CINNARIZINE

Brand Name(s) : Stugeron, Arlevert (with dimenhydrinate)

CINNARIZINE WARNINGS
Cinnarizine should be used with caution in: the elderly, women who arepregnant or who
are breastfeeding, patients with liver or kidney problems,Parkinson's disease, or a blood disorder called
acute porphyria.
It should not be used in: people who are allergic to cinnarizine or any other ingredient in the medicine,
and in children under 5 years of age.
Also see list of precautions and interactions.
STORAGE
No special storage conditions required.
CINNARIZINE USES
What is it used for?
Cinnarizine is used to treat a number of problems.
It is a type of antihistamine drug, sometimes known as a travel sickness or balance disorder treatment.
It is used to treat vestibular disorders (balance disorders).
In general this drug is used to treat balance disorders (such as in Mnires disease), including vertigo (spinning or swaying
sensation when standing still), tinnitus (ringing in the ears), feeling sick (nausea) and vomiting, as well as for travel sickness
(both during road journeys and sea travel).
Benefits of being on this drug can include relief from, or prevention of, the symptoms of travel sickness or balance disorders.
Listed below are the typical uses of cinnarizine.
Treating or preventing problems with balance (such as Mnires disease) to treat symptoms of feeling dizzy or light-headed,
ringing in the ears (tinnitus), feeling sick (nausea) and being sick (vomiting)
To control travel sickness.
On occasion your doctor may prescribe this medicine to treat a condition not on the above list.
HOW TO USE/TAKE
How often do I take it?
Take this medication by mouth, usually three-times daily (for balance problems) or several hours before travelling and every
8 hours during travel (for travel sickness). Tablets should be taken after meals, and may be chewed, sucked or swallowed
whole.
Use this medication regularly in order to get the most benefit from it.
Remember to use it at the same time each day - unless specifically told not to by your doctor.
It may take up to several hours before the full benefit of this drug takes effect.
Certain medical conditions may require different dosage instructions as directed by your doctor.
What dose?
Dosage is based on your age, gender, medical condition, response to therapy, and use of certain interacting medicines.
Do I need to avoid anything?
This drug may cause drowsiness, especially at the start of treatment. If affected in this way avoid driving or operating
machinery. Consult your doctor or pharmacist for more details.
When can I stop?
when taken for balance problems, tt is important to continue taking this medication even if you feel well, unless your doctor
tells you to stop.


Side effects
Feeling sleepy
Upset stomach or digestion
Headache
Dry mouth
Increased sweating
Weight gain
Itchy bumps on the skin, sometimes with mouth sores
Rashes
Yellowing of the skin or eyes (jaundice)
Jerky or slow movements, or muscle stiffness or trembling
Restlessness
More saliva than normal
Twitching or unusual movements of the tongue, face, mouth, jaw or throat, or rolling of the eyes
Depression.
If any of these persist or you consider them severe then inform your doctor.
Tell your doctor immediately if you develop any of the following symptoms: any extrapyramidal symptoms (jerky or slow
movements, or muscle stiffness or trembling, restlessness, more saliva than normal, twitching or unusual movements of the
tongue, face, mouth, jaw or throat, or rolling of the eyes), with or without depression; yellowing of the skin or eyes (jaundice).
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater
than the risk of side effects. Many people using this medication do not have serious side effects.
A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious
allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or
pharmacist.
In the UK you may report side-effects to the MHRA
responsibilities

Before taking cinnarizine, tell your doctor or pharmacist if you are allergic to it; or to other antihistamines; or if you have any
other allergies.
This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor
or pharmacist in case of: none known.
Before using this medication tell your doctor or pharmacist your medical history, especially any of the following: any liver or
kidney problems, Parkinson's disease, or a blood disorder called acute porphyria.
Before having surgery, tell your doctor or dentist that you are taking this medication.
Does alcohol intake affect this drug?
Alcohol should be avoided when taking this drug as it may make you very sleepy.
The elderly: cinnarizine should be used with caution in the elderly as it may be associated with an increased likelihood of
certain adverse events such as extrapyramidal symptoms (e.g. movement disorders), with or without depression.
Pregnancy and breastfeeding - please ensure you read the detailed information below
PREGNANCY
Cinnarizine is not safe to take if you are, or are planning to become, pregnant.
It is sensible to limit use of medication during pregnancy whenever possible. However, your doctor may decide that the
benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.
If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.
BREAST FEEDING
Cinnarizine is not safe to take if you are breastfeeding.
It is sensible to limit use of medication during breastfeeding whenever possible. However, your doctor may decide that the
benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.
If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.



