Cyclizine

Cyclizine

[1 vial for IV administration $2.99]

ADMINISTRATION ROUTES:

  • PO, IM, IV

ALTERNATIVE NAMES:

  • Valoid, Nausicalm

ICU INDICATIONS:

  1. treatment of nausea and vomiting

PRESENTATION AND ADMINISTRATION:

  • PO:
    Nausicalm 50mg tablets (white)
  • IV:
    50mg per ml solution
    Store at room temperature. Protect from light. Cyclizine may be mixed with morphine in a syringe immediately before use
    If cyclizine must be diluted in a syringe, either water for injection or 5% dextrose is recommended as the diluent rather than normal saline. This reduces the risk of crystallisation.
  • IM:
    Inject undiluted solution

DOSAGE:

  • IV:
    25-50mg up to three times daily
  • PO:
    25-50mg 8 hourly

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:

  • Dose as in normal renal function

DOSAGE IN PAEDIATRICS:

  • IV / PO:
    1mg/kg 8 hourly

CLINICAL PHARMACOLOGY:

  • The active ingredient-cyclizine is a piperazine derivative with the general properties of H1-blocking drugs but is used as an anti-emetic in a variety of clinical situations including drug-induced and motion sickness, vertigo, post-operative vomiting and radiation sickness. Cyclizine also possesses anticholinergic activity.

CONTRAINDICATIONS:

  1. hypersensitivity to cyclizine.

WARNINGS

  • In the critically ill, cyclizine often causes significant sedation.

PRECAUTIONS

  • General:
    As with other anticholinergic agents, cyclizine should be used with caution and appropriate monitoring in patients with glaucoma, obstructive disease of the gastrointestinal tract and in males with possible prostatic hypertrophy. Cyclizine should be used with caution in patients with severe heart failure. In such patients, cyclizine may cause a fall in cardiac output associated with increases in heart rate, mean arterial pressure and pulmonary wedge pressure.
  • Laboratory Tests:
    No tests in addition to routine ICU tests are indicated
  • Drug/Laboratory Test Interactions:
    None of note

IMPORTANT DRUG INTERACTIONS FOR THE ICU

  • Cyclizine may have additive effects with alcohol and other central nervous system depressants e.g. hypnotics, tranquillisers. Because of its anticholinergic activity cyclizine may enhance the side-effects of other anticholinergic drugs.

ADVERSE REACTIONS

  • Central Nervous System:
    Restlessness, nervousness, insomnia and auditory and visual hallucinations, drowsiness, blurred vision, dystonia, dyskinesia, extrapyramidal motor disturbances, tremor, twitching, muscle spasms, convulsions, disorientation, dizziness, decreased consciousness and transient speech disorders.
  • Respiratory System:
    dryness of the mouth, nose and throat
  • Cardiovascular System:
    tachycardia
  • Gastrointestinal System:
    Cholestatic jaundice, constipation, hypersensitivity hepatitis
  • Haematological System:
    agranulocytosis
  • Urogenital System:
    Urinary retention
  • Skin:
    Urticaria, drug rash

Critical Care Drug Manual

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