Cyclizine

Cyclizine

Cyclizine
Systematic (IUPAC) name
1-benzhydryl-4-methyl-piperazine
Clinical data
Trade names Marezine, Valoid, Nausicalm
AHFS/Drugs.com
Pregnancy
category
  • AU: A
  • US: B (No risk in non-human studies)
Legal status
Routes of
administration
Oral, IM, IV
Pharmacokinetic data
Metabolism N-demethylated to inactive norcyclizine
Biological half-life 20 hours
Identifiers
CAS Registry Number  Y
ATC code R06
PubChem CID:
IUPHAR/BPS
DrugBank  Y
ChemSpider  Y
UNII  Y
KEGG  Y
ChEBI  Y
ChEMBL  Y
Chemical data
Formula C18H22N2
Molecular mass 266.381 g/mol
 Y   

Cyclizine is an antihistamine drug used to treat nausea, vomiting and dizziness associated with motion sickness, vertigo and post-operatively following administration of general anaesthesia and opioids.

It is on the health system.[1]

Contents

  • Medical uses 1
  • Contraindications 2
  • Adverse effects 3
  • Pharmacology 4
  • History 5
  • Society and culture 6
    • Names 6.1
  • See also 7
  • References 8

Medical uses

Nausea, vomiting and dizziness associated with motion sickness, vertigo and post-operatively following administration of general anaesthesia and opioids. It is sometimes given in hyperemesis gravidarum, although the manufacturer advises that it be avoided in pregnancy. Off-licence use often occurs with specialists in hospitals to treat inpatients who have become severely dehydrated in pregnancy. An off-label use is as an opioid/opiate potentiator.[2]

The drug Diconal is a combination of cyclizine with the opioid dipipanone.[3] Dipipanone is a schedule I controlled substance in the US, due to its high abuse potential.

Contraindications

Its antimuscarinic action warrants caution in patients with prostatic hypertrophy, urinary retention, or angle-closure glaucoma. Liver disease exacerbates its sedative effects.[2]

Adverse effects

Common (over 10%) – Drowsiness, xerostomia (dry mouth).

Uncommon (1% to 10%) – Headache, psychomotor impairment, diplopia (double vision), dermatitis, and antimuscarinic effects such as urinary retention and gastro-intestinal disturbances.

Rare – Hypersensitivity reactions (bronchospasm, angioedema, anaphylaxis, rashes and photosensitivity reactions), extrapyramidal effects, dizziness, confusion, depression, sleep disturbances, tremor, liver dysfunction and hallucinations.

Pharmacology

Cyclizine is a piperazine derivative with histamine H1-receptor antagonist (antihistamine) activity. The precise mechanism of action in inhibiting the symptoms of motion sickness is not well understood. It may have effects directly on the labyrinthine apparatus and on the chemoreceptor trigger zone. Cyclizine exerts a central anticholinergic (antimuscarinic) action.[2]

History

Cyclizine was developed in the American division of pharmacy company Burroughs Wellcome (today GlaxoSmithKline) during a research involving many drugs of the antihistamine group. Cyclizine was quickly clinically found as a potent and long-acting antiemetic. Company named the substance – or more precisely cyclizine's hydrochloride form which it usually appears in – "marezine hydrochloride" and started to sell it in the United States under trade name Marezine. Selling was begun in France under trade name Marzine in 1965.[4][5]

The substance received more credit when NASA chose it as a space antiemetic for the first occupied moon flight. Cyclizine was introduced to many countries as a common antiemetic. It is an over-the-counter drug in many countries because it has been well tolerated, although it has not been very much studied.[4][6]

Society and culture

Some people using methadone recreationally combine cyclizine with their methadone dose, a combination that is known to produce strong psychoactive effects.[7] It has also been used recreationally for its anticholinergic effects to induce hallucinations.[8]

It has also been used illegally in greyhound racing to sabotage a dog's performance.[9]

Names

As cyclizine hydrochloride tablets and cyclizine lactate solution for intramuscular or intravenous injection (brand names: Valoid[2] in UK and Marezine, Marzine and Emoquil in US). Cyclizine is marketed as Bonine for Kids in the US.[10]

See also

References

  1. ^ "WHO Model List of EssentialMedicines" (PDF). World Health Organization. October 2013. Retrieved 22 April 2014. 
  2. ^ a b c d "Valoid Tablets by Amdipharm". Electronic Medicines Compendium. Datapharm. 
  3. ^ "Diconal Tablets by Amdipharm". Electronic Medicines Compendium. Datapharm. 
  4. ^ a b Sneader, Walter (2005). Drug discovery: a history. John Wiley & Sons. p. 404.  
  5. ^ Sittig, Marshall (1988). Pharmaceutical manufacturing encyclopedia. William Andrew. p. 406.  
  6. ^ http://www.drugs.smd.qmul.ac.uk/drugs/html5/Anti-emetics/AN-FEF54A37-6289-402B-E208-9284E183608A.html
  7. ^ Ruben, S. M.; McLean, P. C.; Melville, J. (1989). "Cyclizine abuse among a group of opiate dependents receiving methadone". British Journal of Addiction 84 (8): 929–934.  
  8. ^ Bassett, K.; Schunk, J. E.; Crouch, B. I. (1996). "Cyclizine abuse by teenagers in Utah". The American Journal of Emergency Medicine 14 (5): 472–474.  
  9. ^ Conor Ryan for The Independent. June 20, 2013 IGB left with €250k bill after dog doping case
  10. ^ "Bonine for Kids". Insight Pharmaceuticals.