Cyclizine Disease Interactions
There are 4 disease interactions with cyclizine.
Antihistamines (applies to cyclizine) anticholinergic effects
Moderate Potential Hazard, High plausibility. Applicable conditions: Gastrointestinal Obstruction, Glaucoma/Intraocular Hypertension, Urinary Retention
Antihistamines often have anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with antihistamines should be administered cautiously, if at all, in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Conventional, first-generation antihistamines such as the ethanolamines (bromodiphenhydramine, carbinoxamine, clemastine, dimenhydrinate, diphenhydramine, doxylamine, phenyltoloxamine) tend to exhibit substantial anticholinergic effects. In contrast, the newer, relatively nonsedating antihistamines (e.g., cetirizine, fexofenadine, loratadine) reportedly have low to minimal anticholinergic activity at normally recommended dosages and may be appropriate alternatives.
References (20)
- Schuller DE, Turkewitz D (1986) "Adverse effects of antihistamines." Postgrad Med, 79, p. 75-86
- (2002) "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories
- "Product Information. Chlor-Trimeton (chlorpheniramine)." Schering-Plough
- (2002) "Product Information. Periactin (cyproheptadine)." Merck & Co., Inc
- (2002) "Product Information. Benadryl (diphenhydramine)." Parke-Davis
- (2001) "Product Information. Phenergan (promethazine)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation
- (2001) "Product Information. Antivert (meclizine)." Roerig Division
- (2001) "Product Information. Marezine (cyclizine)." Glaxo Wellcome
- (2001) "Product Information. Optimine (azatadine)." Schering Corporation
- (2001) "Product Information. Semprex-D (acrivastine-pseudoephedrine)." Endo Laboratories LLC
- (2001) "Product Information. Zyrtec (cetirizine)." Pfizer U.S. Pharmaceuticals
- (2001) "Product Information. Drixoral (dextromethorphan)." Schering-Plough
- (2001) "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmacal Company
- Watemberg NM, Roth KS, Alehan FK, Epstein CE (1999) "Central anticholinergic syndrome on therapeutic doses of cyproheptadine." Pediatrics, 103, p. 158-60
- (2001) "Product Information. Vistaril (hydroxyzine)." Pfizer U.S. Pharmaceuticals
- (2001) "Product Information. Dramamine (dimenhydrinate)." Pharmacia and Upjohn
- (2001) "Product Information. Tacaryl (methdilazine)." Westwood Squibb Pharmaceutical Corporation
- (2001) "Product Information. Temaril (trimeprazine)." Allergan Inc
- Talbert RL, Yee GC, DiPiro JT, Matzke GR, Posey LM, Wells BG (1999) "Pharmacotherapy: A Pathophysiologic Approach" Stamford, CT: Appleton & Lange
Antihistamines (applies to cyclizine) asthma/COPD
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Chronic Obstructive Pulmonary Disease
It has been suggested that the anticholinergic effect of antihistamines may reduce the volume and cause thickening of bronchial secretions, resulting in obstruction of respiratory tract. Some manufacturers and clinicians recommend that therapy with antihistamines be administered cautiously in patients with asthma or chronic obstructive pulmonary disease.
References (17)
- (2002) "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories
- "Product Information. Chlor-Trimeton (chlorpheniramine)." Schering-Plough
- (2002) "Product Information. Periactin (cyproheptadine)." Merck & Co., Inc
- (2002) "Product Information. Benadryl (diphenhydramine)." Parke-Davis
- (2001) "Product Information. Phenergan (promethazine)." Wyeth-Ayerst Laboratories
- Maddox DE, Reed CE (1987) "Clinical pharmacodynamics of antihistamines." Ann Allergy, 59, p. 43-8
- (2001) "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation
- (2001) "Product Information. Antivert (meclizine)." Roerig Division
- (2001) "Product Information. Marezine (cyclizine)." Glaxo Wellcome
- (2001) "Product Information. Optimine (azatadine)." Schering Corporation
- (2001) "Product Information. Semprex-D (acrivastine-pseudoephedrine)." Endo Laboratories LLC
- (2001) "Product Information. Drixoral (dextromethorphan)." Schering-Plough
- (2001) "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmacal Company
- (2001) "Product Information. Vistaril (hydroxyzine)." Pfizer U.S. Pharmaceuticals
- (2001) "Product Information. Dramamine (dimenhydrinate)." Pharmacia and Upjohn
- (2001) "Product Information. Tacaryl (methdilazine)." Westwood Squibb Pharmaceutical Corporation
- (2001) "Product Information. Temaril (trimeprazine)." Allergan Inc
Antihistamines (applies to cyclizine) cardiovascular
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Cardiovascular Disease, Hyperthyroidism, Hypotension
Antihistamines may infrequently cause cardiovascular adverse effects related to their anticholinergic and local anesthetic (quinidine-like) activities. Tachycardia, palpitation, ECG changes, arrhythmias, hypotension, and hypertension have been reported. Although these effects are uncommon and usually limited to overdosage situations, the manufacturers and some clinicians recommend that therapy with antihistamines be administered cautiously in patients with cardiovascular disease, hypertension, and/or hyperthyroidism.
