Pharmacy Guide
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Pharmacy Guide
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Cinnarizine/Dimenhydrinate 20 mg/40 mg tablets
⚠ This medicine appears to have been discontinued
The electronic medicines compendium (emc) no longer publishes a Summary of Product Characteristics for this product, which usually means it is no longer marketed in the UK. The patient leaflet below is kept for reference, but the product may not be available.
If you were prescribed this medicine, other products containing Cinnarizine, Dimenhydrinate may still be available. Do not stop your treatment — ask your pharmacist or GP what to use instead.
What it is and what it is used for
for Cinnarizine/dimenhydrinate tablets contain two active ingredients. One is cinnarizine and the other one is dimenhydrinate. The two substances belong to different groups of medicines. Cinnarizine is part of a group called calcium antagonists. Dimenhydrinate belongs to a group called antihistamines. Both substances work by reducing symptoms of vertigo (a feeling of dizziness or 'spinning') and nausea (feeling sick). When these two substances are used together they are more effective than when each one is used on its own. Cinnarizine/dimenhydrinate tablets are used for the treatment of various kinds of vertigo in adults. Vertigo can have a number of different causes. Taking cinnarizine/dimenhydrinate tablets can help you carry on with daily activities that are difficult when you have vertigo.
What you need to know before you take it
e cinnarizine/dimenhydrinate tablets Do not take cinnarizine/dimenhydrinate tablets if you are under the age of 18 years if you are allergic to cinnarizine, dimenhydrinate or diphenhydramine or any of the other ingredients of this medicine (listed in section 6) if you are allergic to any other antihistamines (such as astemizole, chlorpheniramine and terfenadine, used as allergy medicines). You should not take this medicine unless you have been told by your doctor. if you suffer from angle-closure glaucoma (a specific type of eye disease) if you have epilepsy if you have increased pressure in the brain (e.g. due to a tumour) if you suffer from alcohol abuse if you have prostate problems which cause difficulty in urinating if you suffer from liver or kidney failure.
Warnings and precautions Talk to your doctor, pharmacist or nurse before taking cinnarizine/dimenhydrinate tablets if you suffer from: low or high blood pressure raised pressure in the eye obstruction in the bowels an enlarged prostate an overactive thyroid severe heart disease Parkinson's disease The use of cinnarizine/dimenhydrinate tablets may make these conditions worse. Cinnarizine/dimenhydrinate tablets may still be suitable for you but your doctor may need to take these facts into account. Other medicines and cinnarizine/dimenhydrinate tablets Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. Cinnarizine/dimenhydrinate tablets may interact with other medicines that you are taking. Cinnarizine/dimenhydrinate can make you tired or sleepy when taken with the medicines listed below: barbiturates (medicines that are often taken to calm you down) narcotic analgesics (strong painkillers such as morphine) tranquillisers (a type of medicine used to treat depression and anxiety) monoamine oxidase inhibitors (used to treat depression and anxiety). Cinnarizine/dimenhydrinate may increase the effects of the following medicines: tricyclic antidepressants (used to treat depression and anxiety) atropine (a medicine that relaxes muscles and is often used to examine your eye) ephedrine (can be used to treat cough or blocked nose) medicines taken to lower blood pressure. Procarbazine (a medicine used to treat some kinds of cancer) may increase the effect of cinnarizine/dimenhydrinate. Amino glycosides (a type of antibiotic) can damage the inner ear. If you take cinnarizine/dimenhydrinate you may not notice that this damage is happening. You should not take cinnarizine/dimenhydrinate with drugs that are used to correct problems with your heart beat (anti-arrhythmics). Cinnarizine/dimenhydrinate may also change the way your skin reacts to allergy tests. Cinnarizine/dimenhydrinate tablets with food, drink and alcohol Cinnarizine/dimenhydrinate tablets can cause indigestion that can be reduced by taking the tablets after meals. Do not drink alcohol while taking cinnarizine/dimenhydrinate tablets because it may make you tired or sleepy. Pregnancy, breast-feeding and fertility If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. Driving and using machines Cinnarizine/dimenhydrinate may make you feel sleepy. If this occurs you should not drive or operate machinery.
