Cinnarizine Formulation and Dosing
Cinnarizine is available as oral tablets (typically 25 mg) and capsules (75 mg), and the standard adult dosing is 25 mg three times daily for vertigo and vestibular disorders.
Available Formulations
- Tablets: Cinnarizine is commonly available as 25 mg tablets for oral administration 1
- Capsules: Also available as 75 mg capsules, though this represents a higher dose formulation 1, 2
- Both formulations demonstrate equivalent plasma levels and absorption characteristics when administered orally 1
Standard Adult Dosing Schedule
For Vestibular Vertigo (Most Common Indication)
- Fixed-dose combination therapy (preferred): Cinnarizine 20 mg combined with dimenhydrinate 40 mg, taken three times daily 3, 4, 5
- This combination has demonstrated superior efficacy compared to betahistine and other antivertigo medications in multiple randomized controlled trials 3, 5
Monotherapy Dosing
- Standard dose: 20-30 mg three times daily 3, 5
- Alternative dosing: 75 mg as a single dose has been studied, though this represents 2.5 times the normal dose and is not standard practice 2
Timing and Duration
- Treatment duration: Typically 4 weeks for acute vestibular vertigo, with some studies extending to 60 days for persistent symptoms 3, 4
- Onset of action: Clinical effects may take 5-7 hours to manifest, which is slower than some alternative antivertigo medications 2
- Significant symptom improvement is typically observed within 15 days of initiating therapy 4
Clinical Efficacy Considerations
The fixed combination of cinnarizine 20 mg with dimenhydrinate 40 mg three times daily has shown:
- Complete symptom resolution (vertigo score = 0) in approximately 25% of patients after 4 weeks 5
- Reduction in vertigo-associated symptoms in over 75% of patients 4
- Superior efficacy compared to betahistine 16 mg, cinnarizine monotherapy, and dimenhydrinate monotherapy 3, 5
Safety Profile
- Cinnarizine demonstrates minimal side effects even at doses up to 75 mg, with significantly fewer performance impairments compared to hyoscine 2
- The fixed combination is well-tolerated, with 97.9% of patients rating tolerability as "good" or "very good" 5
- Only 2.4% of patients discontinue therapy due to adverse events 5