What is the recommended dosage for Strugeron (cinnarizine) plus?

Recommended Dosage for Strugeron (Cinnarizine) Plus

The recommended dosage for Strugeron Plus (cinnarizine plus dimenhydrinate) is 1 tablet containing cinnarizine 20 mg and dimenhydrinate 40 mg, taken three times daily for optimal management of vestibular disorders. 1

Dosage Information

• Standard therapeutic dosing for the fixed combination of cinnarizine/dimenhydrinate is 20 mg cinnarizine with 40 mg dimenhydrinate administered three times daily 1
• For cinnarizine alone, the typical dosage ranges from 25 mg to 100 mg daily in divided doses 2
• The fixed combination has demonstrated superior efficacy compared to either component alone or to other antivertigo medications like betahistine 1

Clinical Efficacy

• The cinnarizine/dimenhydrinate fixed combination provides significantly greater improvement in vertigo symptoms compared to monotherapy with either component 1
• After 4 weeks of treatment, approximately 25% of patients using the fixed combination become completely symptom-free, which is significantly higher than with other antivertigo treatments 1
• The combination is particularly effective at reducing both vertigo and associated vegetative symptoms 3

Special Populations

• For elderly patients (≥65 years), no significant dose adjustment is required as efficacy is maintained without increased adverse effects 1
• For pediatric patients, caution is advised as overdose can lead to neurological complications; documented cases show that children may experience jitteriness, wide-based gait, stupor, and rarely seizures with excessive doses 4

Safety Considerations

• The fixed combination is generally well-tolerated with approximately 98% of patients rating tolerability as "good" or "very good" 1
• Common adverse effects may include mild sedation due to the antihistaminic properties 4
• No significant cardiovascular effects such as bradycardia or hemodynamic instability have been reported even in overdose cases 4
• The medication should be used with caution in patients with a history of seizures as cinnarizine overdose has been associated with convulsions in some pediatric cases 4

Mechanism of Action

• Cinnarizine works through multiple mechanisms including:
  • Antihistaminic effects (H1 receptor antagonism) 5
  • Calcium channel blocking properties 5
  • Antidopaminergic effects 5
  • Antiserotoninergic properties 5
• The combination with dimenhydrinate enhances the antivertiginous effect through complementary mechanisms 1

Treatment Duration

• Clinical trials have demonstrated significant efficacy with a 4-week treatment course 1
• For chronic vestibular disorders, longer treatment periods may be necessary, with regular assessment of symptom improvement 3