Cinnarazine/dimenhydrinate tablets contain sodium This medicine contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially 'sodium-free'.
How to take it
cinnarizine/dimenhydrinate tablets Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure. The recommended dose is one tablet three times daily, with some liquid after meals. Swallow the tablet whole, do not chew. Usually you will take cinnarizine/dimenhydrinate for up to 4 weeks. Your doctor will tell you if you need to take cinnarizine/dimenhydrinate for any longer. If you take more cinnarizine/dimenhydrinate than you should If you accidentally take too many tablets or if a child takes some, you should seek medical advice urgently. If you take too much of cinnarizine/dimenhydrinate you may become very tired, dizzy and shaky. Your pupils might dilate and you may not be able to urinate. Your mouth may feel dry, your face flush, you may have a faster heart rate, fever, sweat and have a headache. If you have taken a massive amount of cinnarizine/dimenhydrinate you could have fits, hallucinations, high blood pressure, feel shaky, get excited, and find it difficult to breathe. Coma could occur. If you forget to take the cinnarizine/dimenhydrinate tablets If you forget to take a tablet of cinnarizine/dimenhydrinate just miss out that tablet. Take the next tablet of cinnarizine/dimenhydrinate the next time when you would usually take it. Do not take a double dose to make up for a forgotten tablet. If you stop taking cinnarizine/dimenhydrinate tablets Do not stop taking cinnarizine/dimenhydrinate before your doctor tells you to. You are likely to have the symptoms of vertigo again (dizziness and 'spinning') if you stop treatment too soon. If you have any further questions on the use of this medicine, ask your doctor, pharmacist or nurse.
4. Possible side effects Like all medicines, this medicine can cause side effects, although not everybody gets them. Common side effects (may affect up to 1 in 10 people): drowsiness, dry mouth, headache, and stomach pain. These are usually mild and disappear within a few days even if you keep taking cinnarizine/dimenhydrinate. Uncommon side effects (may affect up to 1 in 100 people): sweating, reddening of the skin, indigestion, nausea (feeling sick), diarrhoea, nervousness, cramps, forgetfulness, tinnitus (ringing in the ear), paraesthesia (tingling of the hands or feet), tremor (shaking). Rare side effects (may affect up to 1 in 1 000 people): impaired vision, allergic reactions (e.g. skin reactions), light sensitivity, and difficulty in urinating.
Very rare side effects (may affect up to 1 in 10 000 people): white blood cell and platelet counts may be lowered, and red blood cells may be severely reduced, which can cause weakness, bruising or make infections more likely. If you suffer from infections with fever and serious deterioration of your general health, see your doctor and tell him about your medicine. Other possible reactions (frequency cannot be estimated from the available data) which may occur with this type of medicine include: weight gain, constipation, tightness of the chest, jaundice (yellowing of the skin or whites of the eyes caused by liver or blood problems), worsening of an angle-closure glaucoma (an eye disease with increased pressure inside the eye), uncontrollable movements, unusual excitement and restlessness (especially in children), severe skin reactions. Reporting of side effects If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible
Possible side effects
not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.
How to store it
Cinnarizine/Dimenhydrinate tablets Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the blister and the carton after Exp. The expiry date refers to the last day of that month. Do not store above 30C. Do not throw away any medicines via wastewater. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
6. Content of the pack and other information What Cinnarizine/Dimenhydrinate tablets contain
The active substances are: cinnarizine and dimenhydrinate. Each tablet contains 20 mg
cinnarizine and 40 mg dimenhydrinate. The other ingredients are: maize starch, croscarmellose sodium, cellulose microcrystalline, hypromellose, silica colloidal anhydrous, talc and magnesium stearate.
