Cinnarizine

Cinnarizinum

For medical students2 min readUpdated 2026-10-10

Cinnarizine (Cinnarizinum) is a selective calcium channel blocker with a pronounced tropism for cerebral arterioles. The drug exerts a comprehensive effect on the vascular bed: it not only reduces the reactivity of smooth muscle cells to vasoconstrictor substances, but also significantly improves blood rheology by increasing erythrocyte deformability. This achieves effective improvement in microcirculation, which is particularly critical for areas of cerebral ischemia.

TropismSelectively acts on cerebral arterioles, improving microcirculation.

RheologyIncreases erythrocyte deformability and reduces blood viscosity.

Vestibular systemReduces excitability; used to prevent motion sickness and seasickness.

Therapy monitoringRequires monitoring of liver, kidney function, and blood count during prolonged use.

Pharmacodynamics and Vascular Effects

Cinnarizine is classified as a calcium channel blocker (CCB). Its key pharmacological feature lies in its selective action on cerebral blood flow, specifically on the cerebral arterioles.

The mechanism of vascular action consists of several components:

The drug effectively reduces the sensitivity and reactivity of the vascular smooth muscle to endogenous vasoconstrictors. Such vasoconstricting substances include catecholamines, angiotensin, bradykinin, and vasopressin.
In addition to its central action, cinnarizine exerts a moderate vasodilating effect on peripheral blood vessels, which broadens the spectrum of its clinical applications.

Effects on Blood Rheology and Microcirculation

A crucial aspect of cinnarizine's pharmacodynamics is its ability to alter blood fluidity (rheological effect). This occurs through two main mechanisms:

Increased erythrocyte flexibility. The drug increases the ability of red blood cells to deform (plasticity). This allows them to pass more easily through narrowed capillaries.
Reduced viscosity. Cinnarizine decreases pathologically elevated blood viscosity.

The final result of this dual action (vascular and rheological) is a marked improvement in microcirculation. This effect is crucial for restoring blood supply in ischemic areas of the brain where vessel lumens are narrowed and blood flow is impaired.

Clinical Application in Neurology

Indications for prescribing cinnarizine directly stem from its ability to improve cerebral and peripheral blood flow, as well as its additional pharmacological properties. In neurological and vascular practice, the drug is used to treat the following conditions:

Therapy for residual symptoms following acute cerebrovascular accidents (stroke).
Treatment of the consequences of traumatic brain injury (TBI).
Prevention and comprehensive treatment of various peripheral circulatory disorders.

Additional Properties and Treatment of Kinetosis

In addition to its effects on calcium channels, cinnarizine possesses moderate antihistamine activity. This property underlies its ability to reduce the excitability of the vestibular apparatus.

Due to the depression of vestibular responses, the drug has become a specific agent for combating motion sickness (kinetosis). It is widely used for the prevention of seasickness and airsickness.

Dosing regimen for motion sickness:

The recommended dose is 25 mg.
The drug should be taken 30 minutes before the planned trip or flight.
If necessary (for long journeys), the dose can be repeated every 6 hours.

Safety Profile and Side Effects

Despite its selectivity of action, cinnarizine therapy may be accompanied by several adverse reactions. Characteristic side effects include:

Drowsiness (this sedative effect is directly related to the antihistamine component of the drug).
Dry mouth.
Various dyspeptic disorders (gastrointestinal disturbances).

Precautions: If a patient is prescribed a long-term course of therapy, the clinician must ensure strict monitoring of the body's condition. Liver function, kidney function, and the peripheral blood count are subject to mandatory monitoring.

Mnemonic

To remember the effects of cinnarizine, use the "Three C's" rule: Cerebral vessels (dilates arterioles), Circulation speed (improves rheology and erythrocyte deformability), Calm vestibular apparatus (prevents motion sickness).

Frequently asked questions

What chemical group and generation of calcium channel blockers does cinnarizine belong to?

Cinnarizine belongs to the pharmacological group of calcium channel blockers (calcium antagonists). The drug stands out for its pronounced tropism for cerebral arterioles and selective effect on cerebral blood flow. Unlike some other members of the group, it reduces the sensitivity of vascular smooth muscle to endogenous vasoconstrictors (such as catecholamines, angiotensin, bradykinin, and vasopressin). Specific data classifying cinnarizine into a narrow chemical subclass or exact calcium channel blocker generation are generally not emphasized in standard references.

In which neurological and vascular pathologies is the use of cinnarizine indicated?

The use of cinnarizine is indicated for:

residual effects after strokes;
consequences of traumatic brain injuries;
peripheral circulatory disorders (for prevention and treatment);
early-stage cerebral atherosclerosis as a vasodilator;
meningovascular syphilis as a vasoprotector;
kinetoses (motion sickness) for the prevention of seasickness and airsickness;
gastroesophageal reflux disease as part of neurotropic therapy as a vasoactive drug.

What side effects are characteristic of cinnarizine?

Cinnarizine is associated with several adverse reactions that require monitoring during long-term therapy. The main side effects include:

Drowsiness — a sedative effect directly linked to the drug's antihistamine component.
Dry mouth — a frequent adverse event during administration.
Dyspeptic disorders — gastrointestinal disturbances.

Additionally, in patients with Parkinson's disease, the use of cinnarizine carries a high risk of worsening symptoms. To minimize risks during long-term treatment, regular monitoring of liver function, kidney function, and peripheral blood count is necessary.

Which pharmacological group does cinnarizine belong to?

The drug belongs to the group of calcium channel blockers (CCBs). Its distinguishing feature is its selective effect on cerebral blood flow and cerebral arterioles.

How does the drug improve blood fluidity?

Cinnarizine reduces elevated overall blood viscosity while simultaneously increasing erythrocyte deformability. This allows blood cells to penetrate narrowed capillaries in ischemic zones more easily.

How should the drug be taken to prevent motion sickness?

For kinetosis (seasickness or airsickness), it is recommended to take 25 mg of the drug 30 minutes before travel begins. For longer journeys, the dose can be repeated every 6 hours.

Which parameters require monitoring during long-term treatment?

When prescribing a long-term course of therapy, liver and kidney function must be regularly monitored, alongside the patient's peripheral blood count.

Go deeper

Mechanism of action of endogenous vasoconstrictors (catecholamines, angiotensin, bradykinin, vasopressin) on vascular smooth muscle.
The role of calcium channels in regulating the tone of cerebral arterioles.
Pathophysiology of cerebral ischemia and the importance of blood rheological properties for microcirculation.
The link between antihistamine activity and the development of sedative effects and dry mouth.
Pathophysiological mechanisms of kinetosis (motion sickness) and the role of the vestibular apparatus in this process.