Generic Name : Cinnarizine
Pronunciation : cin-nar-I-zine
Therapeutic Classification : Antihistamines
Trade Name(s):
India- Cinact, Cindail, Cinarin, Cinaver, Cingeron, Cini, Cinnasia, Cintac, Cintigo, Cinvert, Cinzan, Cinzine, Diziron, Diznil,
Dizzigom Emzine, Neurozine, Novacinn, Stedicin, Stugeron, Stugeron F, Syzeron, Vergo, Verticin, Vertigon, Vertiron,
Verto-C, V-Gon, Zivert.
International- Antigeron, Arlevert , Avidazine, Cerebral, Cerepar, Cinadil, Cinaren, Cinarin, Cinarizin, Cinarizina MK,
Cinarizin, Cinazyn, Cinedil, Cinnageron, Cinnarizina, Cinnarizine Katwijk, Cisaken, Cysten, Diclamina, Fabracin, Folcodal,
Inarzin, Medozine, Merron, Nariz, Negaron, Oblant, Perifas, Pyme Cinazin,Sandoz Cinnarizine, Stugeron, Stunarone.
Why it is prescribed (Indications) : This medication is an antihistamine, prescribed for the control of nausea and
vomiting due to motion sickness. It is also used for vertigo and brain disorder. It blocks the histamine action, which
reduces allergy symptoms.
When it is not to be taken (Contraindications):
Contraindicated in patients with Parkinson's disease, newborns, and hypersensitivity.

Pregnancy Category :
A B C D X
Category C : Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-
controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential
risks.

Dosage & When it is to be taken : Adults: The recommended dose is 25 to 75mg per day in divided doses.
How it should be taken : It comes as a tablet to take by mouth, with food.
Warnings and Precautions :
* Caution should be exercised in patients with history of low blood pressure, during pregnancy and breastfeeding.
* It may cause dizziness or drowsiness, do not drive a car or operate machinery while taking this medication.
Side Effects :
Central Nervous System - Drowsiness, headache, GI upset, unsteadiness, headache, depression dizziness and
incoordination.
Skin - Rash.
Gastrointestinal - Nausea, vomiting, diarrhea or constipation, loss of appetite or increased appetite and stomach pain.
Miscellaneous - Weight gain, perspiration or allergic reactions and urinary difficulty or retention.
Other Precautions :
* Avoid excess dosage.
Storage Conditions :
Store it at room temperature (25C).

Read more: Cinnarizine (Antigeron) Drug Information - Indications, Dosage, Side Effects and Precautions |
Medindia http://www.medindia.net/doctors/drug_information/cinnarizine.htm#ixzz2KPwjLemG


Cerebrolysin 101 ml box
For the modern, safe and effective treatment of disturbed cerebral functions
Effective, non-synthetic treatment for stroke, Alzheimers, dementia
Helps sports performance, cognitive function, diabetes
Composition
Cerebrolysin is a peptide preparation. The solution, ready for injection or
infusion, is free of proteins, lipids and antigenic properties. 1ml of
Cerebrolysin concentrate as active ingredient in aqueous solution.
Route of administration
Solution for intramuscular and intravenous injection or intravenous infusion.
Pharmacodynamics
The efficacy of Cerebrolysin is proven in numerous animal experiments
and clinical trials. Cerebrolysin is a brain-specific peptidergic nootropic
drug able to affect the central nervous system in a multimodal way. This
multimodal action of Cerebrolysin expresses itself as : 1) regulation and
improvement of the neuronal metabolism which prevents lactacidoses in
hypoxic or ischaemic episodes, 2) modulation of the synaptic plasticity
which corresponds to an improvement of behaviour and learning capacity,
and 3) a completely unique neurotrophic effect , including neuronal
differentiation, guaranteeing full neuronal function and protection against
different types of ischaemic and neurotoxin lesions .
In Controlled clinical trials Cerebrolysin treatment leads to
an improvement in the cognitive performance and mood of patients
suffering from Alzheimers disease. Therefore, the amount of care needed
by these sufferers decreases.
In these patients marked improvement is observed in 61.7% of the
Cerebrolysin treated group (as assessed by the Clinical Global
Impressions scale CGI ). Another clinical trial in patients with vascular
dementia demonstrates enhancement of memory performance in the group
receiving Cerebrolysin treatment. An improvement in the global clinical
picture is also noticed in this illness. A further study involving patients from
nine different disease entities established the effectiveness of
Cerebrolysin through the use of 11 psychological tests subjected to a
variance analysis.
After stroke and craniocerebral truma treatment wit Cerebrolysin leads to
an accelerated recovery.
Literature on Cerebrolysin is available upon request.
Pharmacokinetics
cerebrolysin passes through the blood-brain barrier . Up to eight hours
after iv administration of Cerebrolysin neurotophic activity can be
detected in the human long-lasting effects even after a single iv
administarion.
Toxicological properties
Cerebrolysin is generally well tolerated and possesses an extremely high
margin of safety. In human therapeutic dosages this produces almost no
toxic symptoms. The toxicological data are listed below.
Acute toxicity: after a single iv administration of Cerebrolysin the following
LD50 values were observed (14 days observation period) :male
rats68ml/kg body weight , female rats 74ml/kg body weight ; dogs, male
and female >52.2ml/kg body weight. Chronic toxicity (multiple doses over
six months) rats received up to 12.5ml/kg body weight daily for 26 weeks.
Only moderate changes in the blood count were observed, dogs ; the
highest administrated doses were 9ml/kg body weight daily for 28 days
(about 10 times the human therapeutic dosage) and 4.5ml/kg body weight
daily for 26 weeks (about five times the human therapeutic dosage): no
systemic substance-dependent intolerance reactions were observed .
Reproductive toxicity: Cerebrolysin was injected iv to the dams at the
highest possible volumes: in no case was an alteration of the gestagenic
period observed, in rabbits. Neither embryotoxic nor teratogenic effects nor
impairments of embryonic or neonatal developments were found; no
influence on the progeny (F1 and F2 generations) was evident. Influence
on the fertility and reproductive performance of the parent anilmals
potential, effect or carcinogenicity in toxicological tests, neither in vitro nor
in vivo.