What Cinnarizine/Dimenhydrinate tablets look like and contents of the pack White to off-white, round, biconvex, uncoated tablets debossed with 'C' on one face and plain on other face with a diameter of approximately 8.00 mm. Cinnarizine/Dimenhydrinate tablets are available in blister packs. Pack sizes: 10, 20, 25, 28, 30, 40, 50, 60, 70, 80, 90 and 100 tablets. Not all pack size may be marketed. Marketing Authorisation Holder and Manufacturer: Brown & Burk UK Ltd Micro House
5 Marryat Close, Hounslow TW4 5DQ United Kingdom This leaflet was last revised in 12/2023.
Other sources of information: To request a copy of this leaflet in Braille, large print or audio, please contact phone +44 208 577 8200 / 208 622 3174.
Frequently asked questions about Cinnarizine/Dimenhydrinate 20 mg/40 mg tablets
How do I take Cinnarizine/Dimenhydrinate 20 mg/40 mg tablets?
Cinnarizine/Dimenhydrinate 20 mg/40 mg tablets comes as tablet containing 20mg / 40mg. Always follow the dose your doctor or pharmacist has given you, and read the leaflet that comes with the medicine.
What is the active substance in Cinnarizine/Dimenhydrinate 20 mg/40 mg tablets?
The active substance in Cinnarizine/Dimenhydrinate 20 mg/40 mg tablets is cinnarizine, dimenhydrinate.
Where does this information come from?
This leaflet reproduces the patient information leaflet approved for Cinnarizine/Dimenhydrinate 20 mg/40 mg tablets, as published on the electronic medicines compendium (emc). The version printed inside your medicine’s packaging is the one that applies to you.
Can I get Cinnarizine/Dimenhydrinate 20 mg/40 mg tablets without a prescription?
Whether a medicine is available over the counter or on prescription only depends on its licence. Check the leaflet, or ask your pharmacist — they can tell you straight away.
About this leaflet
The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.
- Source: electronic medicines compendium (emc), Datapharm
- Active substance: cinnarizine, dimenhydrinate
- Official document: view the original leaflet on emc →
⚕For healthcare professionals — Summary of Product Characteristics (SmPC)Full SmPC: dosage, interactions, contraindications, warnings+
4.1. Therapeutic indications
Treatment of vertigo symptoms of various origins.
Cinnarizine/dimenhydrinate is indicated in adults.
4.2. Posology and method of administration
Posology
Adults:
1 tablet three times daily.
Elderly:
Dosage as for adults.
Renal impairment:
Cinnarizine/dimenhydrinate should be used with caution in patients with mild to moderate renal impairment. Cinnarizine/dimenhydrinate should not be used by patients with a creatinine clearance of ≤ 25 ml/min (severe renal impairment).
Hepatic impairment:
No studies in patients with hepatic impairment are available. Cinnarizine/dimenhydrinate should not be used by patients with severe hepatic impairment.
Paediatric population:
The safety and efficacy of cinnarizine/dimenhydrinate in children and adolescents under the age of 18 years has not been established. No data are available.
In general, the duration of treatment should not exceed four weeks. The physician shall decide whether longer treatment is required.
Method of administration
Cinnarizine/dimenhydrinate tablets are to be taken unchewed, with some liquid after meals.
4.3. Contraindications
Hypersensitivity to the active substances, diphenhydramine or other antihistamines of similar structure or to any of the excipients listed in section 6.1.
Diphenhydramine is completely excreted renally, and patients with severe renal impairment were excluded from the clinical development programme. Cinnarizine/dimenhydrinate should not be used by patients with a creatinine clearance of ≤ 25 ml/min (severe renal impairment).
Since both active components of cinnarizine/dimenhydrinate are extensively metabolised by hepatic cytochrome P450 enzymes, the plasma concentrations of the unchanged drugs and their half-lives will increase in patients with severe hepatic impairment. This has been shown for diphenhydramine in patients with cirrhosis.
Cinnarizine/dimenhydrinate should therefore not be used by patients with severe hepatic impairment.
Cinnarizine/dimenhydrinate should not be used in patients with angle-closure glaucoma, convulsions, suspicion of raised intracranial pressure, alcohol abuse or urine retention due to urethroprostatic disorders.
