Safety of Cinnarizine 25 mg in an 8-Year-Old Child Weighing 25 kg
A single dose of cinnarizine 25 mg can potentially cause neurological side effects in an 8-year-old child weighing 25 kg, including drowsiness, dizziness, and in rare cases, more serious effects like seizures. While not immediately life-threatening, this dose exceeds typical pediatric recommendations and requires monitoring.
Cinnarizine Dosing and Safety in Children
- Cinnarizine is not specifically approved for use in children under 12 years in many countries, and dosing guidelines for young children are limited 1
- For children weighing less than 30 kg, when used for migraine prophylaxis, the recommended dose is approximately 1.5 mg/kg/day 2
- For this 25 kg child, an appropriate dose would be closer to 37.5 mg per day (1.5 mg/kg), but this would typically be for ongoing treatment, not a single dose 2
Potential Side Effects of Cinnarizine Overdose
- Case reports document that cinnarizine overdose in children can cause neurological symptoms including drowsiness, stupor, and in some cases seizures 1
- A documented case of a 30-month-old toddler who ingested 225 mg (18 times the recommended dose) experienced jitteriness, wide-based gait, vomiting, stupor, and generalized tonic-clonic seizures 1
- Common side effects even at therapeutic doses include somnolence (drowsiness) which may affect a child's alertness and coordination 3, 4
Risk Assessment for 25 mg Single Dose
- While 25 mg is higher than the weight-based recommendation for a 25 kg child, it is significantly lower than doses reported to cause serious toxicity 1
- The half-life of cinnarizine is approximately 3.65 hours in pediatric overdose cases, suggesting effects would diminish within 12-24 hours 1
- Cinnarizine has antihistaminic, antiserotoninergic, antidopaminergic, and calcium channel-blocking properties, which contribute to its side effect profile 1, 5
Monitoring and Management
- If the child has already taken this dose, monitor for symptoms including:
- If symptoms develop, supportive care is typically sufficient as full clinical recovery usually occurs within 10-12 hours 1
- In case of seizures (which are rare at this dose), standard seizure management protocols would apply 6
Conclusion
While a single 25 mg dose of cinnarizine in an 8-year-old child weighing 25 kg is unlikely to cause severe toxicity, it exceeds typical pediatric dosing recommendations and may cause temporary neurological symptoms. The child should be monitored for adverse effects, particularly drowsiness and coordination problems, which would typically resolve within 12 hours.