References (15)
- Schuller DE, Turkewitz D (1986) "Adverse effects of antihistamines." Postgrad Med, 79, p. 75-86
- (2002) "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories
- "Product Information. Chlor-Trimeton (chlorpheniramine)." Schering-Plough
- (2002) "Product Information. Periactin (cyproheptadine)." Merck & Co., Inc
- (2002) "Product Information. Benadryl (diphenhydramine)." Parke-Davis
- (2001) "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation
- (2001) "Product Information. Antivert (meclizine)." Roerig Division
- (2001) "Product Information. Optimine (azatadine)." Schering Corporation
- Smith SJ (1994) "Cardiovascular toxicity of antihistamines." Otolaryngol Head Neck Surg, 111 Suppl, p. 348-54
- (2001) "Product Information. Zyrtec (cetirizine)." Pfizer U.S. Pharmaceuticals
- Woosley RL (1996) "Cardiac actions of antihistamines." Annu Rev Pharmacol Toxicol, 36, p. 233-52
- (2001) "Product Information. Drixoral (dextromethorphan)." Schering-Plough
- (2001) "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmacal Company
- (2001) "Product Information. Vistaril (hydroxyzine)." Pfizer U.S. Pharmaceuticals
- (2001) "Product Information. Dramamine (dimenhydrinate)." Pharmacia and Upjohn
Antihistamines (applies to cyclizine) renal/liver disease
Moderate Potential Hazard, High plausibility. Applicable conditions: Renal Dysfunction
Limited pharmacokinetic data are available for the older, first-generation antihistamines. Many appear to be primarily metabolized by the liver, and both parent drugs and metabolites are excreted in the urine. Patients with renal and/or liver disease may be at greater risk for adverse effects from antihistamines due to drug and metabolite accumulation. Therapy with antihistamines should be administered cautiously in such patients. Lower initial dosages may be appropriate.
References (15)
- Glazko AJ, Dill WA, Young RM, Smith TC, Ogilvie RI (1974) "Metabolic disposition of diphenhydramine." Clin Pharmacol Ther, 16, p. 1066-76
- Paton DM, Webster DR (1985) "Clinical pharmacokinetics of H1-receptor antagonists (the antihistamines)." Clin Pharmacokinet, 10, p. 477-97
- Rumore MM (1984) "Clinical pharmacokinetics of chlorpheniramine." Drug Intell Clin Pharm, 18, p. 701-7
- Huang SM, Athanikar NK, Sridhar K, Huang YC, Chiou WL (1982) "Pharmacokinetics of chlorpheniramine after intravenous and oral administration in normal adults." Eur J Clin Pharmacol, 22, p. 359-65
- Simons KJ, Simons FE, Luciuk GH, Frith EM (1984) "Urinary excretion of chlorpheniramine and its metabolites in children." J Pharm Sci, 73, p. 595-9
- Meredith CG, Christian CD Jr, Johnson RF, Madhavan SV, Schenker S (1984) "Diphenhydramine disposition in chronic liver disease." Clin Pharmacol Ther, 35, p. 474-9
- Blyden GT, Greenblatt DJ, Scavone JM, Shader RI (1986) "Pharmacokinetics of diphenhydramine and a demethylated metabolite following intravenous and oral administration." J Clin Pharmacol, 26, p. 529-33
- Albert KS, Hallmark MR, Sakmar E, Weidler DJ, Wagner JG (1975) "Pharmacokinetics of diphenhydramine in man." J Pharmacokinet Biopharm, 3, p. 159-70
- Simons FE, Frith EM, Simons KJ (1982) "The pharmacokinetics and antihistaminic effects of brompheniramine." J Allergy Clin Immunol, 70, p. 458-64
- Bruce RB, Turnbull LB, Newman JH, Pitts JE (1968) "Metabolism of brompheniramine." J Med Chem, 11, p. 1031-4
- Porter CC, Arison BH, Gruber VF, Titus DC, Vandenheuvel WJ (1975) "Human metabolism of cyproheptadine." Drug Metab Dispos, 3, p. 189-97
- Hintze KL, Wold JS, Fischer LJ (1975) "Disposition of cyproheptadine in rats, mice, and humans and identification of a stable epoxide metabolite." Drug Metab Dispos, 3, p. 1-9
- Maddox DE, Reed CE (1987) "Clinical pharmacodynamics of antihistamines." Ann Allergy, 59, p. 43-8
- Simons FE, Simons KJ, Frith EM (1984) "The pharmacokinetics and antihistaminic of the H1 receptor antagonist hydroxyzine." J Allergy Clin Immunol, 73, p. 69-75
- Simons FE, Watson WT, Chen XY, Minuk GY, Simons KJ (1989) "The pharmacokinetics and pharmacodynamics of hydroxyzine in patients with primary biliary cirrhosis." J Clin Pharmacol, 29, p. 809-15
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Cyclizine drug interactions
There are 305 drug interactions with cyclizine.
Cyclizine alcohol/food interactions
There is 1 alcohol/food interaction with cyclizine.
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Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
No interaction information available. |
Further information
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