4.4. Special warnings and precautions for use
Cinnarizine/dimenhydrinate does not reduce blood pressure significantly, however, it should be used with caution in hypotensive patients.
Cinnarizine/dimenhydrinate should be taken after meals to minimise any gastric irritation.
Cinnarizine/dimenhydrinate should be used with caution in patients with conditions that might be aggravated by anticholinergic therapy, e.g. raised intra-ocular pressure, pyloro-duodenal obstruction, prostatic hypertrophy, hypertension, hyperthyroidism or severe coronary heart disease.
Caution should be exercised when administering cinnarizine/dimenhydrinate to patients with Parkinson's disease.
Sodium
This medicine contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially 'sodium-free'.
4.5. Interaction with other medicinal products and other forms of interaction
No interaction studies have been performed.
The anticholinergic and sedative effects of cinnarizine/dimenhydrinate may be potentiated by monoamine oxidase inhibitors. Procarbazine may enhance the effect of cinnarizine/dimenhydrinate.
In common with other antihistamines, cinnarizine/dimenhydrinate may potentiate the sedative effects of CNS depressants including alcohol, barbiturates, narcotic analgesics and tranquillisers. Patients should be advised to avoid alcoholic drinks.
Cinnarizine/dimenhydrinate may also enhance the effects of antihypertensives, ephedrine and anticholinergics such as atropine and tricyclic antidepressants.
Cinnarizine/dimenhydrinate may mask ototoxic symptoms associated with amino glycosidic antibiotics and mask the response of the skin to allergic skin tests.
The concomitant administration of medicines that prolong the QT interval of the ECG (such as Class Ia and Class III anti-arrhythmics) should be avoided.
The information about potential pharmacokinetic interactions with cinnarizine and diphenhydramine and other medicinal products is limited. Diphenhydramine inhibits CYP2D6 mediated metabolism and caution is advised if Cinnarizine/dimenhydrinate is combined with substrates of this enzyme, especially those with narrow therapeutic range.
4.6. Fertility, pregnancy and lactation
Pregnancy
The safety of cinnarizine/dimenhydrinate in human pregnancy has not been established. Animal studies are insufficient with respect to effects on pregnancy, embryonal/foetal development and postnatal development (see section 5.3). The teratogenic risk of the single actives dimenhydrinate/diphenhydramine and cinnarizine is low. No teratogenic effects were observed in animal studies.
There are no data from the use of cinnarizine/dimenhydrinate in pregnant women. Animal studies are insufficient with respect to reproductive toxicity (see section 5.3).
Based on human experience dimenhydrinate is suspected to have an oxytocic effect and may shorten labour.
Cinnarizine/dimenhydrinate is not recommended during pregnancy.
Breast-feeding
Dimenhydrinate and cinnarizine are excreted in human breast milk. Cinnarizine/dimenhydrinate should not be used during breast-feeding.
Fertility
Not known.
4.7. Effects on ability to drive and use machines
Cinnarizine/dimenhydrinate may have minor influence on the ability to drive and use machines.
Cinnarizine/dimenhydrinate may cause drowsiness, especially at the start of treatment. Patients affected in this way should not drive or operate machinery.
4.8. Undesirable effects
The most frequently occurring ADRs are somnolence (including drowsiness, tiredness, fatigue, daze) occurring in about 8% of patients and dry mouth occurring in about 5% of patients in clinical trials. These reactions are usually mild and disappear within a few days even if treatment is continued. The frequency of ADRs associated with cinnarizine/dimenhydrinate in clinical trials and following spontaneous reports are included in the next table.
