Recommended Dosage of Cinnarizine for Adults
The recommended dosage of cinnarizine for adults is 25 mg to 100 mg daily, administered orally in divided doses, depending upon clinical response. 1
Dosing Regimen
The FDA-approved dosing information provides clear guidance for cinnarizine administration in adults:
- Starting dose: 25 mg
- Daily range: 25-100 mg
- Administration: Divided doses throughout the day
- Adjustment: Based on clinical response
Specific Dosing Patterns
Based on clinical practice and pharmacokinetic properties, cinnarizine is typically administered as:
- 25 mg three times daily (75 mg total) for most vestibular disorders
- 25 mg twice daily (50 mg total) for milder symptoms or maintenance therapy
- Up to 50 mg twice daily (100 mg total) for more severe symptoms
Pharmacokinetic Considerations
Cinnarizine has a mean plasma elimination half-life of approximately 3.24 hours 2, which supports the recommendation for divided daily dosing. Despite this relatively short half-life, the clinical effects may last longer due to tissue distribution characteristics.
Formulation Considerations
Research has shown no significant difference in plasma levels or absorption between capsule and tablet formulations of cinnarizine 2. Therefore, the choice of formulation can be based on patient preference and availability.
Clinical Applications
Cinnarizine is particularly effective for:
- Vestibular disorders
- Motion sickness
- Vertigo of various origins
In a clinical study, cinnarizine at a dose of 75 mg twice daily (150 mg total) demonstrated significant efficacy in suppressing vertigo compared to placebo, with particularly favorable results in patients with:
- Sudden peripheral vestibular deficit
- Vertigo of circulatory origin
- Post-traumatic vertigo 3
Special Populations
Elderly Patients
Caution is advised in elderly patients as cinnarizine has been associated with extrapyramidal symptoms in this population due to its moderate antagonistic properties at dopamine D2 receptors 4.
Patients with Renal Impairment
Although specific guidelines for cinnarizine in renal impairment are not provided in the available evidence, general principles of drug dosing suggest that dose reduction may be necessary in patients with significant renal dysfunction.
Side Effects and Monitoring
Common side effects at therapeutic doses include:
- Mild somnolence
- Slight headache
- Transient abdominal pain 3
At higher doses, cinnarizine may cause:
- Increased sedation
- Extrapyramidal symptoms (particularly in elderly)
- Mild catalepsy (at doses ≥60 mg at once) 4
Warning
Overdose of cinnarizine can lead to serious neurological complications, particularly in children, including altered consciousness, extrapyramidal symptoms, and seizures 5. Therefore, strict adherence to recommended dosing is essential.
In conclusion, cinnarizine dosing should be tailored within the 25-100 mg daily range, divided into 2-3 doses, with careful attention to clinical response and potential side effects, particularly in elderly patients.