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
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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 q46h prn (max: 200 mg/d) IM 50 mg q46h prn Child: PO 612 y, 25 mg q46h prn (max: 75 mg/d) IM 612 y, 1 mg/kg t.i.d. prn (max: 75 mg/d)
Postoperative Vomiting Adult: IM 50 mg 1530 min before end of operation, may repeat q46h (t.i.d.) prn during first few days after surgery
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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
2030 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: 46 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.