Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/10/23 23:00:31」(JST)

wiki en

Cyclizine is an antihistamine drug used to treat nausea, vomiting and dizziness associated with motion sickness, vertigo and post-operatively following administration of general anaesthesia and opioids.

Indications

Nausea, vomiting and dizziness associated with motion sickness, vertigo and post-operatively following administration of general anaesthesia and opioids. It is sometimes given in hyperemesis gravidarum, although the manufacturer advises that it be avoided in pregnancy. Off-licence use often occurs with specialists in hospitals to treat inpatients who have become severely dehydrated in pregnancy. An off-label use is as an opioid/opiate potentiator.^[1]

The drug Diconal is a combination of cyclizine with the opioid dipipanone.^[2] Dipipanone is a schedule I controlled substance in the US, due to its high abuse potential.

Contraindications

Its antimuscarinic action warrants caution in patients with prostatic hypertrophy, urinary retention, or angle-closure glaucoma. Liver disease exacerbates its sedative effects.^[1]

Adverse effects

Common (over 10%) – Drowsiness, xerostomia (dry mouth).

Uncommon (1% to 10%) – Headache, psychomotor impairment, diplopia (double vision), dermatitis, and antimuscarinic effects such as urinary retention and gastro-intestinal disturbances.

Rare – Hypersensitivity reactions (bronchospasm, angioedema, anaphylaxis, rashes and photosensitivity reactions), extrapyramidal effects, dizziness, confusion, depression, sleep disturbances, tremor, liver dysfunction and hallucinations.

Formulations

As cyclizine hydrochloride 50 mg tablets and cyclizine lactate solution for intramuscular or intravenous injection (brand names: Valoid^[1] in UK and Marezine, Marzine and Emoquil in US). Cyclizine HCl 25 mg is marketed as Bonine for Kids in the US.^[3]

Pharmacology

Cyclizine is a piperazine derivative with histamine H₁-receptor antagonist (antihistamine) activity. The precise mechanism of action in inhibiting the symptoms of motion sickness is not well understood. It may have effects directly on the labyrinthine apparatus and on the chemoreceptor trigger zone. Cyclizine exerts a central anticholinergic (antimuscarinic) action.^[1]

History

Cyclizine was developed in the American division of pharmacy company Burroughs Wellcome (today GlaxoSmithKline) during a research involving many drugs of the antihistamine group. Cyclizine was quickly clinically found as a potent and long-acting antiemetic. Company named the substance – or more precisely cyclizine's hydrochloride form which it usually appears in – "marezine hydrochloride" and started to sell it in the United States under trade name Marezine. Selling was begun in France under trade name Marzine in 1965.^[4]^[5]

The substance received more credit when NASA chose it as a space antiemetic for the first occupied moon flight. Cyclizine was introduced to many countries as a common antiemetic. It is an over-the-counter drug in many countries because it has been well tolerated, although it has not been very much studied.^[4]^[6]

Society and culture

Some people using methadone recreationally combine cyclizine with their methadone dose, a combination that is known to produce strong psychoactive effects.^[7] It has also been used recreationally for its anticholinergic effects to induce hallucinations.^[8]

It has also been used illegally in greyhound racing to sabotage a dog's performance.^[9]

References

^ ^a ^b ^c ^d "Valoid Tablets by Amdipharm". Electronic Medicines Compendium. Datapharm.
^ "Diconal Tablets by Amdipharm". Electronic Medicines Compendium. Datapharm.
^ "Bonine for Kids". Insight Pharmaceuticals.
^ ^a ^b Sneader, Walter (2005). Drug discovery: a history. John Wiley & Sons. p. 404. ISBN 0-471-89979-8.
^ Sittig, Marshall (1988). Pharmaceutical manufacturing encyclopedia. William Andrew. p. 406. ISBN 0-8155-1144-2.
^ http://www.drugs.smd.qmul.ac.uk/drugs/html5/Anti-emetics/AN-FEF54A37-6289-402B-E208-9284E183608A.html
^ Ruben, S. M.; McLean, P. C.; Melville, J. (1989). "Cyclizine abuse among a group of opiate dependents receiving methadone". British Journal of Addiction 84 (8): 929–934. doi:10.1111/j.1360-0443.1989.tb00766.x. PMID 2775912.
^ Bassett, K.; Schunk, J. E.; Crouch, B. I. (1996). "Cyclizine abuse by teenagers in Utah". The American Journal of Emergency Medicine 14 (5): 472–474. doi:10.1016/S0735-6757(96)90156-4. PMID 8765114.
^ Conor Ryan for The Independent. June 20, 2013 IGB left with €250k bill after dog doping case