Tabulated list of adverse reactions:
Frequency of ADR
Common
≥ 1/100 to < 1/10
Uncommon
≥ 1/1 000 to < 1/100
Rare
≥ 1/10 000 to < 1/1 000
Very rare
< 1/10 000
System organ class:
Blood and Lymphatic System disorders
Leukopenia
Thrombopenia
Aplastic anaemia
Immune System disorders
Hypersensitivity reactions (e.g. cutaneous reactions)
Nervous System disorders
Somnolence
Headache
Paraesthesia
Amnesia
Tinnitus
Tremor
Nervousness
Convulsions
Eye disorders
Visual disorders
Gastrointestinal disorders
Dry mouth
Abdominal pain
Dyspepsia
Nausea
Diarrhoea
Skin and subcutaneous tissue disorders
Perspiration
Rash
Photosensitivity
Renal and urinary disorders
Urinary hesitancy
In addition the following adverse reactions are associated with dimenhydrinate and cinnarizine (frequency cannot be estimated from the available data):
Dimenhydrinate: paradoxical excitability (especially in children), worsening of an existing angle-closure glaucoma, reversible agranulocytosis.
Cinnarizine: constipation, weight gain, tightness of the chest, cholestatic jaundice, extrapyramidal symptoms, lupus-like skin reactions, lichen planus.
Reporting of suspected adverse reactions:
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App store.
4.9. Overdose
Symptoms of overdosage with cinnarizine/dimenhydrinate include drowsiness, dizziness and ataxia with anticholinergic effects such as dry mouth, flushing of the face, dilated pupils, tachycardia, pyrexia, headache and urinary retention. Convulsions, hallucinations, excitement, respiratory depression, hypertension, tremor and coma may occur, particularly in cases of massive overdosage.
Management of overdose: General supportive measures should be used to treat respiratory insufficiency or circulatory failure. Gastric lavage with isotonic sodium chloride solution is recommended. Body temperature should be closely monitored, since pyrexia may occur as a consequence of antihistamine intoxication, especially in children.
Cramp-like symptoms may be controlled by careful application of a short-acting barbiturate. In cases of marked central-anticholinergic effects, physostigmine (after physostigmine test) should be administered slowly intravenously (or, if necessary, intramuscularly): 0.03 mg/kg body weight (adults max. 2 mg, children max. 0.5 mg).
Dimenhydrinate is dialyzable, however treatment of overdosage by this measure is considered as unsatisfactory. Sufficient elimination can be achieved by means of haemoperfusion using activated charcoal. No data are available concerning the dialysability of cinnarizine.
🇷🇴 Known in Romania as
Medicines sold in Romania with the same active substance: Cunoscut în România ca
- ARLEVERT 20mg + 40mg prescriptionCOMBINATII (CINNARIZINUM+DIMENHYDRINATUM) · taken by mouth
- LIVOSTIN 20 mg/40 mg prescriptionCOMBINATII (CINNARIZINUM+DIMENHYDRINATUM) · taken by mouth
- AZALONUM 20 mg/40 mg prescriptionCOMBINATII (CINNARIZINUM+DIMENHYDRINATUM) · taken by mouth
- VERTIGIX 20 mg/40 mg prescriptionCOMBINATII (CINNARIZINUM+DIMENHYDRINATUM) · taken by mouth
Same active substance. The strength, the form and whether you need a prescription can differ. Always ask a pharmacist before you switch. Romanian medicines in the UK →
🇵🇱 Known in Poland as
Medicines sold in Poland with the same active substance: W Polsce znany jako
- ArlevertCinnarizinum + Dimenhydrinatum · taken by mouth
- SymtiverCinnarizinum + Dimenhydrinatum · taken by mouth
- ArtigoCinnarizinum + Dimenhydrinatum · taken by mouth
- AludranCinnarizinum + Dimenhydrinatum · taken by mouth
Same active substance. The strength, the form and whether you need a prescription can differ. Always ask a pharmacist before you switch. Polish medicines in the UK →
💬 Ask about this leaflet
Ask anything about Cinnarizine/Dimenhydrinate 20 mg/40 mg tablets. The assistant answers only from this leaflet — if the leaflet does not cover it, it will say so. It does not give medical advice.
Answers come from the patient leaflet published on the electronic medicines compendium (emc). They are not medical advice. Ask a pharmacist or your GP if you are unsure. For urgent help call NHS 111, or 999 in an emergency.