Cinnarizine + domperidone

Oral
Motion sickness
Adult: Each tab contains cinnarizine 20 mg and domperidone 15 mg: 1 tab taken 1-2 hr before travel and 1 tab every 6 hr during journey if necessary.

Hypersensitivity. Parkinson's disease. GI haemorrhage, obstruction and perforation, patients with prolactin releasing pituitary hormone or chronic admin or for prophylaxis of postoperative nausea and vomiting. Neonates, children.

Hypotension. May impair ability to drive or operate machinery. Pheochromocytoma; renal or hepatic impairment; risk of cardiac arrhythmias and hypokalaemia if administered IV. Pregnancy, lactation; elderly.

Extrapyramidal symptoms sometimes associated with severe depression. Drowsiness, headache, GI upsets, unsteadiness, headache; rarely skin and hypersensitivity reactions, dry mouth, thickened resp depression, blurred vision, urinary difficulty or retention, constipation and increased gastric reflux, fatigue. Hypolipidaemic effect, extrapyramidal reactions, galactorrhoea, gynaecomastia; lassitude, decreased libido, skin rash, itch.
Potentially Fatal: Convulsions, arrhythmias and cardiac arrest, dysrrhythmias in patients with CVS disease or hypokalaemia, patients on cancer chemotherapy. Seizures, hypertensive crisis in patients with phaeochromocytoma.

CNS depressant effect of cinnarizine is enhanced with alcohol. Domperidone reduces absorption of oral digoxin. It increases absorption of aspirin, paracetamol and oral diazepam. Enhances CNS depression by phenothiazine. Antimuscarinic agents and opioids antagonise GI effects. Prolongs suxamethonium-induced neuromuscular blockade.

Delayed absorption but higher bioavailability due to reduced first-pass metabolism in gut wall.

Cinnarizine has Ca channel blocking activity selective for arterial smooth muscles. It has some antihistamine activity. Cinnarizine acts as a labyrinthine sedative. It also improves microcirculation by reducing ischaemia-induced blood viscosity. Domperidone is a peripheral dopamine-receptor blocker. It increases both the oesophageal peristalsis and the lower oesophageal sphincter pressure. It also increases gastric motility and peristalsis, and enhances gastroduodenal coordination, thus facilitating gastric emptying and decreasing small bowel transit time.

Antiemetics

A03FA03 - domperidone ; Belongs to the class of propulsives. Used in the treatment of functional gastrointestinal disorders.
N07CA02 - cinnarizine ; Belongs to the class of antivertigo preparations.