Calcium channel blocker with antihistamine activity
ATC code: N07CA02 (Cinnarizine)
A selective L-type calcium channel blocker in vascular smooth muscle and vestibular neurons. Also blocks H1-histamine and dopamine D2 receptors – driving marked sedation and extrapyramidal risk. Crosses the blood-brain barrier well. Half-life 3–6 hours, dosed three times daily. In older adults, on the 2023 Beers list – risk of falls, cognitive impairment, and drug-induced parkinsonism with prolonged use.
Second line
Used in vestibular vertigo from various causes as a symptomatic agent. Dose 25–50 mg three times daily. Cochrane 2018 showed moderate efficacy over placebo with low certainty. Not recommended in patients over 65 (Beers 2023) – falls, cognitive impairment, and drug-induced parkinsonism risk outweigh the modest symptomatic benefit. Course limited to 4 weeks.
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Cinnarizine is a calcium channel blocker prescribed widely in Russia to older adults for cerebral malnutrition, cognitive decline, and brain circulation improvement. Cinnarizine is not approved in the US or UK. The AEMPS Ficha Técnica limits cinnarizine to vertigo and Meniere's disease. Cochrane reviews do not support cinnarizine for vertebrobasilar insufficiency as an independent diagnosis. In older adults the drug causes parkinsonian symptoms: tremor, rigidity, slowed movement, depression, sometimes persisting after discontinuation. If cinnarizine was prescribed for brain circulation or memory, consider seeking a second opinion.
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Safety not established. Not recommended in pregnancy.
No data. Not used during lactation.
Cinnarizine is evaluated for the following indications with varying evidence strength: Vertigo (evidence tier C), Memory and concentration enhancement (evidence tier F). See the full indication matrix with dosing and citations above on this page.
Common side effects of Cinnarizine (≥ 1 in 100): Drowsiness, Weight gain, Dry mouth, Fatigue, GI complaints. See the Safety section for uncommon and serious reactions.
FDA category C. Safety not established. Not recommended in pregnancy.
No data. Not used during lactation.
Cinnarizine is contraindicated in: Cinnarizine hypersensitivity; Parkinson's disease and other extrapyramidal disorders; Current or past depression; Severe hepatic impairment; Age over 65 (relative contraindication per Beers 2023). Full list in the Safety section.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.