CYCLIZINE HYDROCHLORIDE

CYCLIZINE HYDROCHLORIDE
(sye'kli-zeen)
Marezine, Marzine 
CYCLIZINE LACTATE
Marezine Lactate, Marzine
Classifications: antihistamine (h1-receptor antagonist); antivertigo agent; antiemetic;
Therapeutic:antivertigo; antiemetic; antihistamine

Prototype: Meclizine
Pregnancy Category: B

Availability

50 mg tablets; 50 mg/mL injection

Action

Piperazine antihistamine (H1-receptor antagonist) that exhibits CNS depression and anticholinergic, antispasmodic, local anesthetic, and antihistaminic activity. Has prominent depressant action on labyrinthine excitability and on conduction in vestibular-cerebellar pathways.

Therapeutic Effect

Produces marked antimotion and antiemetic effects.

Uses

Chiefly for prevention and treatment of motion sickness and postoperative nausea and vomiting.

Contraindications

Increased intraocular pressure; asthma, closed-angle glaucoma; children <6 y.

Cautious Use

Narrow-angle glaucoma; prostatic hypertrophy; elderly; obstructive disease of GU or GI tracts; postoperative patients; pregnancy (category B), lactation.

Route & Dosage

Motion Sickness
Adult: PO 50 mg 30 min before travel, then q4–6h prn (max: 200 mg/d) IM 50 mg q4–6h prn
Child: PO 6–12 y, 25 mg q4–6h prn (max: 75 mg/d) IM 6–12 y, 1 mg/kg t.i.d. prn (max: 75 mg/d)

Postoperative Vomiting
Adult: IM 50 mg 15–30 min before end of operation, may repeat q4–6h (t.i.d.) prn during first few days after surgery

Administration

Oral
  • Give dose 30 min prior to any activity likely to cause motion sickness.
Intramuscular
  • Aspirate needle carefully before injecting IM. Anaphylactic reactions following inadvertent IV injection have been reported.
  • For prophylaxis of postoperative nausea and vomiting, drug usually prescribed with preoperative medication or is administered 20–30 min before expected termination of surgery.
  • Store tablets in tight, light-resistant container at 15°–30° C (59°–86° F) unless otherwise directed. Store parenteral form in a cold place at 5°–10° C (41°–50° F). When parenteral solution is stored at room temperature for prolonged periods, it may become slightly yellow, but this does not indicate loss of potency.

Adverse Effects (≥1%)

CV: Hypotension, palpitation, tachycardia. GI: Anorexia, nausea, vomiting, diarrhea, or constipation, cholestatic jaundice. CNS: Drowsiness, excitement, euphoria, auditory and visual hallucinations, hyperexcitability alternating with drowsiness, convulsions, respiratory paralysis (rare). Skin: Urticaria, rash. Special Senses: Dry mouth, nose, and throat; blurred vision, diplopia; tinnitus. Other: Pain at IM injection site.

Diagnostic Test Interference

Because cyclizine is an antihistamine, inform patient that skin testing procedures should not be scheduled for about 4 d after drug is discontinued or false-negative reactions may result.

Interactions

Drug: Alcohol, barbiturates, cns depressants (e.g., hypnotics, sedatives, and anxiolytics) may compound effects of cyclizine.

Pharmacokinetics

Onset: Rapid. Duration: 4–6 h. Metabolism: Unknown.

Nursing Implications

Assessment & Drug Effects

  • Monitor post-operative patient's vital signs closely, as cyclizine can cause hypotension.
  • Monitor for and report signs of CNS stimulation (e.g., hyperexcitability, euphoria). Dose reduction or discontinuation of drug may be indicated.

Patient & Family Education

  • Take cyclizine with food or a glass of milk or water to minimize GI irritation.
  • Do not drive a car or engage in other potentially hazardous activities until reaction to the drug is known. Adverse effects include drowsiness and dizziness.
  • Alcohol, barbiturates, narcotic analgesic, and other CNS depressants may compound sedative action.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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