

Use with caution in renal impairment

Hepatic

Use with caution in hepatic impairment

Paediatric weight-based calculator

BNFc: cinnarizine not licensed in children under 5 years; 5–12 years 15 mg TDS; ≥12 years adult dose

Clinical pearls

  • Alternative to betahistine for vestibular disorders — different mechanism (antihistamine + calcium channel blocker vs histamine agonist)
  • Extrapyramidal side effects reported with prolonged use — particularly in elderly; review and minimise duration of treatment
  • Not recommended for acute vestibular neuritis beyond 72 hours — vestibular suppressants impair central compensation; early vestibular rehabilitation preferred
  • Travel sickness: cinnarizine 15 mg, 2 hours before travel — MHRA licensed indication
  • Compared to betahistine: cinnarizine preferred for acute symptomatic relief; betahistine preferred for long-term Menière's prophylaxis

Contraindications

  • Porphyria
  • Parkinson's disease (relative — may worsen extrapyramidal symptoms)

Side effects

  • Sedation (drowsiness)
  • Weight gain
  • GI disturbance
  • Extrapyramidal effects (rare — Parkinsonism, tardive dyskinesia with prolonged use)
  • Depression

Interactions

  • CNS depressants — additive sedation
  • Alcohol — additive CNS depression

Monitoring

  • Vertigo and symptom control
  • Extrapyramidal symptoms (prolonged use)
  • Driving ability (sedation)

Reference: BNFc; BNF 90; BNFc; BSO Menière's Disease Guidelines; NICE CKS Vertigo. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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