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 乗物酔い motion sickness
2. 麻酔後ケア病棟における合併症発生の概要 overview of complications occurring in the post anesthesia care unit
3. 制吐剤の特性 characteristics of antiemetic drugs
4. 患者情報：妊娠による悪心および嘔吐（詳細） nausea and vomiting of pregnancy beyond the basics
5. 患者情報：緊急避妊（モーニングアフターピル）（詳細） emergency contraception morning after pill beyond the basics

English Journal

Prolonged tachycardia following analytically confirmed cyclizine ingestion.

Kamour A, George S, Vale A.
Clinical toxicology (Philadelphia, Pa.).Clin Toxicol (Phila).2013 Jun;51(5):456-7. doi: 10.3109/15563650.2013.794283. Epub 2013 May 7.
PMID 23646828

Locked-in syndrome as a result of cyclizine administration.

Lee P.
Journal of pain and symptom management.J Pain Symptom Manage.2013 May;45(5):e5-7. doi: 10.1016/j.jpainsymman.2013.02.005. Epub 2013 Apr 6.
PMID 23571205

Incidence and causes for syringe driver site reactions in palliative care: A prospective hospice-based study.

Mitchell K, Pickard J, Herbert A, Lightfoot J, Roberts D.SourceSt. Ann's Hospice, Manchester, UK.
Palliative medicine.Palliat Med.2012 Dec;26(8):979-85. doi: 10.1177/0269216311428096. Epub 2011 Nov 14.
BACKGROUND: Syringe drivers are routinely used in palliative care for the subcutaneous infusion of drugs for pain and symptom control. Local site reactions occurring at the site of infusion can lead to patient discomfort and the potential for sub-optimal symptom control.AIM: The aim of this study wa
PMID 22084491

Japanese Journal

Application of Adsorptive Voltammetry for the Detection of Sub-nano Molar Cyclizine in Biological Fluids and Tablets Using Fast Fourier Transform Continuous Cyclic Voltammetry in a Flowing System

NOROUZI Parviz,DINARVAND Rassoul,GANJALI Mohammad Reza,MOOSAVI-MOVAHEDI Aliakbar,SABOURY Aliakbar,TAMADDON Atefeh
Analytical sciences : the international journal of the Japan Society for Analytical Chemistry 25(4), 505-510, 2009-04-10
NAID 10025211614

An LC-MS-MS method for the determination of cyclizine in human serum

MOHAMMADI A.,KANFER I.,SEWRAM V.,WALKER R. B.
Journal of chromatography. B, Analytical technologies in the biomedical and life sciences 824(1), 148-152, 2005-09-25
NAID 10017124042

Related Pictures

★リンクテーブル★

リンク元	「シクリジン」「サイクリジン」
拡張検索	「homochlorcyclizine」「cyclizine lactate」「cyclizine hydrochloride」

「シクリジン」

Cyclizine
Systematic (IUPAC) name
	1-benzhydryl-4-methyl-piperazine
Clinical data
Trade names	Marezine, Valoid, Nausicalm
AHFS/Drugs.com	Consumer Drug Information
Pregnancy; category	AU: A; US: B (No risk in non-human studies);
Legal status	AU: Pharmacist Only (S3); UK: Prescription-only (POM); US: OTC; OTC (Netherlands);
Routes of; administration	Oral, IM, IV
Pharmacokinetic data
Metabolism	N-demethylated to inactive norcyclizine[citation needed]
Biological half-life	20 hours
Identifiers
CAS Registry Number	82-92-8
ATC code	R06AE03
PubChem	CID: 6726
IUPHAR/BPS	7151
DrugBank	DB01176
ChemSpider	6470
UNII	QRW9FCR9P2
KEGG	D03621
ChEBI	CHEBI:3994
ChEMBL	CHEMBL648
Chemical data
Formula	C18H22N2
Molecular mass	266.381 g/mol
	SMILES CN(CC1)CCN1C(C2=CC=CC=C2)C3=CC=CC=C3 ;
	InChI InChI=1S/C18H22N2/c1-19-12-14-20(15-13-19)18(16-8-4-2-5-9-16)17-10-6-3-7-11-17/h2-11,18H,12-15H2,1H3 ; Key:UVKZSORBKUEBAZ-UHFFFAOYSA-N ;
(what is this?) (verify)