Indications
disturbances of concentration and memory
degenerative dementias, including Alzheimers disease
vascular demenatias, eg multi-infarct dementia
mixed forms of dementia (degenerative and vascular contribution)
sequels of stroke (ischaemic and haemorrhagic)
posttraumatic or postoperative complaints, eg following cerebral
contusion, concussion, or neurosurgical operation.

Contraindications
hypersensitivity to one of the components of the drug
status epilepticus or grand mal conulsions; an increase in the seizure
frequency may be seen in these cases
status epilepticus or grand mal conulsions; an increase in the seizure
frequency may be seen in these cases
severe impairments of renal function

Side effects
Cerebrolysin is generally well tolerated. If injected too fast it may cause a
moderate heat sensation. In extremely rare cases a hypersensitivity
reaction manifested itself as chills, headaches or as slight increase in body
temperature the cause of which is probably the hyperresponiveness of the
patient. In no case to date has the undesirable effect persisted or proved
threatening to the patient.

Warning and precautionary measures
Patients with severe renal impairment must be excluded from a
Cerebrolysin therapy. Animal experimental data did not show any
evidence to teratogenic effects. There is no clinical experience with
Cerebrolysin in women.
Therefore, unless the potential benefits outweigh any potential risk.
Cerebrolysin should not be administered during preguancy and the
lactation period.

Interactions
The concomitant administration of Cerebrolysin with antidepressive drugs
or MAO inhibitors can lead to cumulative effects. In these cases a dose
reduction of the antidepressive drug is advisable.
Dasage and administration

Cerebrolysin is available in 1ml, 5ml and 10ml ampoules and vials of
30ml and 50ml. Up to 5ml per intramuscular administration, for
administration over 5ml an intravenous injection or infusion is advised.
Cerebrolysin can also be given diluted in a standard iv solution (eg
physiological saline solution, flingers solution, glucose 5%, dextran 40)
infused slowly over approximately 20 to 60 minutes, Once daily application
of Cerebrolysin for a minimum of 10 to 20 days are recommended. This
constitutes a course of therapy. In mild cases 1-5ml, in severe cases 10-
30ml should be applied. The length of the therapy and the individual doses
on the age of the patient as well as on the disease. Usually a treatment
period of three to four weeks is recommended. Therapy courses can be
repeated several times in accordance with the clinical picture of the patient
until no further improvement can be observed.
Therapy-free intervals should be maintained between courses. In severe
cases it is advisable not to interrupt treatment abruptly but to continue with
one injection every other day for a period of four weeks.
From the above mentioned clinical trials the following daily dosage guits
can be deducted dementias 3-50ml daily, in postapplectic deficits and brain
injuries 10-50ml daily.
Storage
Keep in a safe place out the reach of children. Store at room temperature
not over 25C, away from light.